Coping with a loss of independence in older adults

Coping with a loss of independence can feel confusing and unsettling. It can even feel disorienting when the things you or your loved one used to do easily can seem almost impossible. 

If you are experiencing these changes, or are supporting someone who is, you’re not alone. A loss of independence is a common concern among adults over age 50. 

In this guide, we’ll walk through why this loss of independence happens, how it can affect emotional or mental health, and how therapy can help you regain confidence and a sense of control. 

Key takeaways

• Loss of independence can be both physical and emotional, and it can come on gradually. 
• Changes in independence can affect mental health, identity, confidence, and relationships. 
• Therapy can help older adults work through these changes, boost self-esteem, and learn to adapt to changes more easily. 

What loss of independence really means

Losing full independence doesn’t always happen with a big event. Oftentimes, it starts with small situations that interfere with daily life. For instance, taking the stairs feels more unsteady now. Or, driving doesn’t feel as natural as when you were younger. 

It can feel like a little shift in your confidence—worrying about your safety or the risk of falling, or a feeling of hesitation when leaving the house. You might start avoiding your social circles because you don’t want anyone to know. 

A loss of independence can show up in any or all aspects of your life: physically, emotionally, mentally, and socially:

• You might start needing help with tasks such as transportation, cleaning, or getting dressed. 
• It can feel harder to manage your calendar and remember to take medications.
• You may feel more tired than usual, or less motivated. 
• Visiting with friends or family can make you feel more anxious. 
• Tasks that used to be simple now feel overwhelming.  

Why we lose independence as we age

According to a 2021 study, loss of independence is part of the aging process. It might stem from:

• Mobility issues
• Chronic illness or pain
• A recent hospital stay
• Cognitive changes

The transition to needing more help managing tasks can happen quickly, like after a hospital stay or a fall. You might have pain that affects your ability to take care of your daily needs. 

Cognitive changes or health issues can lead to a more gradual loss of independence. About 77% of older adults have at least two chronic health conditions, including serious illnesses such as cancer or stroke. You might be finding yourself needing help preparing meals, when several months ago, you needed help only with getting groceries.  

Some of the reasons older adults lose independence are due to the normal aging process itself. These changes include:

• Slower reaction time
• Problem-solving challenges
• Mild forgetfulness 

But dementia isn’t part of normal aging. If you are supporting someone with loss of independence and notice them losing track of time, struggling with managing daily tasks, or frequently misplacing things, it could be a sign of a bigger issue. 

How loss of independence affects mental and emotional health

For many people, independence is tied to identity and a sense of self. When you start losing certain abilities or routines like driving a car or dressing yourself, it can feel like losing a part of yourself. 

Decreased independence can chip away at self-esteem as you start relying on others for help. Loss of independence can also bring loneliness and social isolation, which can cause sadness, frustration, or irritability. 

These emotions are sometimes dismissed as just part of getting older, but that’s not true. Without support to manage these feelings, they can develop into depression and anxiety. And that can create a difficult cycle where mental health conditions lead to more loss of independence, which then worsens mental health.  

Ways that older adults can deal with a loss of independence

While losing independence can feel unsettling, there are ways to regain a sense of autonomy in your daily life. Being independent doesn’t mean you have to do things completely on your own. 

Here are some ways to look at independence differently:

• Start with small steps. Break down more complex tasks into smaller steps. Keep your routines as consistent as possible to avoid too many distractions. Before things get too stressful, ask for help. 
• Embrace the idea of interdependence, or being connected with others. Being independent doesn’t mean you do everything on your own. Problem-solve with caregivers, communicate your needs and struggles, and offer mutual support. 
• Adapt your home to fit your needs now. Make sure assistive devices like canes or walkers are in easy reach of your bed or chair. Keep walkways clear of clutter to avoid tripping. Install grab bars and a shower chair in the tub to maintain as much independence as possible. 
• Be intentional about choices. While you might need assistance with dressing, you can still decide what clothes to wear and when to get dressed. This still allows to direct your own care.

If you’re supporting an older adult facing these challenges

Caregivers may notice emotional or behavioral changes before the older adult does. Look for these signs that could indicate distress or depression and seek out help from your loved one’s healthcare provider or therapist:

• Low energy or fatigue
• Appearing anxious, irritable, restless, or sad
• Loss of interest in things they used to enjoy
• Trouble concentrating or difficulty making decisions
• Sleep problems like waking up frequently or oversleeping
• Decreased appetite or eating too much

You can offer support without taking over or diminishing your loved one’s autonomy. Try offering choices instead of directions, and ask before you step in. Instead of saying, “Let me do that for you,” try “How can I help?” Use a calm, reassuring tone, avoid assuming, and ask open-ended questions. 

Therapy and other outside support can strengthen your relationship with your loved one. It gives you both space to process each of your emotions and be able to set healthy boundaries. It isn’t about a quick solution, but a long-term plan to navigate a new normal for both of you. 

How therapy can help

Even though gradually losing independence may feel inevitable, therapy can be valuable. A good therapist can help you adapt to changes with more confidence, which can improve overall quality of life. 

Rather than disappearing, your independence shifts, takes different forms, and shows up in new choices and routines. 

Online and telehealth therapy can support older adults on Medicare by providing a safe space to talk through challenges from the comfort of home. A therapist can help you:

• Process grief about changes in independence
• Gain confidence and a sense of identity
• Learn coping strategies
• Work through mood changes and motivation challenges
• Strengthen decision-making skills 

Emotional well-being is important at any age. If changes to your independence feel overwhelming, consider connecting with a therapist through Sailor Health. We offer therapy via computer, phone, or even landline. Plus, most of our Medicare patients have a $0 copay. 

We’re here to help you take care of your mental health as you navigate the changes life brings. Call us today to get started.

References

1. AARP Data Stories. (2024). “The Lived Experience of Adults 50-Plus: Independence and Autonomy.” AARP Data Stories. https://datastories.aarp.org/the-lived-experience-of-adults-50-plus/factors/independence-and-autonomy/index.html
2. Bimou, C., Harel, M., Laubarie-Mouret, C., et al. (2021). Patterns and predictive factors of loss of the independence trajectory among community-dwelling older adults. BMC Geriatrics, 21(1), 142. https://doi.org/10.1186/s12877-021-02063-7. https://pmc.ncbi.nlm.nih.gov/articles/PMC7908646/
3. American Psychological Association. (2021). Older Adults Health and age-related changes. https://www.apa.org/pi/aging/resources/guides/older
4. National Institute on Aging. (2023). Memory Problems, Forgetfulness, and Aging. https://www.nia.nih.gov/health/memory-loss-and-forgetfulness/memory-problems-forgetfulness-and-aging
5. Goodarzi, F., Khoshravesh, S., Ayubi, E., et al. (2024). Psychosocial determinants of functional independence among older adults: A systematic review and meta-analysis. Health Promotion Perspectives. 14(1), 32. https://doi.org/10.34172/hpp.42354. https://pmc.ncbi.nlm.nih.gov/articles/PMC11016145/
6. National Institute on Aging. (2025). Depression and Older Adults. https://www.nia.nih.gov/health/mental-and-emotional-health/depression-and-older-adults