Why Dad Doesn't Tolerate Things Like He Used To
Understanding Anxiety, Uncertainty, and the Aging Brain
One of the most common things families tell us is: "Dad never used to be like this."
Suddenly, the television is too loud. A crowded restaurant feels overwhelming. A last-minute change in plans causes unexpected distress. An unfamiliar doctor's appointment leads to days of worry.
Families often ask, "Is this dementia?"
Sometimes it is. But often, what they're seeing is anxiety - and anxiety in older adults doesn't always look the way we expect.
Rather than panic attacks or obvious fear, anxiety may look like:
Becoming upset when routines change
Asking the same questions repeatedly
Avoiding unfamiliar situations
Feeling overwhelmed by noise or crowds
Seeking frequent reassurance
Becoming discouraged or wanting to withdraw
These behaviors are often mistaken for stubbornness or personality changes when, in reality, they may reflect a growing difficulty coping with uncertainty.
The Science Behind Anxiety
Researchers use the term Intolerance of Uncertainty (IU) to describe how difficult it is for some people to tolerate situations where the future feels unclear. A 2025 scoping review and meta-analysis found that higher levels of intolerance of uncertainty are associated with greater anxiety and lower psychological well-being in older adults.¹
This makes sense when we consider what many older adults experience.
Health changes.
Hospitalizations.
Losses.
Medication adjustments.
Changes in independence.
Unfamiliar environments.
Questions about what comes next.
Often, it's not one major event that creates anxiety—but dozens of unanswered questions accumulating over time.
What Anxiety Can Really Look Like
Recently, I visited one of our clients during his rehabilitation stay following a hospitalization. When I arrived, he quietly shared that he was tired, discouraged, and wondered whether anyone should have to live this long.
Many people might have heard depression.
Others may have heard someone giving up.
As a social worker with more than 20 years of experience serving older adults, I heard something different. I heard a man whose world had become increasingly uncertain. Rather than trying to convince him to "think positively," we began restoring a sense of control. Together, we:
Reconnected his continuous glucose monitor so he no longer worried about repeated finger sticks.
We charged his phone so he could reconnect with family.
We arranged his room exactly as he wanted it, creating a space that felt orderly and peaceful.
We regained access to his blog after several unsuccessful attempts so he could return to an activity that brought him purpose.
We talked through a difficult decision, carefully exploring each option until he confidently arrived at the choice that felt right for him.
Finally, we discussed what life after rehabilitation might look like and reassured him that he would not have to navigate those decisions alone.
By the end of our visit, his medical condition had not changed. His diagnosis had not changed.
But his sense of control had.
As I prepared to leave, he smiled and asked, "What's next?" He wasn't asking for another task. He was asking for reassurance that there was a plan - and that he wouldn't be left alone to face uncertainty.
Before leaving, we reviewed my schedule for the next two days so he knew when he could reach me. I encouraged him to spend some quiet time writing in his blog, an activity that had always helped him process his thoughts. He took several slow, deep breaths, settled back into his chair, and looked noticeably more peaceful than when I had arrived.
Why That Worked
If you had asked me, as a social worker, what needed to happen during that visit, I probably wouldn't have started by treating anxiety itself. I would have focused on restoring three things that anxiety quietly steals:
Control.Confidence.Connection.
Interestingly, psychological research supports this approach. Self-Determination Theory suggests that emotional well-being improves when three basic psychological needs are supported:
Autonomy and Control - having meaningful choices and a sense of control.
Competence and Confidence - feeling capable of managing life's challenges.
Connection and Relatedness - knowing we are connected to and supported by others.
Without consciously thinking about the theory, that's exactly what we were working toward during that visit. Every small success—solving a problem, making a decision, organizing his surroundings, reconnecting him with an activity he enjoyed, and creating a clear plan for the days ahead—helped reduce uncertainty while restoring confidence.
Research supports this approach. A study published in Aging & Mental Health found that older adults who had a better understanding of the aging process experienced less worry because they were better able to tolerate uncertainty.² In other words, when people understand what is happening, know what to expect, and feel included in the plan, uncertainty begins to lose its power.
Looking back, I wasn't simply organizing a room or solving practical problems. I was helping restore predictability, supporting his ability to make meaningful decisions, and reminding him that he would not have to face the future alone. Those seemingly small interventions can have a profound effect on reducing anxiety because they restore a person's sense of autonomy, competence, and connection.
Where Heart to Soul Solutions Fits
At Heart to Soul Solutions, we don't simply provide companionship.
We help older adults navigate change.
Sometimes that means organizing a room that has begun to feel chaotic.
Sometimes it means talking through a difficult decision.
Sometimes it's coordinating services, providing cognitive engagement, completing professional assessments, or simply offering a calm, reassuring presence when life feels uncertain.
Our goal is never to take over someone's life.
Our goal is to help them regain confidence in living it.
Because anxiety isn't always asking for someone to fix everything. Sometimes it's asking for someone to help make tomorrow feel manageable.
References
¹ O'Connor, D. B., et al. (2025). Intolerance of Uncertainty and Psychological Well-Being in Older Adults: A Scoping Review and Meta-Analysis.Journal of Anxiety Disorders.
Read the study: https://pubmed.ncbi.nlm.nih.gov/39842138/
²Nuevo, R., Wetherell, J. L., Montorio, I., Ruiz, M. A., & Cabrera, I. (2009). Knowledge about Aging and Worry in Older Adults: Testing the Mediating Role of Intolerance of Uncertainty.Aging & Mental Health.