Many older Americans lead healthy, interesting and productive lives well into their later years. Instead of hearing about it, the emphasis is often on the limitations people experience from problems as varied as falls, heart disease and Alzheimer’s disease.

This creates a bleak picture of getting older. Fortunately, the future can be far brighter.

 1) Old people are lonely

Older adults are less lonely than younger people think they are. In a recent study, 61 percent of Americans ages 18 to 34 said that loneliness was a serious problem for those over age 65. Only 33 percent of those surveyed thought it was a problem — and only 13 percent said it was a problem for them. Maintaining social interactions, good health and creative activity can help stave off boredom and loneliness.

2) You’ll end up in a nursing home

The Retirement Project predicts one third of people over 65 will live in a nursing home. The numbers are lower for Californians. Most people admitted to skilled nursing care are unable to perform personal Activities of Daily Living (ADLs) and need assistance daily or several times per day. Staying active, physically fit, and socially connected or involved in community efforts can all reduce the likelihood of living in a nursing home.

3) Everyone will eventually get Alzheimer’s disease

Only 11 percent of Americans ages 65 and older, approximately 5.2 million or 1.6 percent of the total U.S. population, have Alzheimer’s disease or another form of dementia. This is hardly “everyone” and learning the facts about Alzheimer’s disease helps. The Alzheimer’s Association (alz.org) is an excellent resource and provides annual updates on statistics.

4) Your bones will get weak and brittle

Half of all women and a quarter of all men will break a bone in old age because of osteoporosis. This is not inevitable. Fight brittle bones by eating a diet rich in calcium and vitamin D, taking supplements, exercising, avoiding smoking and asking a care provider if medications might help. Screening for bone mineral density is recommended for women 65 years and older. Ask a care provider about the risk and screening options.

5) Older people have to scale back their physical activity

Recent recommendations from the Centers for Disease Control (CDC) put virtually no restrictions on activity for people over 65. Consistent activity and exercise can help avoid frailty and generalized debility. New forms of exercise, even in later years, demonstrates improvements in health and life expectancy for older individuals.

6) Falling is a normal part of aging

Although falls are more common as people age, they shouldn’t be viewed as normal. In fact, falls should alert family members to have their older loved one checked by a doctor, as the falling could be a sign of another illness. An assessment includes a physical exam and a few simple tests.

7) Older people need a lot of medication to function properly

Taking medication may be vital for some older adults, and it’s important to listen to a doctor’s advice. Monitor medications to avoid dangerous drug interactions or unusual side effects. Keep an eye on anything unusual when a loved one takes medication. A physician should review an individual’s medication list, including supplements and over the counter medications, at least annually to note possible interactions. Many medications can be reduced or stopped as care goals change or effectiveness wanes.

8) Older people need fewer fluids than younger people

Although older people tend to drink fewer fluids than younger people, it is not due to a diminished need. Rather, with age, the body doesn’t notify for thirst as readily. Older people need more awareness about drinking fluids regularly to avoid dehydration, which can be severe and debilitating in later years. Some elders are prescribed fluid restrictions due to medical conditions such as heart failure. Ask a physician what appropriate intake and urine output should be to assess personal needs.

9) Older people all experience urinary incontinence

Levels of urinary incontinence rates range from 10 to 42 percent among hospitalized older adults. It’s not inevitable and it’s highly treatable. A number of conditions, from an infection to medication side effects, might cause incontinence. Ask about treatments that might correct incontinence.

10) You don’t need as much sleep when you are older

Actually, older adults need just as much as sleep as younger adults, approximately seven to nine hours a night. Older people may not get the recommended amount of sleep due to a variety of physical and emotional factors. Some lifestyle changes that help older adults get more sleep at night are avoiding daytime naps, getting more exercise, and learning from a care provider what medications affect sleep habits.

Sherellen Gerhart, MD, specializes in internal medicine, palliative and hospice medicine, and geriatric medicine. She oversees Barton Palliative Care, a comprehensive, team-oriented approach to care for patients at any stage of a serious or terminal illness. Barton Palliative Care has moved and is now located at 1067 Fourth Street in South Lake Tahoe. Learn more by calling 530.600.1960 or visiting bartonhealth.org/palliative.