Everyday life is getting harder as I grow older. What should I check first?

Start with what changed, rather than an explanation

Perhaps shopping and appointments used to be manageable but are now getting missed. Perhaps noisy gatherings have always been tiring, but even one-to-one speech is becoming difficult to hear. You do not have to decide first whether you have become “more autistic.” Separate familiar patterns, new difficulties and changes around you to work out what needs attention.

This article does not predict autistic ageing or offer a test for burnout, depression or dementia. Similar difficulties can have different explanations, and several can coexist. NICE’s adult autism guidance warns clinicians about under-reporting and under-recognition of physical disorders. Knowing someone is autistic does not explain a new episode of ill health.

If someone suddenly becomes confused, disorientated or markedly unlike their usual self in thinking or speaking, seek local emergency medical help. The NHS treats sudden confusion as urgent; do not wait to see whether it is stress. The relevant comparison is a sudden change from that person’s usual functioning. Lifelong non-speaking communication is not itself sudden confusion.

Section sources [1] [2]

Compare with your own earlier life

“I do not go out much now” describes an outcome, not its cause. Is this a group you no longer enjoy, pain on the walk to the bus, difficulty hearing conversation, or the absence of someone who used to accompany you? When did it start, and does it happen in other settings? You are not expected to diagnose yourself; the aim is to turn a vague sense of failure into a question that can be investigated.

In our fictional example, a retired reader has always used a paper diary but misses two appointments after booking moves to a phone. If a paper schedule still works, the new process deserves attention. If familiar steps are also repeatedly going wrong, tell a clinician. The first pattern does not rule out memory problems; the second does not establish dementia. Understanding the sequence is more useful than assigning a label.

NHS guidance recommends medical review when memory problems affect everyday life. Stress, anxiety, depression and sleep problems can contribute; sometimes a more serious condition is involved. An online test cannot rule out the cause. Explain what was missed, how it used to be managed and what help is now needed. With your agreement, someone who knows you can add observations while distinguishing them from guesses.

Section sources [3]

The task may be familiar while its support has changed

A task that looks independent may rely on stable conditions: leaving at the same time, a colleague’s reminder, or a partner putting letters where you notice them. Retirement, moving or a supporter’s changed circumstances can remove those conditions. This is our way of analysing a situation, not a research finding about retirement. Some people experience relief after retiring; difficulty is not inevitable.

In the appointment example, a colleague may previously have asked about afternoon plans at lunch. That conversation disappears after retirement. “Try to remember” does not identify a useful change. You might choose a paper prompt, a regular time to check appointments or an agreed reminder from someone you trust. The right arrangement depends on hearing, vision, reading, technology and daily life, not the number of features in an app.

If reminders make attendance easier, that shows the arrangement helps; it does not settle other persistent changes. Equally, an inconclusive medical visit does not make daily difficulties imaginary. Assessment and practical help can run alongside each other. Arrange support for meals or essential appointments while continuing to investigate why the help is now needed.

What if explaining discomfort is difficult?

You do not need the right medical vocabulary before an appointment. Describe a change: “I used to walk this route without stopping; now I stop twice,” or “I now lie down after meals.” The sensory chapter of The Complete Guide to Asperger’s Syndrome includes accounts of pain experience and outward response not matching expectations. These are older practice and personal accounts, not ageing research. We do not adopt broad claims about pain tolerance or infer absence of pain from a calm appearance.

Leicestershire Partnership NHS Trust recommends preparing questions and information, using suitable written or visual communication and checking understanding. Pain ratings do not work equally well for everyone. If “seven out of ten” is unclear, say so and ask for another way to describe it. Existing communication information can help, but preparing a perfect document should not delay care.

Ask in advance about a less demanding waiting space or information delivered in shorter parts. Agree the companion’s role: “Let me answer in writing first; then help with dates I miss.” Before leaving, clarify the next step, how results will arrive and whom to contact if they do not. Requests need discussion with the service; availability and eligibility vary, and UK arrangements are not universal.

If an initial explanation is “that is how you have always been” but this feels different, give one specific change and ask what further assessment or follow-up is appropriate. Communication difficulties also need accommodation; they should not be a reason to hear only a companion’s account. Emergencies require urgent care rather than waiting for a routine follow-up.

Section sources [4] [5]

Can I receive more help and still make choices?

NICE adult guidance emphasises autonomy, participation in care decisions and continuity of relationships. Help with appointments, post or meals need not mean wanting every decision taken over. Define a smaller role: “Help me make the booking call; I want to choose the time.” This concerns everyday collaboration, not a determination of legal capacity or authority to act for another person.

Planning for a supporter’s absence does not commit you to moving or giving up independent living. Start with one essential task: if your usual companion becomes unavailable, who knows the next appointment and can help contact the service? Share only the information needed for the agreed role. If no trusted person is available, ask local health or social services about coordination and practical support; eligibility and availability need checking.

Supporters may also be growing older, working or unwell. Rather than assuming permanent availability, discuss what they can do, for how long, and how to flag a gap or involve a service. A sustainable arrangement lets both people describe limits; caring should not depend on an unspoken promise of unlimited responsibility.

Section sources [1]

How can I tell whether an arrangement fits?

Choose something that matters to you rather than measuring success against everything you did when younger. Can you find the appointment information, communicate your main concern and understand the next step afterwards? An appointment completed while a companion answers everything may solve one problem while leaving participation unresolved. The arrangement can still need adjustment.

You do not need a detailed daily log or a self-reflection score for “decline.” If promised help was unavailable, address the handover. If it was provided but difficulties are worsening, bring that information back to the clinical and support discussion. The task is to understand what changed, what needs assessment and what conditions can be adjusted while keeping you involved in your own life.