Caring for Older Adults with Tick-Borne Disease Symptoms

Caring for older adults with tick-borne disease symptoms requires a combination of vigilance, medical coordination, and supportive care. Tick-borne illnesses—such as Lyme disease, Rocky Mountain spotted fever, or anaplasmosis—can present unique challenges in older populations due to age-related immune changes, comorbidities, and medication interactions. 

Older people can and do get tick-borne diseases. Age itself doesn’t prevent someone from being bitten by a tick or contracting a disease like Lyme disease, Rocky Mountain spotted fever, or others carried by ticks. In fact, older adults might be at higher risk for severe outcomes from these illnesses due to weaker immune systems or underlying health conditions that often come with aging.

For example, Lyme disease, caused by the bacterium Borrelia burgdorferi, can affect anyone exposed to infected ticks, but studies show that adults over 50 tend to have higher rates of diagnosis—possibly because they spend more time outdoors in tick-heavy areas like gardens or wooded regions, or because symptoms like joint pain and fatigue get noticed more in this group. The CDC notes that while kids aged 5-14 have a peak in Lyme cases, there’s another spike in adults over 50. Severe cases can lead to complications like arthritis or neurological issues, which might hit older folks harder.

Other tick-borne diseases, like babesiosis (a malaria-like illness), also tend to be more severe in older adults, especially those over 60, or people with compromised immunity. Data from endemic areas shows hospitalization rates for babesiosis climb with age. Same goes for anaplasmosis—older patients are more likely to end up with serious symptoms like respiratory or organ failure.

That said, it’s not a death sentence. Prevention (long sleeves, repellents, tick checks) works across all ages, and early treatment—usually antibiotics—can knock most of these diseases out before they get bad. Older people just need to be extra vigilant, especially if they’re in tick hotspots like the Northeast U.S. or Upper Midwest.

Below is a protocol for caring for older adults with tick-borne disease symptoms

• Common Signs: Look for fever, chills, fatigue, muscle aches, joint pain, headache, or a rash (e.g., the bullseye rash of Lyme disease or spotted rash in Rocky Mountain spotted fever). Symptoms can appear days to weeks after a tick bite.
• Challenges in Older Adults: Symptoms like fatigue or confusion might be mistaken for normal aging or other conditions (e.g., dementia, arthritis). Be thorough—don’t dismiss subtle changes.
• Action: Check for a history of tick exposure (e.g., outdoor activities in wooded or grassy areas) and inspect skin for bites or rashes, especially in hard-to-see areas like the scalp, back, or behind knees.

• Contact a Doctor: Early diagnosis is critical. Describe all symptoms, even vague ones, and mention any known tick exposure. Older adults may need faster intervention due to weaker immune responses. 
• Testing: Blood tests (e.g., for Lyme antibodies or PCR tests) may be ordered, though results can take time. Treatment often starts based on symptoms and exposure history, especially if the disease progresses quickly (e.g., Rocky Mountain spotted fever).
• Medication: Antibiotics like doxycycline or amoxicillin are common, but dosages may need adjustment for kidney or liver function in older adults. Ensure the doctor knows all current medications to avoid interactions.

• Rest: Fatigue is a hallmark of these diseases. Encourage plenty of rest and minimize physical strain. - Hydration and Nutrition: Fever or poor appetite can lead to dehydration or weakness. Offer fluids (water, broth) and easy-to-digest meals (e.g., soups, fruits).
• Pain Management: Muscle or joint pain can be severe. Use doctor-approved pain relievers like acetaminophen; avoid NSAIDs if there’s a risk of bleeding (e.g., in some tick-borne illnesses).
• Monitor Fever: Use a thermometer to track temperature. If it spikes (above 100.4°F/38°C) or persists, inform the doctor—older adults are more prone to complications like sepsis.

• Neurological Signs: Confusion, memory issues, or weakness could signal worsening (e.g., Lyme neuroborreliosis). These may mimic stroke or dementia, so don’t assume it’s “just aging.”
• Heart or Breathing Issues: Some diseases (e.g., Lyme carditis) can affect the heart, causing palpitations or shortness of breath. Seek emergency care if these appear.
• Worsening Symptoms: If symptoms escalate—high fever, severe headache, or vomiting—call a doctor or go to the ER immediately.

• Clothing: Dress them in long sleeves, pants, and light-colored clothing for outdoor time (easier to spot ticks). - Repellents: Use EPA-approved options like DEET or permethrin (on clothes, not skin).
• Tick Checks: After outdoor activities, check skin and clothing thoroughly. Showering within two hours can help remove unattached ticks.
• Yard Care: Keep grass short and clear brush to reduce tick habitats near the home.

• Reassurance: Older adults may feel anxious or frustrated by vague symptoms or slow recovery. Listen and validate their concerns.
• Cognitive Help: If confusion or fatigue lingers (e.g., post-Lyme syndrome), assist with daily tasks like medication reminders or appointments.

Recovery from a tick-borne disease can take weeks to months, especially in older adults. Be patient and follow up with healthcare providers if symptoms persist or relapse. If you’re unsure about a rash or bite, take a clear photo to show the doctor—it can aid diagnosis. Coordinate closely with their healthcare team, and tailor care to their specific needs and medical history.

Older adults can recover from tick-borne diseases, but the recovery process may be slower and more complicated compared to younger individuals.

In some cases, older adults may experience longer-lasting symptoms or complications, such as chronic fatigue or joint issues, especially if the disease wasn't diagnosed and treated early. However, with proper medical treatment, which may include antibiotics for bacterial infections like Lyme disease or other medications depending on the condition, many older adults can recover successfully.

By providing supportive care, encouraging rest, following the prescribed treatment, and being mindful of potential complications, older adults can recover more comfortably from tick-borne diseases.