problem solving questions for elderly

10 Best Problem-Solving Therapy Worksheets & Activities

Cognitive science tells us that we regularly face not only well-defined problems but, importantly, many that are ill defined (Eysenck & Keane, 2015).

Sometimes, we find ourselves unable to overcome our daily problems or the inevitable (though hopefully infrequent) life traumas we face.

Problem-Solving Therapy aims to reduce the incidence and impact of mental health disorders and improve wellbeing by helping clients face life’s difficulties (Dobson, 2011).

This article introduces Problem-Solving Therapy and offers techniques, activities, and worksheets that mental health professionals can use with clients.

Before you continue, we thought you might like to download our three Positive Psychology Exercises for free . These science-based exercises explore fundamental aspects of positive psychology, including strengths, values, and self-compassion, and will give you the tools to enhance the wellbeing of your clients, students, or employees.

This Article Contains:

What is problem-solving therapy, 14 steps for problem-solving therapy, 3 best interventions and techniques, 7 activities and worksheets for your session, fascinating books on the topic, resources from positivepsychology.com, a take-home message.

Problem-Solving Therapy assumes that mental disorders arise in response to ineffective or maladaptive coping. By adopting a more realistic and optimistic view of coping, individuals can understand the role of emotions and develop actions to reduce distress and maintain mental wellbeing (Nezu & Nezu, 2009).

“Problem-solving therapy (PST) is a psychosocial intervention, generally considered to be under a cognitive-behavioral umbrella” (Nezu, Nezu, & D’Zurilla, 2013, p. ix). It aims to encourage the client to cope better with day-to-day problems and traumatic events and reduce their impact on mental and physical wellbeing.

Clinical research, counseling, and health psychology have shown PST to be highly effective in clients of all ages, ranging from children to the elderly, across multiple clinical settings, including schizophrenia, stress, and anxiety disorders (Dobson, 2011).

Can it help with depression?

PST appears particularly helpful in treating clients with depression. A recent analysis of 30 studies found that PST was an effective treatment with a similar degree of success as other successful therapies targeting depression (Cuijpers, Wit, Kleiboer, Karyotaki, & Ebert, 2020).

Other studies confirm the value of PST and its effectiveness at treating depression in multiple age groups and its capacity to combine with other therapies, including drug treatments (Dobson, 2011).

The major concepts

Effective coping varies depending on the situation, and treatment typically focuses on improving the environment and reducing emotional distress (Dobson, 2011).

PST is based on two overlapping models:

Social problem-solving model

This model focuses on solving the problem “as it occurs in the natural social environment,” combined with a general coping strategy and a method of self-control (Dobson, 2011, p. 198).

The model includes three central concepts:

Social problem-solving
The problem
The solution

The model is a “self-directed cognitive-behavioral process by which an individual, couple, or group attempts to identify or discover effective solutions for specific problems encountered in everyday living” (Dobson, 2011, p. 199).

Relational problem-solving model

The theory of PST is underpinned by a relational problem-solving model, whereby stress is viewed in terms of the relationships between three factors:

Stressful life events
Emotional distress and wellbeing
Problem-solving coping

Therefore, when a significant adverse life event occurs, it may require “sweeping readjustments in a person’s life” (Dobson, 2011, p. 202).

Enhance positive problem orientation
Decrease negative orientation
Foster ability to apply rational problem-solving skills
Reduce the tendency to avoid problem-solving
Minimize the tendency to be careless and impulsive

D’Zurilla’s and Nezu’s model includes (modified from Dobson, 2011):

Initial structuring Establish a positive therapeutic relationship that encourages optimism and explains the PST approach.
Assessment Formally and informally assess areas of stress in the client’s life and their problem-solving strengths and weaknesses.
Obstacles to effective problem-solving Explore typically human challenges to problem-solving, such as multitasking and the negative impact of stress. Introduce tools that can help, such as making lists, visualization, and breaking complex problems down.
Problem orientation – fostering self-efficacy Introduce the importance of a positive problem orientation, adopting tools, such as visualization, to promote self-efficacy.
Problem orientation – recognizing problems Help clients recognize issues as they occur and use problem checklists to ‘normalize’ the experience.
Problem orientation – seeing problems as challenges Encourage clients to break free of harmful and restricted ways of thinking while learning how to argue from another point of view.
Problem orientation – use and control emotions Help clients understand the role of emotions in problem-solving, including using feelings to inform the process and managing disruptive emotions (such as cognitive reframing and relaxation exercises).
Problem orientation – stop and think Teach clients how to reduce impulsive and avoidance tendencies (visualizing a stop sign or traffic light).
Problem definition and formulation Encourage an understanding of the nature of problems and set realistic goals and objectives.
Generation of alternatives Work with clients to help them recognize the wide range of potential solutions to each problem (for example, brainstorming).
Decision-making Encourage better decision-making through an improved understanding of the consequences of decisions and the value and likelihood of different outcomes.
Solution implementation and verification Foster the client’s ability to carry out a solution plan, monitor its outcome, evaluate its effectiveness, and use self-reinforcement to increase the chance of success.
Guided practice Encourage the application of problem-solving skills across multiple domains and future stressful problems.
Rapid problem-solving Teach clients how to apply problem-solving questions and guidelines quickly in any given situation.

Success in PST depends on the effectiveness of its implementation; using the right approach is crucial (Dobson, 2011).

Problem-solving therapy – Baycrest

The following interventions and techniques are helpful when implementing more effective problem-solving approaches in client’s lives.

First, it is essential to consider if PST is the best approach for the client, based on the problems they present.

Is PPT appropriate?

It is vital to consider whether PST is appropriate for the client’s situation. Therapists new to the approach may require additional guidance (Nezu et al., 2013).

Therapists should consider the following questions before beginning PST with a client (modified from Nezu et al., 2013):

Has PST proven effective in the past for the problem? For example, research has shown success with depression, generalized anxiety, back pain, Alzheimer’s disease, cancer, and supporting caregivers (Nezu et al., 2013).
Is PST acceptable to the client?
Is the individual experiencing a significant mental or physical health problem?

All affirmative answers suggest that PST would be a helpful technique to apply in this instance.

Five problem-solving steps

The following five steps are valuable when working with clients to help them cope with and manage their environment (modified from Dobson, 2011).

Ask the client to consider the following points (forming the acronym ADAPT) when confronted by a problem:

Attitude Aim to adopt a positive, optimistic attitude to the problem and problem-solving process.
Define Obtain all required facts and details of potential obstacles to define the problem.
Alternatives Identify various alternative solutions and actions to overcome the obstacle and achieve the problem-solving goal.
Predict Predict each alternative’s positive and negative outcomes and choose the one most likely to achieve the goal and maximize the benefits.
Try out Once selected, try out the solution and monitor its effectiveness while engaging in self-reinforcement.

If the client is not satisfied with their solution, they can return to step ‘A’ and find a more appropriate solution.

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Positive self-statements

When dealing with clients facing negative self-beliefs, it can be helpful for them to use positive self-statements.

Use the following (or add new) self-statements to replace harmful, negative thinking (modified from Dobson, 2011):

I can solve this problem; I’ve tackled similar ones before.
I can cope with this.
I just need to take a breath and relax.
Once I start, it will be easier.
It’s okay to look out for myself.
I can get help if needed.
Other people feel the same way I do.
I’ll take one piece of the problem at a time.
I can keep my fears in check.
I don’t need to please everyone.

5 Worksheets and workbooks

Problem-solving self-monitoring form.

Answering the questions in the Problem-Solving Self-Monitoring Form provides the therapist with necessary information regarding the client’s overall and specific problem-solving approaches and reactions (Dobson, 2011).

Ask the client to complete the following:

Describe the problem you are facing.
What is your goal?
What have you tried so far to solve the problem?
What was the outcome?

Reactions to Stress

It can be helpful for the client to recognize their own experiences of stress. Do they react angrily, withdraw, or give up (Dobson, 2011)?

The Reactions to Stress worksheet can be given to the client as homework to capture stressful events and their reactions. By recording how they felt, behaved, and thought, they can recognize repeating patterns.

What Are Your Unique Triggers?

Helping clients capture triggers for their stressful reactions can encourage emotional regulation.

When clients can identify triggers that may lead to a negative response, they can stop the experience or slow down their emotional reaction (Dobson, 2011).

The What Are Your Unique Triggers ? worksheet helps the client identify their triggers (e.g., conflict, relationships, physical environment, etc.).

Problem-Solving worksheet

Imagining an existing or potential problem and working through how to resolve it can be a powerful exercise for the client.

Use the Problem-Solving worksheet to state a problem and goal and consider the obstacles in the way. Then explore options for achieving the goal, along with their pros and cons, to assess the best action plan.

Getting the Facts

Clients can become better equipped to tackle problems and choose the right course of action by recognizing facts versus assumptions and gathering all the necessary information (Dobson, 2011).

Use the Getting the Facts worksheet to answer the following questions clearly and unambiguously:

Who is involved?
What did or did not happen, and how did it bother you?
Where did it happen?
When did it happen?
Why did it happen?
How did you respond?

2 Helpful Group Activities

While therapists can use the worksheets above in group situations, the following two interventions work particularly well with more than one person.

Generating Alternative Solutions and Better Decision-Making

A group setting can provide an ideal opportunity to share a problem and identify potential solutions arising from multiple perspectives.

Use the Generating Alternative Solutions and Better Decision-Making worksheet and ask the client to explain the situation or problem to the group and the obstacles in the way.

Once the approaches are captured and reviewed, the individual can share their decision-making process with the group if they want further feedback.

Visualization

Visualization can be performed with individuals or in a group setting to help clients solve problems in multiple ways, including (Dobson, 2011):

Clarifying the problem by looking at it from multiple perspectives
Rehearsing a solution in the mind to improve and get more practice
Visualizing a ‘safe place’ for relaxation, slowing down, and stress management

Guided imagery is particularly valuable for encouraging the group to take a ‘mental vacation’ and let go of stress.

Ask the group to begin with slow, deep breathing that fills the entire diaphragm. Then ask them to visualize a favorite scene (real or imagined) that makes them feel relaxed, perhaps beside a gently flowing river, a summer meadow, or at the beach.

The more the senses are engaged, the more real the experience. Ask the group to think about what they can hear, see, touch, smell, and even taste.

Encourage them to experience the situation as fully as possible, immersing themselves and enjoying their place of safety.

Such feelings of relaxation may be able to help clients fall asleep, relieve stress, and become more ready to solve problems.

We have included three of our favorite books on the subject of Problem-Solving Therapy below.

1. Problem-Solving Therapy: A Treatment Manual – Arthur Nezu, Christine Maguth Nezu, and Thomas D’Zurilla

This is an incredibly valuable book for anyone wishing to understand the principles and practice behind PST.

Written by the co-developers of PST, the manual provides powerful toolkits to overcome cognitive overload, emotional dysregulation, and the barriers to practical problem-solving.

Find the book on Amazon .

2. Emotion-Centered Problem-Solving Therapy: Treatment Guidelines – Arthur Nezu and Christine Maguth Nezu

Another, more recent, book from the creators of PST, this text includes important advances in neuroscience underpinning the role of emotion in behavioral treatment.

Along with clinical examples, the book also includes crucial toolkits that form part of a stepped model for the application of PST.

3. Handbook of Cognitive-Behavioral Therapies – Keith Dobson and David Dozois

This is the fourth edition of a hugely popular guide to Cognitive-Behavioral Therapies and includes a valuable and insightful section on Problem-Solving Therapy.

This is an important book for students and more experienced therapists wishing to form a high-level and in-depth understanding of the tools and techniques available to Cognitive-Behavioral Therapists.

For even more tools to help strengthen your clients’ problem-solving skills, check out the following free worksheets from our blog.

Case Formulation Worksheet This worksheet presents a four-step framework to help therapists and their clients come to a shared understanding of the client’s presenting problem.
Understanding Your Default Problem-Solving Approach This worksheet poses a series of questions helping clients reflect on their typical cognitive, emotional, and behavioral responses to problems.
Social Problem Solving: Step by Step This worksheet presents a streamlined template to help clients define a problem, generate possible courses of action, and evaluate the effectiveness of an implemented solution.

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While we are born problem-solvers, facing an incredibly diverse set of challenges daily, we sometimes need support.

Problem-Solving Therapy aims to reduce stress and associated mental health disorders and improve wellbeing by improving our ability to cope. PST is valuable in diverse clinical settings, ranging from depression to schizophrenia, with research suggesting it as a highly effective treatment for teaching coping strategies and reducing emotional distress.

Many PST techniques are available to help improve clients’ positive outlook on obstacles while reducing avoidance of problem situations and the tendency to be careless and impulsive.

The PST model typically assesses the client’s strengths, weaknesses, and coping strategies when facing problems before encouraging a healthy experience of and relationship with problem-solving.

Why not use this article to explore the theory behind PST and try out some of our powerful tools and interventions with your clients to help them with their decision-making, coping, and problem-solving?

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free .

Cuijpers, P., Wit, L., Kleiboer, A., Karyotaki, E., & Ebert, D. (2020). Problem-solving therapy for adult depression: An updated meta-analysis. European P sychiatry , 48 (1), 27–37.
Dobson, K. S. (2011). Handbook of cognitive-behavioral therapies (3rd ed.). Guilford Press.
Dobson, K. S., & Dozois, D. J. A. (2021). Handbook of cognitive-behavioral therapies (4th ed.). Guilford Press.
Eysenck, M. W., & Keane, M. T. (2015). Cognitive psychology: A student’s handbook . Psychology Press.
Nezu, A. M., & Nezu, C. M. (2009). Problem-solving therapy DVD . Retrieved September 13, 2021, from https://www.apa.org/pubs/videos/4310852
Nezu, A. M., & Nezu, C. M. (2018). Emotion-centered problem-solving therapy: Treatment guidelines. Springer.
Nezu, A. M., Nezu, C. M., & D’Zurilla, T. J. (2013). Problem-solving therapy: A treatment manual . Springer.

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Problem Solving in Older Age

Tips for Problem Solving

Imagine the outcome you want. Use your creativity and imagination. A problem is a situation in need of a solution. Some solutions are more apparent than others. Throughout our day and lives we are finding a solution to some situation. What to have for dinner, how to get to where we are going, how to keep a budget, etc.
Being Confident is essential – come up with several options and consider each one – from the outlandish to the more practical. We feel more confident when we see more options. It is important to gain a feeling of “being in control” when facing a problem, that you control things rather than they controlling you.
Curiosity lights up our “higher brain” which we need for problem solving. Our “lower brain” tends to be more reactive to fear and frustration. Triggering our curiosity helps to ignite the brain to plan and to imagine other possibilities.
You know what they say about ASSUME… don’t figure an idea won’t work and dismiss it too quickly. Consider each idea as an option, the more options, the better chance at solutions.
Aging often makes us risk averse as we stick to the familiar rather than trying a new tact. Time to be bold if what you usually try doesn’t work. Being bolder beats just being older.
Solo solving doesn’t always work. Few things happen in a vacuum so ask for help. Speak with folks you usually don’t approach. You never know when or where a good idea comes from.
Get your creative juices flowing by asking new questions, or approaching the problem in a different way. Ask new or different questions which can lead to new solutions.
Cut negativity loose. Whether negative people or negative ideas have a hold on you, break away as they prevent you reaching your goal of a positive solution to your problem.
Find the positive people to spend time with. Positive people spark new ideas and energy to get to your solution. Positive energy begets positive energy which gets you going in the right direction.
Stay the course. You may need to “try and try again” so be persistent. Important things don’t happen so easily, they take work and patience. Consider all ideas and pursue them the best you can until you either have success or have run out of options. Not every problem is solvable in the way we hope.

Sometimes the Goal has to be changed

If you have exhausted all of your ideas and have retooled but still do not reach your goal, you may have to reassess the entire problem or project and adjust to the reality of it. Not every problem has the solution, sometimes “it is what it is” and as humans we adapt… hopefully the best we can. Not every problem needs these ten steps and sometimes a problem needs steps to be repeated. Share your thoughts with trusted folks and with strangers too. Wisdom comes from many places.

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By: Elizabeth Bemis on January 14th, 2020

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Top Cognitive Games and Mental Exercises for Seniors

senior living homes | dependent senior living | Retirement home | senior brain health | Cognitive Health

It is never too late to help your aging loved one focus on their cognitive health and improve their brain function. While it’s certainly true that age plays a major role in the decline of memory and other cognitive abilities , studies show there are proven ways to work on maintaining and enhancing these capabilities at any age.

If you’re looking for opportunities to help the senior in your life focus on this important aspect of their overall health, take advantage of the following tips and information.

Cognitive Health 101

It was once believed that the brain’s ability to learn and grow was hardwired and finite, but more recent studies and research reveal that the brain can continue to change, reorganize and create new pathways . Essentially, it is becoming more evident that the human brain can adapt and stay sharp well past the formative years. To realize the full benefits of neuroplasticity, however, one must practice using their brain.

The U.S. Department of Health and Human Services’ National Institute on Aging (NIH) explains that cognitive health, or the ability to think, learn and remember, is an important component of brain health. Scientists believe that certain stimulating activities may protect the brain by establishing a “cognitive reserve.” This means that they can enable the brain to become more adaptable in some mental functions, compensating for age-related brain changes and health conditions that affect the brain.

Optimizing Neuroplasticity

To support your aging loved one in optimizing their brain health and positively impacting neuroplasticity, it is important to encourage them to engage their mind with cognitive stimulation. The most effective opportunities to introduce this kind of mental exercise into their everyday lives include ones that focus on the following elements :

Attention : strengthening, for example, sustained, selective, visual or auditory attention
Perception : improving or developing visual, auditory and tactile perception
Memory : counterbalancing the deterioration of long- and short-term memory as a result of age or injury
Processing speed : maximizing the capability to process information quickly, without losing efficacy
Reasoning : protecting the superior cognitive functions (numerical, logical and abstract reasoning) that help one think and make decisions in the face of stimuli, events, and situations

Games and strategies that focus on these specific areas of maintaining and improving the cognitive capabilities of older adults are key to promoting mental health for seniors.

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6 Worthwhile Games and Exercises for Cognitive Stimulation

To keep your aging loved one’s brain active and healthy, here are some valuable activities you can work into their daily or weekly routine:

1. Puzzles: These help seniors stretch their mental muscles and stimulate their brain function. Completing a puzzle alone or together can help the senior in your life practice problem-solving functions, look for patterns and pay attention to details. There are a range of options spanning from traditional jigsaw puzzles to crossword puzzles, word searches, and memory games.

2. Trivia Games: These are especially helpful for seniors who want to exercise their recall skills and engage with family or friends. Games of trivia encourage seniors to recall past events or facts they have learned throughout their lives. Consider playing a general trivia game, or try one that covers specific categories like TV shows, movies, religion, pop culture, music or particular periods in time.

3. Sudoku: This is a game that focuses on numeric patterns and is accessible in a variety of difficulty levels. Sudoku can be found in print form or on a handheld digital device.

4. Cards & Board Games: Lots of games played with a deck or more of cards give seniors the chance to stimulate their brains in a fun and engaging way. You could also suggest some strategic games like chess or checkers, which require players to use reasoning for choosing their next move, anticipating the moves of opponents and developing an overall strategy.

5. Computer & Mobile Applications: Today, there is a seemingly limitless array of downloadable cognitive applications that can be used on a mobile phone, tablet or personal computer. Look for options that allow you to choose or adjust the level of complexity and hone in on specific cognitive capabilities, like attention, reasoning, language, and memory.

6. Crafts & Hobbies: The NIH indicates that people who engage in meaningful activities and hobbies say they feel happier and healthier and that learning new skills may improve thinking ability. One study, in particular, found that older adults who learned quilting or digital photography, for example, had more memory improvement than those who only socialized or did less cognitively demanding activities.

Supporting Seniors Through Engagement

The cognitive games and exercises recommended above allow seniors to not only maintain and improve their brain health but also overcome boredom or loneliness and engage in personal interactions. Whether your aging loved one lives alone, with you or in an assisted living community , it’s important to support them in participating in activities like these.

If a senior in your life is experiencing any type of memory loss or cognitive deterioration, be sure to check out this informative guide on understanding their experience and developing the best care plan for them .

If you're a caregiver exploring senior living options for your loved one, or perhaps looking into the possibility of making a move to an assisted living community yourself, then this guide was written with you in mind!

About Elizabeth Bemis

In 1998, I drove past an assisted living community construction site, learned that it was part of United Methodist Homes and realized the next stop on my professional journey was to work for a mission driven organization. Soon after, I joined the team as Executive Director of our Middlewoods of Farmington community and later served as Regional Manager for the Middlewoods properties before accepting my current role as Vice President of Marketing, Promotions, and Assisted Living Operations. I enjoy spending time with my family, cooking, reading, walking, and love working alongside our staff, residents, and families to build strong communities that reflect the mission, vision, and values of United Methodist Homes.

Our Blog is a 2016 Platinum Generations Award Winner! The Generations Award is an annual international competition for excellence in senior marketing recognizing professionals who have communicated to the 50+ Mature Markets.

Unlocking Wisdom: 61 Questions to Ask Older Adults About Life

Life is a fascinating journey, and who better to learn from than those who have walked the path before us? Engaging in conversations with older adults can be incredibly enriching, providing insights and wisdom that only time can bestow. So, grab a cup of coffee, lean in, and let’s dive into 11 thought-provoking questions to ask our elders about life.

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Reflections on the Past

1. what were your dreams and aspirations when you were younger.

As we embark on our own dreams, it’s fascinating to hear about the dreams our elders once held. Their experiences can inspire us and offer valuable perspectives on the different paths life can take. Perhaps they dreamed of being an astronaut, a musician, or a teacher. By listening to their stories, we can gain insight into their motivations and the choices they made.

2. What are some of the most significant changes you’ve witnessed in your lifetime?

The world has evolved in countless ways over the years, and hearing about these changes from someone who has experienced them firsthand can be eye-opening. From technological advancements to social and cultural shifts, the older generation has seen it all. Their observations can shed light on the progress we’ve made and the challenges we still face.

Lessons from Life’s Challenges

3. what are some of the biggest challenges you’ve faced, and how did you overcome them.

Life is full of ups and downs, and our elders have weathered their fair share of storms. By asking about their struggles and how they overcame them, we can learn valuable lessons in resilience, determination, and problem-solving. Their stories of perseverance can provide us with guidance when we face our own obstacles.

4. Is there a decision you made that you regret? What did you learn from it?

Regret is a powerful teacher, and it’s human nature to wonder about the “what-ifs.” Older adults have had more time to reflect on their choices, and hearing about their regrets can offer invaluable insights. Whether it’s a career decision, a relationship choice, or a missed opportunity, understanding their lessons can help us make wiser decisions in our own lives.

Nurturing Relationships and Love

5. what advice would you give about building and maintaining meaningful relationships.

Relationships form the foundation of a fulfilling life. Who better to learn about love, friendship, and connection than those who have lived through decades of relationships? Ask your elder for their insights on cultivating strong bonds, resolving conflicts, and finding joy in the company of others. Their wisdom can guide us in creating lasting connections.

6. What does true love mean to you?

man sitting in a nursing home with his loved one

Love is a timeless topic that has captured hearts throughout history. Asking older adults about their definition of true love can elicit heartfelt responses filled with experiences and life lessons. Their insights can broaden our understanding of love, challenging us to reflect on our own relationships and what we seek in a partner.

The Pursuit of Happiness and Fulfillment

7. how do you define happiness and fulfillment.

Happiness and fulfillment are deeply personal concepts, and they can evolve. By asking older adults about their definitions of these elusive states, we can gain new perspectives on what truly matters in life. Their answers may range from simple pleasures to profound moments of contentment, reminding us to cherish the little things that bring us joy.

8. Looking back, what would you have done differently to lead a more fulfilling life?

Regrets aside, exploring what older adults wish they had done differently can be enlightening. Their answers might highlight the importance of pursuing passions, taking risks, or nurturing personal growth. By learning from their hindsight, we can make conscious choices to prioritize what truly matters and create a life that aligns with our deepest values.

9. What brings you the most joy and contentment in life?

5 Tips on Dealing With an Alzheimer's Parent

Happiness is subjective, and what brings joy to one person may differ from another. By asking older adults about the simple pleasures and sources of contentment in their lives, we open ourselves to a broader spectrum of experiences. Their answers could range from spending quality time with loved ones to pursuing hobbies, being in nature, or finding solace in creativity. Their insights can inspire us to seek joy in everyday moments.

Reflections on Aging and Legacy

10. how do you view the process of aging, and what advice would you give to embrace it gracefully.

Aging is a natural part of life, and each stage brings its own beauty and challenges. Older adults have accumulated wisdom on navigating the complexities of aging, and asking them about their perspectives can offer invaluable insights. Their advice might revolve around self-care, staying mentally and physically active, cultivating a positive mindset, and finding fulfillment in new ways.

11. What do you hope your legacy will be? How do you want to be remembered?

Legacy is a reflection of how we’ve touched the lives of others and the mark we leave behind. Asking older adults about their hopes for their legacy can be deeply introspective. Their answers might emphasize the importance of kindness, compassion, making a positive impact, or leaving a lasting contribution to their community. Their reflections can inspire us to consider the mark we want to make on the world.

I Am Not Done Yet. I Have Got More More for You

Take a deep breath and relax because I’ve got you covered with not just 11, but 50 more thought-provoking questions to ask older adults about life. Get ready to dive even deeper into the well of wisdom!

12. What advice would you give to your younger self?

13. How has your perspective on success evolved over the years?

14. What are some of the most valuable life lessons you’ve learned?

15. What role has spirituality played in your life?

16. How do you find a balance between work and personal life?

17. What are your thoughts on the importance of education?

18. How have your values and priorities changed over time?

19. What are some of the most memorable trips or adventures you’ve experienced?

20. How have you coped with loss and grief throughout your life?

21. What do you consider to be the key to a lasting and fulfilling marriage?

22. How have you navigated challenges in maintaining friendships as you’ve grown older?

23. What have you discovered about yourself through the process of aging?

24. How have you stayed mentally and physically active as you’ve gotten older?

25. What are your favorite books or movies that have shaped your perspective on life?

26. How have you embraced change throughout your life?

27. What is the biggest risk you’ve taken, and what did you learn from it?

28. How do you handle setbacks and bounce back from failure?

29. What role has humor played in your life, and how has it helped you navigate difficult times?

30. How do you define success and fulfillment in your own terms?

31. What are your thoughts on the concept of “finding your purpose” in life?

32. How have you dealt with regrets, and what advice would you give for letting go of them?

33. What traditions or rituals do you hold dear and why?

34. How have you managed to maintain a positive mindset in the face of adversity?

35. What are your thoughts on the importance of community and giving back?

36. How has technology influenced your life, and what positive or negative impacts have you observed?

37. How have you approached financial planning and security throughout your life?

38. What advice would you give to younger generations about handling stress and finding balance?

39. How have you navigated changes in societal norms and values over the years?

40. What are your thoughts on the pursuit of lifelong learning?

41. How have you fostered personal growth and self-improvement throughout your life?

42. What role has art or creativity played in your life, and how has it contributed to your well-being?

43. How have you maintained a sense of purpose and meaning in retirement?

44. What advice would you give to someone about finding and pursuing their passions?

45. How have you managed to stay connected with family and friends despite the physical distance?

46. What are your thoughts on the importance of self-care and well-being?

47. How have you approached decision-making throughout your life?

48. What has been your most significant accomplishment, and what did you learn from it?

49. How have you maintained a healthy work-life balance?

50. What are your thoughts on the role of gratitude in living a fulfilling life?

51. How have you embraced and celebrated your own uniqueness and individuality?

52. What advice would you give to someone about facing their fears and taking risks?

53. How have you found meaning and purpose through volunteer work or community involvement?

54. How have you approached aging with a positive mindset?

55. What advice would you give to younger generations about nurturing their mental health?

56. How have you maintained a sense of curiosity and wonder throughout your life?

57. What are your thoughts on the importance of forgiveness and letting go of grudges?

58. How have you approached retirement and the transition to a new phase of life?

59. What are your thoughts on the pursuit of happiness and its connection to personal values?

60. How have you navigated the changing dynamics of family relationships over time?

61. What legacy do you hope to leave behind, and how do you plan to make it a reality?

Phew! That’s quite a list of questions to explore! Remember, each conversation is a unique opportunity to learn and grow. So, go ahead and ask these questions with an open heart, and don’t forget to share your own insights and experiences in the comments section below. Let’s keep the conversation going!

Engaging in conversations with older adults about life can be an incredible source of wisdom and inspiration. Through their experiences, challenges, and triumphs, we gain a broader perspective on the human journey. So, let’s cherish the opportunity to learn from our elders, listening to their stories and insights.

Remember, the beauty of these questions lies not only in the answers but also in the conversations they spark. Share your own reflections, stories, and insights in the comments section below. Let’s create a space where wisdom is shared, connections are fostered, and generations can come together to learn from one another.

Now it’s your turn: What question would you like to ask an older adult about life? Share it in the comments and let’s continue the conversation!

I have lived-experience taking care of my parent with dementia. My goal is to help you overcome challenges involved in family caregiving.

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Age Differences in Everyday Problem-Solving Effectiveness: Older Adults Select More Effective Strategies for Interpersonal Problems

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Fredda Blanchard-Fields, Andrew Mienaltowski, Renee Baldi Seay, Age Differences in Everyday Problem-Solving Effectiveness: Older Adults Select More Effective Strategies for Interpersonal Problems, The Journals of Gerontology: Series B , Volume 62, Issue 1, January 2007, Pages P61–P64, https://doi.org/10.1093/geronb/62.1.P61

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Using the Everyday Problem Solving Inventory of Cornelius and Caspi, we examined differences in problem-solving strategy endorsement and effectiveness in two domains of everyday functioning (instrumental or interpersonal, and a mixture of the two domains) and for four strategies (avoidance–denial, passive dependence, planful problem solving, and cognitive analysis). Consistent with past research, our research showed that older adults were more problem focused than young adults in their approach to solving instrumental problems, whereas older adults selected more avoidant–denial strategies than young adults when solving interpersonal problems. Overall, older adults were also more effective than young adults when solving everyday problems, in particular for interpersonal problems.

DESPITE cognitive declines associated with advancing age ( Zacks, Hasher, & Li 2000 ), older adults function independently. Furthermore, evidence is equivocal as to the impact that cognitive decline has on older adults' abilities to navigate complicated social situations (see, e.g., Cornelius & Caspi, 1987 ; Marsiske & Willis, 1995 ). Some research suggests that older adults are more effective than young adults when solving everyday problems (Cornelius & Caspi; Blanchard-Fields, Chen, & Norris, 1997 ; Blanchard-Fields, Jahnke, & Camp, 1995 ; Blanchard-Fields, Stein, & Watson, 2004 ). Our goal in the current study was to examine age differences in (a) the strategies selected to solve everyday problems from different problem domains and (b) how effective these strategy choices are relative to ideal everyday problem solutions.

Blanchard-Fields and colleagues (1995 , 1997 , 2004 ) demonstrated that older adults are equally likely, if not more likely, than young adults to choose proactive strategies to directly confront instrumental problems. However, when they are facing interpersonal problems, older adults are more likely than young adults to choose passive emotion regulation strategies. Differential strategy preferences may reflect a maturing of the strategy repertoire of older adults. As people age, experience may hone strategy preferences on the basis of successes and failures, making it easier for older adults to invest energy into strategies that have been effectively used when dealing with problems in the past.

The important issue is what constitutes effective strategy use. Past research defines it as one's sensitivity to the context that is underlying problems when one is selecting strategies ( Blanchard-Fields et al., 1995 ), the number of strategies and one's satisfaction with problem solution ( Thornton & Dumke, 2005 ), or the evaluation of strategy choices on an everyday problem-solving inventory against a panel of external judges ( Cornelius & Caspi, 1987 ). In the current study we examined the latter approach to problem-solving effectiveness from the level of domain-specific strategy use in order to simultaneously investigate age differences in effective problem solving and age differences in strategy selection (i.e., differential strategy preference related to context). We sought to replicate past research examining interpersonal and instrumental problem-solving contexts, while also determining whether age differences in strategy preferences actually lead to more effective problem solving in the two domains. Because domain effects are sensitive to the amount of overlap that is allowed between problem definitions when problems are classified (e.g., Artistico, Cervone, & Pezzuti, 2003 ), we expanded the typical instrumental–interpersonal dichotomy by adding a mixed-problem domain to describe problems that are not unambiguously instrumental or interpersonal.

We expected older adults to show a greater preference than young adults for emotion-focused strategies when they were solving interpersonal problems. For instrumental problems, we expected older adults to prefer more problem-focused strategies than did young adults. We also expected older adults to have higher effectiveness scores than young adults ( Cornelius & Caspi, 1987 ). Finally, we expected older adults to be more effective than young adults in their application of emotion-focused strategies.

Participants

We recruited young adults ( n = 53, with 36 women and 17 men; age = 18–27 years, M = 20.6, SD = 1.6) and older adults ( n = 53, with 33 men and 20 women; age = 60–80 years, M = 68.9, SD = 4.9) from a southeastern metropolitan area. Participants were primarily Caucasian (∼77%) and reported similar levels of education (i.e., some college). On average, both groups indicated good health [young adults, M = 3.49, SE = 0.08; older adults, M = 3.15, SE = 0.09; t (1, 102) = 2.89, p <.01].

Everyday problem-solving task

We selected 24 of 48 hypothetical problems from the Everyday Problem Solving Inventory (EPSI; Cornelius & Caspi, 1987 ). We randomly selected 4 problems from each of the six original problem domains (i.e., home management, information use, consumer issues, conflicts with friends, work-related issues, and family conflicts). We presented participants with a single manifestation of each strategy type tailored to each problem (without strategy labels) and asked them to indicate how likely they were to use each of four strategies to solve each problem: avoidance–denial, passive dependence, planful problem solving, and cognitive analysis (see Table 1 for strategy definitions).

Dependent variables

Strategy endorsement ratings indicated participants' preferred methods for solving hypothetical everyday problems. Higher scores represented greater endorsement of a particular strategy. We calculated effectiveness scores for each domain and strategy by correlating participant strategy endorsement ratings with those of a panel of external judges ( Cornelius & Caspi, 1987 ). 1 Correlations (range: r = −1.0 to r = 1.0) represented the degree of similarity between a participant's responses and the ideal solutions nominated by judges. Large positive correlations indicated effective problem solving.

Classification of problem type

For each problem indicate whether it is an (A) instrumental problem, or (B) interpersonal problem. Instrumental problems involve competence concerns and stem from complications that arise when one is trying to accomplish, achieve, or get better at something. Instrumental problems are situations in which one is having difficulty achieving something that is personally relevant. Interpersonal problems involve social/interpersonal concerns and stem from complications that arise when one is trying to reach an outcome that involves other people. Interpersonal problems are situations in which one is dealing with a social conflict or obstacle in a relationship. Please provide only one classification per problem.

We conducted 2 (age: young, old) × 3 (domain: instrumental, mixed, interpersonal) × 4 (strategy: avoidance–denial, passive dependence, planful problem solving, cognitive analysis) mixed-model analyses of variance on the strategy endorsement and effectiveness scores. Age was the between-subjects factor. We followed each analysis of variance by contrasts to examine age differences for each strategy by domain.

Strategy endorsement ratings

For each domain (interpersonal, instrumental, or mixed), we calculated average endorsement ratings for each strategy type (e.g., avoidance–denial). Analyses indicated that main effects of domain, F (2, 312) = 34.57 (η p 2 =.25, p <.001), and strategy, F (2, 312) = 265.54 (η p 2 =.72, p <.001), were qualified by Strategy × Age, F (3, 312) = 5.46 (η p 2 =.05, p =.001), Domain × Strategy, F (6, 624) = 46.59 (η p 2 =.31, p <.001), and Domain × Strategy × Age, F (6, 624) = 5.30 (η p 2 =.05, p <.001), interactions. The patterns of age differences in strategy endorsement varied by domain (see Table 2 for mean strategy endorsement ratings). For instrumental problems, young adults preferred avoidance–denial more than old adults did, t (104) = 2.26 ( p <.05), whereas old adults preferred passive dependence, t (104) = 2.28 ( p <.05), planful problem solving, t (104) = 3.74 ( p <.001), and cognitive analysis, t (104) = 3.30 ( p <.01), more than young adults did. For mixed problems, young adults preferred avoidance–denial, t (104) = 4.36 ( p <.001), and passive dependence, t (104) = 3.87 ( p <.001), more than old adults did. The opposite pattern held for interpersonal problems. Old adults preferred avoidance–denial, t (104) = 2.15 ( p <.05), and cognitive analysis, t (104) = 2.39 ( p <.05), more than young adults did. Old adults also marginally preferred passive dependence more than young did, t (104) = 1.42 ( p =.08, one-tail).

Effectiveness scores

For each domain and each strategy, we calculated an overall effectiveness score across problems by correlating each participant's strategy endorsement ratings with the effectiveness ratings of the judges (e.g., avoidance–denial strategies for each interpersonal problem and judges' average rating for avoidance–denial for the same problems). Analyses indicated main effects of age, F (1, 92) = 7.15 (η p 2 =.07, p <.01), and domain, F (2, 184) = 18.66 (η p 2 =.17, p <.001). Older adults ( M = 0.46, SE = 0.02) were more effective than young adults ( M = 0.39, SE = 0.02) in their overall choice of strategies ( Cornelius & Caspi, 1987 ). These main effects were qualified by Domain × Age, F (2, 184) = 3.04 (η p 2 =.03, p =.05), and Domain × Strategy, F (6, 552) = 44.19 (η p 2 =.32, p <.001), interactions (see Table 2 for mean strategy effectiveness scores). Although both age groups were more effective at solving instrumental problems (young adults, M = 0.40, SE = 0.02; old adults, M = 0.48, SE = 0.02) and mixed problems (young adults, M = 0.50, SE = 0.03; old adults, M = 0.50, SE = 0.03) than interpersonal problems, young adults were especially less effective than old adults at solving interpersonal problems (young adults, M = 0.27, SE = 0.03; old adults, M = 0.41, SE = 0.03).

Although the Domain × Strategy × Age interaction failed to reach significance, F (6, 552) = 1.67 (η p 2 =.02, p =.13), we conducted planned contrasts to investigate age differences in problem-solving effectiveness for each strategy by domain. For interpersonal problems, old adults were more consistent than young adults in endorsing avoidance–denial, t (103) = 1.90 ( p <.05, one-tail), passive dependence, t (104) = 1.30 (only marginal at p =.10, one-tail), planful problem solving, t (105) = 1.65 ( p <.05), and cognitive analysis, t (96) = 1.72 ( p <.05), at levels that were deemed to be effective by the judges. For instrumental problems, old adults were more consistent than young adults in endorsing avoidance–denial, t (104) = 4.21 ( p <.001), at the level deemed to be effective by the judges. No age differences emerged for mixed problems. 2

Consistent with past research, in our research the older adults preferred more passive emotion-focused strategies (e.g., avoidance or passive dependence) than the young adults did when facing interpersonal problems, and they preferred more proactive strategies such as planful problem solving (in combination with emotion regulation strategies) for instrumental problems ( Blanchard-Fields et al., 1995 , 1997 ; Watson & Blanchard-Fields, 1998 ). In contrast, young adults used similar amounts of planful problem solving, irrespective of the type of problem. It is interesting to note that young adults preferred (a) more passive emotion-focused strategies in mixed problems and (b) more avoidance emotion-focused strategies in instrumental problems than older adults. Perhaps young adults are motivated to behave more passively when managing personally relevant achievement-oriented problems, especially those involving potentially awkward social interactions. This deserves further research.

Second, we moved beyond previous indices of effectiveness by basing problem-solving efficacy on the degree of similarity in strategy endorsement between participants and a panel of judges to control for individual differences in strategy accessibility. Older adults were more effective at solving problems than young adults were (which is similar to the findings of Cornelius & Caspi, 1987 ). More importantly, we found that older adults' greater effectiveness was driven by strategy selection within interpersonal problems. Extending past research, we assessed effectiveness at the level of the problem domain and at the level of specific strategies. Thus, it is not simply that older people use more or less of a strategy in various domains; they use these strategies appropriately (as determined by panel effectiveness scores) to match the context of the problem. This adaptivity may be crucial to interpersonal problems. Although proactive strategies are typically key to resolving causes of problems (e.g., Thornton & Dumke, 2005 ), older adults' use of passive (emotion regulation) strategies may buffer them from intense emotional reactions in order to maintain tolerable levels of arousal given increased vulnerability and reduced energy reserves (Consedine, Magai, & Bonanno, 2003).

One limitation of the EPSI is that effective solutions tend to be biased toward instrumental strategies. Nevertheless, we still find older adults to be more effective in their application of emotion-focused strategies in the interpersonal domain. Future research must include a greater balance in situations in which both problem-focused and emotion-focused strategies are judged effective. Another limitation is that the EPSI problem contexts are sparse. Thus, problem appraisal could possibly play a role in producing age differences in strategy preference. Past research demonstrates age differences in problem definitions ( Berg et al., 1998 ) and goals evoked when approaching problems ( Strough, Berg, & Sansone, 1996 ). A third limitation of the current study is that we did not control for age relevance of each problem. Future research should address how age relevance influences problem-solving effectiveness, especially as it pertains to emotion regulation in interpersonal problems and to whether age differences in effectiveness are maintained for the oldest-old individuals.

Given recent interest in the role of emotion in older adulthood, these findings are significant because they provide further evidence for the capacity of older adults to draw on accumulated experience in socioemotional realms to solve problems successfully. Older adults' strategy use suggests that they are capable of complex and flexible problem solving. Furthermore, whereas advancing age is associated with cognitive decline, such declines do not readily translate into impaired everyday problem-solving effectiveness. Instead, both types of developmental trajectories exist in tandem and may even complement one another.

Cornelius and Caspi (1987) recruited 23 judges to determine which of four strategies could be used to effectively solve a series of everyday problems. Of these 23 judges, 18 were “laypersons without formal training in psychology” and 5 were “graduate students majoring in developmental psychology” (p. 146). Overall, the panel consisted of young adults ( n = 9, ages 24–40, M = 28.4), middle-aged adults ( n = 8, ages 44–54, M = 50.3), and older adults ( n = 6, ages 62–72, M = 67.3). Ten members of the panel were men and 13 were women. Given that the panel (a) consisted of such small samples from each of the three age groups, (b) was probably sampled from a single geographic region, and (c) was sampled about 20 years ago, it is possible that the effective solutions endorsed by this particular panel are not entirely representative of those effective solutions that might be offered by individuals sampled today and who are living in different regions of the country. Future research should examine the metric properties of the EPSI to see if the effective solutions reported by the earlier panel (Cornelius & Caspi) are consistent with those endorsed by a more current sample of everyday problem solvers.

If we examine the effectiveness scores by using the six original EPSI domains, the results replicate those of Cornelius and Caspi (1987) . Older adults were more effective than younger adults in the consumer (young adults, M = 0.20, SE = 0.04; old adults, M = 0.36, SE = 0.04), t (104) = 2.80 ( p <.01), home (young adults, M = 0.37, SE = 0.04; old adults, M = 0.45, SE = 0.03), t (104) = 1.75 ( p <.05, one-tail), information (young adults, M = 0.61, SE = 0.03; old adults, M = 0.66, SE = 0.03), t (104) = 1.32 ( p <.10, one-tail), and work (young adults, M = 0.53, SE = 0.04; old adults, M = 0.61, SE = 0.03), t (104) = 1.69 ( p <.05, one-tail), domains.

Decision Editor: Thomas M. Hess, PhD

Problem Solving Strategies Included in the Everyday Problem Solving Inventory.

Mean Strategy Endorsement and Problem-Solving Effectiveness Ratings by Age and Domain.

Notes : Strategy endorsement ratings ranged from 1 (definitely would not do) to 5 (definitely would do). Problem-solving effectiveness scores ranged from r = −1.0 to r = 1.0. Parenthetical material represents the extreme ends of the strategy endorsement ratings. ADE = Avoidance–denial, PD = passive dependence, PPS = planful problem solving, and CA = cognitive analysis.

EPSI Problems Used in the Current Study.

This research was supported by the National Institute on Aging under Research Grant AG-11715, awarded to Fredda Blanchard-Fields.

Artistico, D., Cervone, D., Pezzuti, L. ( 2003 ). Perceived self-efficacy and everyday problem-solving among young and older adults. Psychology and Aging , 18 , 68 -79.

Berg, C. A., Strough, J., Calderone, K. S., Sansone, C., Weir, C. ( 1998 ). The role of problem definitions in understanding age and context effects on strategies for solving everyday problems. Psychology and Aging , 13 , 29 -44.

Blanchard-Fields, F., Chen, Y., Norris, L. ( 1997 ). Everyday problem solving across the adult life span: Influence of domain specificity and cognitive appraisal. Psychology and Aging , 12 , 684 -693.

Blanchard-Fields, F., Jahnke, H., Camp, C. ( 1995 ). Age differences in problem-solving style: The role of emotional salience. Psychology and Aging , 10 , 173 -180.

Blanchard-Fields, F., Stein, R., Watson, T. L. ( 2004 ). Age differences in emotion-regulation strategies in handling everyday problems. Journals of Gerontology: Psychological and Social Sciences , 59B , P261 -P269.

Consedine, N., Magai, C., Bonanno, G. ( 2002 ). Moderators of the emotion inhibition-health relationship: A review and research agenda. Review of General Psychology , 6 , 204 -228.

Cornelius, S. W., Caspi, A. ( 1987 ). Everyday problem solving in adulthood and old age. Psychology and Aging , 2 , 144 -153.

Marsiske, M., Willis, S. L. ( 1995 ). Dimensionality of everyday problem solving in older adults. Psychology and Aging , 10 , 269 -283.

Strough, J., Berg, C. A., Sansone, C. ( 1996 ). Goals for solving everyday problems across the life span: Age and gender differences in the salience of interpersonal concerns. Developmental Psychology , 32 , 1106 -1115.

Thornton, W. J. L., Dumke, H. A. ( 2005 ). Age differences in everyday problem-solving and decision-making effectiveness: A meta-analytic review. Psychology and Aging , 20 , 85 -99.

Watson, T. L., Blanchard-Fields, F. ( 1998 ). Thinking with your head and your heart: Age differences in everyday problem-solving strategy preferences. Aging, Neuropsychology, and Cognition , 5 , 225 -240.

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Cognitive Decline Symptoms in Young and Older Adults

Symptoms and Effects
When Does It Begin?
How Fast Does It Happen?

Causes and Risk Factors

How to Slow Cognitive Decline
Coping With Changes

Cognitive decline—or cognitive impairment —is a reduction in the ability to remember , reason, learn, and pay attention. While some loss of these thinking skills is a normal part of aging, cognitive decline is when the loss is worse than expected for your age.

Noticeable cognitive decline is most common in people older than 70, though younger adults are susceptible, too, as a number of neurological and psychological conditions cause this condition.

This article breaks down the signs of cognitive decline, how it progresses, its causes, as well as what you can do to take this condition on.

FG Trade Latin / Getty Images

Symptoms and Effects of Cognitive Decline

Cognitive decline causes a broad range of deficits in memory, reasoning, concentration, and learning. Some healthcare providers categorize cognitive decline into four stages based on the symptom severity.

Very Mild Cognitive Decline

There are no reported signs in the earliest stages of cognitive decline. However, connections between neurons (brain cells) change and break down long before you notice symptoms.

This progresses to very mild cognitive decline (or subjective cognitive decline) when symptoms are reported but not evident in diagnosis. You may have more lapses in memory, such as forgetting where you put your keys, meetings you have scheduled, and the names of people, or you have difficulty staying focused.

Mild Cognitive Decline

Many healthcare providers view mild cognitive decline—often called mild cognitive impairment (MCI)—as an intermediate stage between typical age-related cognitive decline and dementia . This stage of cognitive decline causes noticeable symptoms that start to impact work and daily living, including:

Getting lost traveling to a familiar location
Having difficulty remembering or learning names
Reading without retaining any of the material
Losing a valuable or treasured item
Experiencing difficulty socializing or being in social settings
Forgetting words or the names of loved ones
Performing noticeably worse at work

Moderate Cognitive Decline

With moderate cognitive decline—or mild dementia—the symptoms are apparent in clinical evaluation. Hallmarks of moderate cognitive decline include:

Reduced awareness of current events and news
Difficulty remembering your personal history
Difficulty concentrating
Loss of ability to take care of finances, travel, and work
Denial of the condition
Retained ability to remember faces, time or location, and familiar places

Disorientation around time and place is another sign, as is loss of arithmetic ability and inability to dress independently. As this stage progresses to moderately severe cognitive decline or moderate dementia, a person may no longer be able to live independently.

Severe Cognitive Decline

Later stages, including severe and very severe cognitive decline, involve a continued deterioration of cognitive abilities. Signs of severe cognitive decline include:

Sometimes, forgetting a spouse’s name
Difficulty remembering past events
Lack of awareness of time, location, or season
Difficulty with counting down
Inability to live independently, incontinence
Delusional behavior, paranoia, agitation
Obsessive behavior

In very severe cognitive decline (severe dementia), people lose their ability to read, write, and speak and require assistance with every aspect of daily living. Eventually, walking and motor abilities gradually deteriorate.

When Does Cognitive Decline Begin?

Your brain constantly changes throughout your life, and some cognitive decline is expected after middle age. The older you are, the more likely you are to experience signs; mild cognitive impairment was estimated to affect 6.7% of 60- to 64-year-olds but more than 25% of 80 to 84-year-olds.

In one cross-sectional study of 29,000 participants with dementia, the age of symptom onset was 73 for women and 70 for men. Other studies have found that early signs of cognitive decline can start before age 60 and even arise in your 20s or 30s.

Race or ethnicity can also affect how early your cognitive function begins to decline. Studies have found that African American and Latinx populations are disproportionately affected by cognitive decline and experience symptoms between two and six years earlier than their white counterparts.

In addition, cognitive decline can accompany psychological conditions like major depressive disorder or other diseases, which affect those of all ages, races, and ethnicity.

Post COVID Brain Fog

A growing body of research indicates that some people experience cognitive decline for months to years after a COVID-19 infection. In particular, researchers found effects on executive function, which includes working memory, adaptable thinking, and self-control.

How Fast Does Cognitive Decline Happen?

Cognitive decline can develop rapidly or gradually, depending on the underlying cause. In the research, between 8% and 13% of those with mild cognitive impairment develop dementia, most often Alzheimer’s disease , within one year.

Certain conditions can contribute to decline, with cognitive changes seen within weeks or months. This is the case for a range of brain infections, injuries, neurological diseases like Alzheimer’s disease, other diseases, or certain medications.

Mild Cognitive Impairment and Dementia

While mild cognitive impairment increases your risk of dementia conditions, such as Alzheimer’s disease, not all cases progress this way. Researchers found as many as 16% of those with MCI see a restoration of normal cognition within a year. However, other studies found as many as 65% develop full dementia three years after a mild cognitive impairment diagnosis.

Fundamentally, cognitive decline occurs as neurons (brain cells) in certain parts of the brain start to weaken and die. A wide range of diseases and health factors can bring this on, including:

Brain injury due to trauma, concussion
Endocarditis or other types of heart infection
Encephalitis , meningitis , or other brain infections
Viral or bacterial infections
Alzheimer’s disease, Parkinson’s disease , multiple sclerosis (MS) and other neurodegenerative disorders
Major depressive disorder, depression
Schizophrenia, psychosis
Kidney, liver, or thyroid disease
Alcohol or drug use or withdrawal
Specific corticosteroid , sedative, antihistamine , or antidepressant medications

Risk Factors

Several health factors can raise your risk of developing cognitive decline, including things that are within your control and those that aren’t. Examples are:

Hypertension (high blood pressure)
Hearing loss
Insufficient physical activity
Having obesity
Excessive alcohol use
Family history of cognitive decline

How to Slow Cognitive Decline

In most cases, cognitive decline is irreversible. But there are things you can do to delay its progress. This means addressing any underlying health factors and making lifestyle changes. The following are some ways to slow down cognitive decline:

Get active : Incorporating regular exercise or physical activity—at least 150 minutes of moderate activity a week—takes on underlying health factors and improves brain function.
Eat healthy : Studies suggest that healthy diets, such as the DASH (Dietary Approaches to Stop Hypertension) and MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diets, can slow cognitive decline; emphasize fresh vegetables and lean proteins and avoid sugars, salt, and processed foods.
Manage diabetes : If you have diabetes, managing your blood sugar can slow cognitive decline.
Treat hypertension : Get treatment , take medications, and assess your diet to lower blood pressure if you have hypertension.
Take on hearing loss : Since hearing loss is a risk factor for cognitive decline and can contribute to it, get your ears checked and wear hearing aids or other assistive devices.
Consider counseling : Depression and cognitive decline can go hand in hand; therapy or counseling to manage the condition can help.
Brain training : Brain games, such as crosswords, Sudoku, and others, engage your mind, exercising your reasoning, memory, and other cognitive skills; researchers found playing these types of games is effective in slowing dementia progression.

Testing to Confirm Cognitive Decline

A cognitive decline diagnosis primarily begins with the individual or a family member reporting symptoms and growing concerned about their condition. A healthcare provider will perform additional evaluations to get at the root causes of the issue.

To confirm a suspected case, a healthcare provider—often a neurologist, neuropsychiatrist, or other specialist—may perform the following tests:

Cognitive and neurological testing : Providers use a wide range of tests to assess your cognitive function; they evaluate your ability to remember, solve problems, coordinate movements, language ability, and math skills.
Imaging : A healthcare provider may call for X-ray , magnetic resonance imaging (MRI), and positron-emission tomography (PET) imaging of your brain to screen for stroke, tumor growth, or other neurological conditions.
Psychiatric evaluation : You may need a psychiatric assessment of mood disorders or behavioral changes accompanying your symptoms.
Cerebrospinal fluid (CSF) test : Healthcare providers use this test to diagnose Alzheimer’s and other types of dementia. This involves testing a sample of the fluid surrounding your spinal cord and brain.
Blood tests : Abnormal levels of beta-amyloid, a protein in the blood, are a sign of Alzheimer’s disease. Blood tests may also help detect risk factors or other potential causes.

Coping With Changes

The impact of cognitive decline can be severe, affecting your ability to function and live independently. Often, living with this condition means learning to adapt to it. Consider the following coping strategies:

Keep a routine : Eat meals, go to bed, bathe, and schedule other daily activities at consistent times.
Understand the treatment : Keep track of your medications and take prescriptions on schedule using a pill organizers or apps.
Reminders : Use Post-It notes, dry-erase boards, apps, or alarms to remind you to take medications or plan for appointments.
Organize : Keep a planner or use apps to keep track of appointments and important tasks; craft to-do lists.
Enjoyable activities : Schedule enjoyable activities and do them at consistent times every day.
Accessible clothing : Choose loose-fitting clothing that's easy to put on and take off.
Falls prevention : Use a shower chair and install anti-slip runners in the bath, keep your home well-lit, and clear away trip hazards to prevent falls.

Cognitive decline is a loss of reasoning, memory, concentration, language, and problem-solving skills. Early signs are less severe, but in most cases, the condition gets worse and progresses to dementia, which makes you unable to function independently.

Neurological diseases like Alzheimer’s disease, brain injury, medication side effects, and systemic (body-wide) diseases are among the many causes. Adopting lifestyle changes and treating the underlying causes of cognitive decline can slow its progress.

American Psychological Association. Spotting the signs of mild cognitive impairment .

Gil-Peinado M, Alacreu M, Ramos H, et al. The A-to-Z factors associated with cognitive impairment: results of the DeCo study . Front Psychol . 2023;14:1152527. doi:10.3389/fpsyg.2023.1152527

Beason-Held LL, Goh JO, An Y, et al. Changes in brain function occur years before the onset of cognitive impairment . J Neurosci . 2013;33(46):18008-18014. doi:10.1523/JNEUROSCI.1402-13.2013

Florida Health Care Association. The Global Deterioration Scale for assessment of primary degenerative dementia .

Legdeur N, Heymans MW, Comijs HC, Huisman M, Maier AB, Visser PJ. Age dependency of risk factors for cognitive decline . BMC Geriatr . 2018;18(1):187. doi:10.1186/s12877-018-0876-2

Salthouse TA. When does age-related cognitive decline begin? . Neurobiol Aging . 2009;30(4):507-514. doi:10.1016/j.neurobiolaging.2008.09.023

Hale JM, Schneider DC, Mehta NK, Myrskylä M. Cognitive impairment in the U.S.: lifetime risk, age at onset, and years impaired . SSM Popul Health . 2020;11:100577. doi:10.1016/j.ssmph.2020.100577

Allott K, Fisher CA, Amminger GP, Goodall J, Hetrick S. Characterizing neurocognitive impairment in young people with major depression: state, trait, or scar? . Brain Behav . 2016;6(10):e00527. doi:10.1002/brb3.527

Li Z, Zhang Z, Zhang Z, Wang Z, Li H. Cognitive impairment after long COVID-19: current evidence and perspectives . Front Neurol . 2023;14:1239182. doi:10.3389/fneur.2023.1239182

McGirr A, Nathan S, Ghahremani M, Gill S, Smith EE, Ismail Z. Progression to dementia or reversion to normal cognition in mild cognitive impairment as a function of late-onset neuropsychiatric symptoms . Neurology . 2022;98(21):e2132-e2139.

Chandra SR, Viswanathan LG, Pai AR, Wahatule R, Alladi S. Syndromes of rapidly progressive cognitive decline-our experience . J Neurosci Rural Pract . 2017;8(Suppl 1):S66-S71. doi:10.4103/jnrp.jnrp_100_17

National Library of Medicine. Neurocognitive disorder .

Centers for Disease Control and Prevention. Dementia risk reduction .

Arora S, Santiago JA, Bernstein M, Potashkin JA. Diet and lifestyle impact the development and progression of Alzheimer’s dementia . Front Nutr . 2023;10:1213223. doi:10.3389/fnut.2023.1213223

Kim H, Kim YS. A study of dementia preventions trough brain training by serious games . JNCIST . 2016;5(1):35-44. doi:10.29056/jncist.2016.06.05

Centers for Disease Control and Prevention. What is dementia? Symptoms, types, and diagnosis .

National Institutes on Aging. Tips for caregivers and families of people with dementia .

By Mark Gurarie Gurarie is a freelance writer and editor. He is a writing composition adjunct lecturer at George Washington University.

Occupational Therapy Interventions for Older Adults With Chronic Conditions and Their Care Partners

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Beth Fields; Occupational Therapy Interventions for Older Adults With Chronic Conditions and Their Care Partners. Am J Occup Ther November/December 2021, Vol. 75(6), 7506390010. doi: https://doi.org/10.5014/ajot.2021.049294

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Evidence Connection articles provide a clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association’s Evidence-Based Practice Project. In this Evidence Connection article, I describe a clinical case report of an older adult with a chronic condition and his daughter who received home health occupational therapy services. I discuss the occupational therapy evaluation and intervention processes with these clients to support chronic condition self-management, coping skills, and problem solving, drawing on findings from the systematic review on the effectiveness of interventions for care partners of people with chronic conditions published in the July/August 2021 issue of the American Journal of Occupational Therapy . It is my hope that this Evidence Connection article can be used to inform and guide clinical decision making when working with older adults with chronic conditions and their care partners.

As the population continues to age and experience chronic conditions, care partners (i.e., family members and friends who provide care, usually without payment) have become increasingly critical to the long-term care system. In response, many prominent organizations, including the Institute of Medicine and the Institute for Healthcare Improvement, are endorsing a person- and family-centered model of geriatric care ( Clay & Parsh, 2016 ). Key features of this model include collaboration and information sharing, education and training, and active participation and decision making by health care practitioners, older adults, and their care partners. To support this model, payment and coverage innovations in Medicare and Medicaid are beginning to emerge. For example, home health agencies can provide care partner supportive services such as education and training to Medicare beneficiaries ( Centers for Medicare & Medicaid Services, 2017 ; National Academies of Sciences, Engineering, and Medicine, 2016 ).

In this article, I provide a clinical case report that demonstrates how occupational therapy practitioners can support and participate in this model of care. This case report exemplifies findings of a systematic review on the effectiveness of interventions for care partners of people with chronic conditions, published in the July/August 2021 issue of the American Journal of Occupational Therapy ( Rouch et al., 2021 ). I describe the occupational therapy evaluation and intervention processes for supporting chronic condition self-management, coping skills, and problem solving for an older adult with a chronic condition and his daughter receiving home health occupational therapy services.

Clinical Case Report

John, age 70 yr, was referred to home health occupational therapy because of a recent diagnosis of peripheral neuropathy made during his annual check-up with his primary care practitioner. He self-reported that since his wife died, he has not been managing his Type 2 diabetes well. His peripheral neuropathy has been limiting his ability to do normal activities because of mild numbness and pain in his feet. John’s daughter, Dawn, attended his annual check-up with him for the first time. Dawn was surprised to learn that her father has not been managing his diabetes. Together, John and Dawn decide that she will take a more active role in helping her father improve his health, the role that John’s wife had previously assumed.

Occupational Therapy Evaluation and Findings

John is independent in activities of daily living, including dressing, feeding, functional mobility, and personal hygiene.

He is a retired computer programmer and enjoys surfing the web and playing online games.

John feels lonely since his wife passed and has not been sleeping well.

He enjoys visiting with his daughter and would like her to play a more active role in helping him get back on track with his health. Dawn confirmed that she is willing and able to better support her father.

John describes his home as being accessible after changes made to accommodate his wife’s progressive condition.

Previous performance patterns included going on short morning walks with his wife, going out to eat with friends, and taking care of all the yard work. Before her death, John’s wife managed the house, including grocery shopping, cleaning, and cooking.

Table 1 presents findings from the other assessments Madeline administered during the evaluation: the Canadian Occupational Performance Measure (COPM; Law et al., 2014 ), the Brief Health Literacy Screening Tool ( Haun et al., 2012 ), and the Patient-Reported Outcome Measurement Information System (PROMIS) Global Health scale (Version 1.2; Hays et al., 2009 ).

Occupational Therapy Intervention

Moderate evidence for group-based interventions in which older adults and their care partners focus on learning and applying chronic condition–specific education, coping skills, and problem solving to improve well-being and quality of life.

Moderate evidence for educational interventions in which older adults and their care partners focus on learning how to adapt daily living skills.

Given that most of the studies in the systematic review had moderate to low strength of evidence, Madeline also reviewed other pertinent sources, including the Occupational Therapy Practice Framework: Domain and Process (4th ed.; OTPF–4; AOTA, 2020 ), the Centers for Disease and Control and Prevention (CDC), and the Self-Management Resource Center (SMRC). In the OTPF–4, she found descriptions of occupations related to health management. From the CDC and SMRC, she identified recommendations for physical activity and online workshops. Drawing from available evidence, her clinical expertise, and John’s and Dawn’s preferences, Madeline developed a plan of care for home health occupational therapy. Over the course of 2 mo, John and Dawn participated in four in-person home health occupational therapy sessions. Targeted outcomes included improved well-being, quality of life, and knowledge of John’s chronic condition.

Group Self-Management Intervention

After learning from the occupational profile and COPM that John and Dawn wanted to work on building a healthier lifestyle together, Madeline suggested they attend a virtual diabetes self-management group workshop. The workshop lasts 6 wk, requires about 2 hr of work each week, and covers establishing healthy nutrition and exercise habits, communicating effectively with loved ones and health care practitioners, managing medications, and using relaxation and breathing techniques ( Cai & Hu, 2016 ; SMRC, 2021 ; Toseland et al., 2004 ). John and Dawn reported that they would sign up to take the online workshop together. Dawn shared that she was particularly interested in talking with other care partners online to find out how they empower their loved ones to improve their health. John and Dawn both expressed that they want to learn strategies to prevent problems caused by peripheral neuropathy (i.e., swollen feet, pain, loss of muscle tone and balance).

Coping Skills Intervention

Findings from the PROMIS Global Health scale indicated to Madeline that John and Dawn are experiencing decreased quality of life and poor mental health. During the first and second occupational therapy sessions, Madeline provided strategies to John and Dawn to help them cope with the recent passing of their loved one. In particular, she helped them establish a journaling routine in which John and Dawn would each record their thoughts and feelings on a daily or weekly basis. She also shared information on the impact of sleep on health and provided some suggestions for building a better nighttime routine, including listening to music, taking a warm bath, and reading a favorite book. Last, Madeline encouraged both John and Dawn to either resume participating in a meaningful hobby or explore a new one ( Hood et al., 2015 ; Hoppes & Segal, 2010 ; Wolff et al., 2009 ).

Problem-Solving Intervention

During the third and fourth occupational therapy sessions, Madeline worked with John and Dawn to adapt their daily living skills by using problem-solving strategies. Because John has limited health literacy, Madeline used plain language, visual aids, and the teach-back method when introducing strategies. For example, John identified that he has had a hard time preparing healthy meals and finding time to exercise. Madeline had John brainstorm potential solutions while encouraging Dawn to think about how she could help her father improve his meal preparation and exercise routines. They both decided that they needed to learn how to read nutrition labels and how much exercise is recommended on a weekly basis.

Madeline described the basics of nutrition using good and bad “nutrition facts” labels as examples. She then had John and Dawn teach these facts back to her. Dawn reported that she was willing and able to help her father create a grocery list that included healthier food choices as part of their weekly routine. Madeline also shared that the general recommendation for exercise is about 150 min spread out throughout the week. John and Dawn discussed what it would take for them to establish a walking routine together. They reviewed their schedules and determined that they could meet up at a nearby park to walk the various trails 3 times a week for at least 30 min. Madeline suggested that if they found themselves having a difficult time sticking to this routine, they should evaluate the activity to determine what alterations could be made ( CDC, 2020 ).

Discharge Summary

Through the use of these evidence-based interventions, John and Dawn met their established goals after completing four occupational therapy home health sessions and a 6-wk online workshop. At follow-up, John’s COPM scores had improved from 5 to 9 (of 10) on both the Performance and Satisfaction scales. John and Dawn also started a weekly walking routine, which was improving their well-being and relationship. They have met up to walk the trails at three different parks near their neighborhoods. John and Dawn found the journaling helpful for coping with their recent loss and managing their health. John’s scores on the PROMIS scale improved to 16 ( T score = 50.8) for the physical health items and 16 ( T score = 53.3) for the mental health items, indicating good global health.

John and Dawn reported that they have not followed through with developing a weekly grocery list and meal preparation plan. They determined that Dawn has been juggling too many work demands to help with this health management–related task. However, they discussed and set up a meal delivery option for John that includes healthier food items that he prepares on his own.

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Everyday problem solving in older adults: observational assessment and cognitive correlates

Affiliation.

1 Department of Psychology, Wayne State University, Detroit, Michigan 48202, USA.
PMID: 8527068
DOI: 10.1037//0882-7974.10.3.478

Older adults' ability to solve practical problems in 3 domains of daily living was assessed using a new measure of everyday problem solving, the Observed Tasks of Daily Living (OTDL). Findings showed that the OTDL formed internally consistent scales representing 3 distinct factors of everyday problem solving. Moreover, the OTDL showed convergent validity with related scales of a paper-and-pencil test. Older adults' performance on the OTDL was significantly correlated with their scores on measures of basic mental abilities. Path analysis showed that age affected older adults' performance on the OTDL directly and indirectly via cognitive abilities. Participants' education and health affected their everyday competence indirectly through cognitive abilities. The effects of perceptual speed and memory span were mediated by fluid and crystallized intelligence.

Publication types

Research Support, U.S. Gov't, P.H.S.
Activities of Daily Living
Age Factors
Educational Status
Health Status
Intelligence
Middle Aged
Problem Solving*

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R01 AG08082/AG/NIA NIH HHS/United States

By Mike Simpson

When candidates prepare for interviews, they usually focus on highlighting their leadership, communication, teamwork, and similar crucial soft skills . However, not everyone gets ready for problem-solving interview questions. And that can be a big mistake.

Problem-solving is relevant to nearly any job on the planet. Yes, it’s more prevalent in certain industries, but it’s helpful almost everywhere.

Regardless of the role you want to land, you may be asked to provide problem-solving examples or describe how you would deal with specific situations. That’s why being ready to showcase your problem-solving skills is so vital.

If you aren’t sure who to tackle problem-solving questions, don’t worry, we have your back. Come with us as we explore this exciting part of the interview process, as well as some problem-solving interview questions and example answers.

What Is Problem-Solving?

When you’re trying to land a position, there’s a good chance you’ll face some problem-solving interview questions. But what exactly is problem-solving? And why is it so important to hiring managers?

Well, the good folks at Merriam-Webster define problem-solving as “the process or act of finding a solution to a problem.” While that may seem like common sense, there’s a critical part to that definition that should catch your eye.

What part is that? The word “process.”

In the end, problem-solving is an activity. It’s your ability to take appropriate steps to find answers, determine how to proceed, or otherwise overcome the challenge.

Being great at it usually means having a range of helpful problem-solving skills and traits. Research, diligence, patience, attention-to-detail , collaboration… they can all play a role. So can analytical thinking , creativity, and open-mindedness.

But why do hiring managers worry about your problem-solving skills? Well, mainly, because every job comes with its fair share of problems.

While problem-solving is relevant to scientific, technical, legal, medical, and a whole slew of other careers. It helps you overcome challenges and deal with the unexpected. It plays a role in troubleshooting and innovation. That’s why it matters to hiring managers.

How to Answer Problem-Solving Interview Questions

Okay, before we get to our examples, let’s take a quick second to talk about strategy. Knowing how to answer problem-solving interview questions is crucial. Why? Because the hiring manager might ask you something that you don’t anticipate.

Problem-solving interview questions are all about seeing how you think. As a result, they can be a bit… unconventional.

These aren’t your run-of-the-mill job interview questions . Instead, they are tricky behavioral interview questions . After all, the goal is to find out how you approach problem-solving, so most are going to feature scenarios, brainteasers, or something similar.

So, having a great strategy means knowing how to deal with behavioral questions. Luckily, there are a couple of tools that can help.

First, when it comes to the classic approach to behavioral interview questions, look no further than the STAR Method . With the STAR method, you learn how to turn your answers into captivating stories. This makes your responses tons more engaging, ensuring you keep the hiring manager’s attention from beginning to end.

Now, should you stop with the STAR Method? Of course not. If you want to take your answers to the next level, spend some time with the Tailoring Method , too.

With the Tailoring Method, it’s all about relevance. So, if you get a chance to choose an example that demonstrates your problem-solving skills, this is really the way to go.

We also wanted to let you know that we created an amazing free cheat sheet that will give you word-for-word answers for some of the toughest interview questions you are going to face in your upcoming interview. After all, hiring managers will often ask you more generalized interview questions!

Click below to get your free PDF now:

Get Our Job Interview Questions & Answers Cheat Sheet!

FREE BONUS PDF CHEAT SHEET: Get our " Job Interview Questions & Answers PDF Cheat Sheet " that gives you " word-word sample answers to the most common job interview questions you'll face at your next interview .

CLICK HERE TO GET THE JOB INTERVIEW QUESTIONS CHEAT SHEET

1. Can you tell me about a time when you had to solve a challenging problem?

In the land of problem-solving questions, this one might be your best-case scenario. It lets you choose your own problem-solving examples to highlight, putting you in complete control.

When you choose an example, go with one that is relevant to what you’ll face in the role. The closer the match, the better the answer is in the eyes of the hiring manager.

EXAMPLE ANSWER:

“While working as a mobile telecom support specialist for a large organization, we had to transition our MDM service from one vendor to another within 45 days. This personally physically handling 500 devices within the agency. Devices had to be gathered from the headquarters and satellite offices, which were located all across the state, something that was challenging even without the tight deadline. I approached the situation by identifying the location assignment of all personnel within the organization, enabling me to estimate transit times for receiving the devices. Next, I timed out how many devices I could personally update in a day. Together, this allowed me to create a general timeline. After that, I coordinated with each location, both expressing the urgency of adhering to deadlines and scheduling bulk shipping options. While there were occasional bouts of resistance, I worked with location leaders to calm concerns and facilitate action. While performing all of the updates was daunting, my approach to organizing the event made it a success. Ultimately, the entire transition was finished five days before the deadline, exceeding the expectations of many.”

2. Describe a time where you made a mistake. What did you do to fix it?

While this might not look like it’s based on problem-solving on the surface, it actually is. When you make a mistake, it creates a challenge, one you have to work your way through. At a minimum, it’s an opportunity to highlight problem-solving skills, even if you don’t address the topic directly.

When you choose an example, you want to go with a situation where the end was positive. However, the issue still has to be significant, causing something negative to happen in the moment that you, ideally, overcame.

“When I first began in a supervisory role, I had trouble setting down my individual contributor hat. I tried to keep up with my past duties while also taking on the responsibilities of my new role. As a result, I began rushing and introduced an error into the code of the software my team was updating. The error led to a memory leak. We became aware of the issue when the performance was hindered, though we didn’t immediately know the cause. I dove back into the code, reviewing recent changes, and, ultimately, determined the issue was a mistake on my end. When I made that discovery, I took several steps. First, I let my team know that the error was mine and let them know its nature. Second, I worked with my team to correct the issue, resolving the memory leak. Finally, I took this as a lesson about delegation. I began assigning work to my team more effectively, a move that allowed me to excel as a manager and help them thrive as contributors. It was a crucial learning moment, one that I have valued every day since.”

3. If you identify a potential risk in a project, what steps do you take to prevent it?

Yes, this is also a problem-solving question. The difference is, with this one, it’s not about fixing an issue; it’s about stopping it from happening. Still, you use problem-solving skills along the way, so it falls in this question category.

If you can, use an example of a moment when you mitigated risk in the past. If you haven’t had that opportunity, approach it theoretically, discussing the steps you would take to prevent an issue from developing.

“If I identify a potential risk in a project, my first step is to assess the various factors that could lead to a poor outcome. Prevention requires analysis. Ensuring I fully understand what can trigger the undesired event creates the right foundation, allowing me to figure out how to reduce the likelihood of those events occurring. Once I have the right level of understanding, I come up with a mitigation plan. Exactly what this includes varies depending on the nature of the issue, though it usually involves various steps and checks designed to monitor the project as it progresses to spot paths that may make the problem more likely to happen. I find this approach effective as it combines knowledge and ongoing vigilance. That way, if the project begins to head into risky territory, I can correct its trajectory.”

17 More Problem-Solving-Based Interview Questions

In the world of problem-solving questions, some apply to a wide range of jobs, while others are more niche. For example, customer service reps and IT helpdesk professionals both encounter challenges, but not usually the same kind.

As a result, some of the questions in this list may be more relevant to certain careers than others. However, they all give you insights into what this kind of question looks like, making them worth reviewing.

Here are 17 more problem-solving interview questions you might face off against during your job search:

How would you describe your problem-solving skills?
Can you tell me about a time when you had to use creativity to deal with an obstacle?
Describe a time when you discovered an unmet customer need while assisting a customer and found a way to meet it.
If you were faced with an upset customer, how would you diffuse the situation?
Tell me about a time when you had to troubleshoot a complex issue.
Imagine you were overseeing a project and needed a particular item. You have two choices of vendors: one that can deliver on time but would be over budget, and one that’s under budget but would deliver one week later than you need it. How do you figure out which approach to use?
Your manager wants to upgrade a tool you regularly use for your job and wants your recommendation. How do you formulate one?
A supplier has said that an item you need for a project isn’t going to be delivered as scheduled, something that would cause your project to fall behind schedule. What do you do to try and keep the timeline on target?
Can you share an example of a moment where you encountered a unique problem you and your colleagues had never seen before? How did you figure out what to do?
Imagine you were scheduled to give a presentation with a colleague, and your colleague called in sick right before it was set to begin. What would you do?
If you are given two urgent tasks from different members of the leadership team, both with the same tight deadline, how do you choose which to tackle first?
Tell me about a time you and a colleague didn’t see eye-to-eye. How did you decide what to do?
Describe your troubleshooting process.
Tell me about a time where there was a problem that you weren’t able to solve. What happened?
In your opening, what skills or traits make a person an exceptional problem-solver?
When you face a problem that requires action, do you usually jump in or take a moment to carefully assess the situation?
When you encounter a new problem you’ve never seen before, what is the first step that you take?

Putting It All Together

At this point, you should have a solid idea of how to approach problem-solving interview questions. Use the tips above to your advantage. That way, you can thrive during your next interview.

FREE : Job Interview Questions & Answers PDF Cheat Sheet!

Download our " Job Interview Questions & Answers PDF Cheat Sheet " that gives you word-for-word sample answers to some of the most common interview questions including:

What Is Your Greatest Weakness?
What Is Your Greatest Strength?
Tell Me About Yourself
Why Should We Hire You?

Click Here To Get The Job Interview Questions & Answers Cheat Sheet

Co-Founder and CEO of TheInterviewGuys.com. Mike is a job interview and career expert and the head writer at TheInterviewGuys.com.

His advice and insights have been shared and featured by publications such as Forbes , Entrepreneur , CNBC and more as well as educational institutions such as the University of Michigan , Penn State , Northeastern and others.

Learn more about The Interview Guys on our About Us page .

About The Author

Mike simpson.

Co-Founder and CEO of TheInterviewGuys.com. Mike is a job interview and career expert and the head writer at TheInterviewGuys.com. His advice and insights have been shared and featured by publications such as Forbes , Entrepreneur , CNBC and more as well as educational institutions such as the University of Michigan , Penn State , Northeastern and others. Learn more about The Interview Guys on our About Us page .

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Evidence-based programs for older persons in the Americas

Programas basados en la evidencia para personas mayores en la región de las américas, programas com base em evidências científicas para pessoas idosas nas américas, patricia morsch.

1 Pan American Health Organization, Washington, D.C. , United States of America, Pan American Health Organization, Washington, D.C., United States of America

Martha Pelaez

Enrique vega, carolina hommes.

2 Self-Management Resource Center, Aptos, Calif. , United States of America, Self-Management Resource Center, Aptos, Calif., United States of America

In the current context of the aging of populations and the increase in multiple chronic conditions and dependence, it is important that health systems provide opportunities to improve capacities of older adults to enable healthy aging. Opportunities to enhance older adults’ abilities, including self-management, can be offered through evidence-based programs. Such programs have been proven effective in improving individuals’ symptoms and quality of life, often lowering health-care costs. Self-management evidence-based programs can foster the development of personal skills, increase confidence and motivation on self-care, and help individuals to make better decisions about their own health. This special report describes the implementation history of a self-management program in the Region of the Americas, and the barriers to and facilitators of implementation that can serve as examples for evidence-based program dissemination in the Region.

En el contexto actual de envejecimiento poblacional y aumento de la dependencia y de diversas enfermedades crónicas, es importante que los sistemas de salud brinden oportunidades para mejorar las capacidades de las personas mayores para propiciar un envejecimiento saludable. Las oportunidades de mejorar las capacidades de las personas mayores, incluido el autocuidado, se pueden ofrecer mediante programas basados en la evidencia. Estos programas han resultado eficaces para mejorar y la calidad de vida y los síntomas de las personas y, a menudo, para reducir los costos de salud. Los programas de autocuidado basados en la evidencia pueden fomentar el desarrollo de aptitudes personales, aumentar la confianza y la motivación sobre el autocuidado y ayudar a las personas a tomar mejores decisiones sobre su propia salud. En este informe especial se describe el proceso de ejecución de un programa de autocuidado en la Región de las Américas, y los factores facilitadores y los obstáculos para la ejecución que pueden servir de ejemplo para la difusión de los programas basados en la evidencia en la Región.

No contexto atual de envelhecimento populacional e o consequente aumento de diversas doenças crônicas e da dependência, é importante que os sistemas de saúde criem oportunidades para a melhora da capacidade funcional da pessoa idosa visando ao envelhecimento saudável. Programas desenvolvidos com base em evidências científicas podem ser oferecidos porque comprovadamente ajudam a melhorar os sintomas e a qualidade de vida da pessoa idosa, reduzindo os custos em saúde. Os programas com enfoque no autocuidado estimulam o desenvolvimento de habilidades pessoais, aumentam a confiança e a motivação das pessoas idosas no próprio cuidado e contribuem para que elas tomem melhores decisões sobre a própria saúde. Este informe especial apresenta um programa de autocuidado implementado na Região das Américas, com a descrição do processo de implementação, das barreiras e dos facilitadores – uma experiência que pode servir de exemplo para difundir programas com base em evidências científicas na região.

For nearly two decades, the World Health Organization (WHO) has included the terms “self-management,” “self-care,” and “self-management support” in its documents. Self-management is associated with activities conducted by individuals themselves so they can live well with chronic conditions and, more importantly, increase their own ability and confidence to deal with these ( 1 ). As self-management strengthens an individual’s belief in his or her capacity to execute specific behaviors, it improves self-efficacy. This confidence in the ability to have control over one’s own motivation, behavior, and social environment culminates in more opportunities to maintain capacities and develop/maintain a better health status and quality of life ( 2 , 3 ). While many publications distinguish between self-management and self-care, this report considers the two terms interchangeable.

Self-management support is defined by the activities conducted by health staff to enable individuals to self-manage. This includes education and support as well as more specific tasks such as problem-solving strategies and goal setting ( 1 ). This type of strategy can be delivered by evidence-based interventions. WHO has defined evidence-based as using data and results from research to address the health of populations in their own contexts, including identifying causes and related factors to health needs, as well as best practices of health promotion ( 4 ). It is important to point out that there is a difference between programs based on evidence and those that are evidence-based. The Evidence-Based Leadership Council (EBLC) states that evidence-based community health programs have specific characteristics to guarantee their effectiveness, such as having been tested with rigorous scientific methods, translated to the community, and further disseminated to the general population. Therefore, for a program’s successful replication at the community level, it is crucial to deliver training and provide essential materials, such as administrative manuals, to guarantee its fidelity ( 5 ).

It should be noted that both self-management and self-management support refer to skills and confidence as key elements of both self-management (what the individual does for him or herself) and for self-management support (what health professionals and others provide for patients).

Self-management strategies have been recognized as an important part of primary care to address chronic diseases and stimulate secondary prevention, due to the high involvement of individuals on their own care. Research has shown that apart from the benefits for the individual’s health and well-being, self-management strategies can reduce the economic impact of the increase of chronic conditions and provide more sustainable health systems ( 6 ). This special report aims to describe the implementation of a self-management program in the Region of the Americas and the barriers to and facilitators of implementation that can serve as case examples for program dissemination in the Region.

SELF-MANAGEMENT EVIDENCE-BASED PROGRAMS IN THE CONTEXT OF AGING POPULATIONS

Life expectancy has increased, averaging 73 years worldwide, 77 years in the Region of the Americas, 75 in Latin America and the Caribbean (LAC), and 79 in North America ( 7 , 8 ). Additionally, life expectancy in the Americas at 60 years of age has been estimated at 21 years; 81% of people born in the Region will live until age 60, while 42% will live beyond 80 ( 9 ).

Even though individuals are living longer, there is no evidence to support the idea that they are living longer with better health. In fact, life expectancy has increased faster than healthy life expectancy for both men and women, which reflects an increase in the number of years in ill-health at birth and at age 60 ( 10 ). As our population ages, there is an increase in chronic illness, a decrease in functioning, and for those over 80, which is the age group that is increasing more rapidly, an increase in poverty ( 11 ). These facts require a change in health systems and in the way programs and services are delivered. Care should be person-centered, integrated, consider a life-course perspective, and driven to improve individuals’ abilities ( 12 ). Healthy aging does not mean that people need to be disease-free. Healthy aging means ensuring coordinated care that manages disease with a focus on individuals’ personal goals, reflecting the ultimate objective which is living well and optimizing functional ability and intrinsic capacity. Intrinsic capacity, which is all the mental and physical capacities that an individual has, is a key component of healthy aging, as it is based on the concept of maintaining functional ability; that is, being able to be and to do the things one values for as long as possible ( 11 ).

Older people are the most vulnerable to chronic and infectious illness, as has been seen during the COVID-19 pandemic ( 13 ). Chronic conditions demand day-to-day self-management for the 99% of the time people are not in direct health care, as while living in the community, individuals are making judgements and taking actions concerning their health. In other words, they are self-managing. Self-management can be an important tool to promote healthy aging and avoid the losses of functional ability associated with chronic conditions, which can ultimately lead to dependence. In LAC, care dependence affects 12% of people over age 60 and almost 27% of people over age 80; it means that more than 8 million older people in LAC are unable to independently perform at least one basic activity of daily living. In the next 30 years, long-term care for older people will become an increasingly pressing concern for LAC countries, which calls for a better preparation for the delivery of long-term care services ( 14 ) but also strategies to better address diseases associated with care dependence from a preventive perspective.

In the face of a growing older population and the concomitant growth of demand for chronic illness care, emergency preparedness, including COVID-19 prevention and care, and management of functional ability, our health systems are facing financial challenges. They are called upon to increase their capabilities for diagnosis, treatment, rehabilitation, medication, monitoring, hospitalization, and end-of-life care to fully address the population’s needs.

CALL TO ACTION TO IMPLEMENT EVIDENCE-BASED PROGRAMS TO ACHIEVE HEALTHY AGING

Actions to address older people with chronic conditions and losses of intrinsic capacity are not that different from those for mothers raising young children. The difference is that most countries have in place extensive maternal and child health care, including well-child visits, community vaccination programs, lactation programs, community education, mothers’ clubs, and community health visitors. What is missing for older people is a similar system to support chronic disease management, falls prevention, exercise, healthful eating, and caregiving. Just as in maternal and child health, the individual and the community have a key role in containing health care costs and improving the quality of life of older populations.

The WHO 2015 Global Report on Aging and Health made a call to support self-management, consisting in providing key information, skills, and necessary tools to manage health conditions, avert complications, increase intrinsic capacity, and maintain the quality of life of older persons ( 11 ).

More recently, the WHO proposal for a Decade of Healthy Aging (2021–2030) highlights evidence-based interventions as an opportunity to strengthen programs and services to improve health literacy and self-management and increase the opportunities for physical activity, good nutrition, and oral health ( 15 ). The Decade of Healthy Aging baseline report (2020) claims that evidence-based practices can provide insights on how best to facilitate choice and autonomy for older people, including managing self-care and using health services ( 10 ).

There is a wide range of different evidence-based programs that can be implemented in community settings to improve older adults’ intrinsic capacity, depending on the local needs and resources for implementation. Each domain of intrinsic capacity has an important impact on the others. Additionally, individuals’ self-efficacy and ability in making decisions have a direct impact on their adherence to such programs, and self-management can impact all the domains of intrinsic capacity. Such programs have been proven effective in improving individuals’ symptoms and quality of life, and often lower health care costs. They are beginning to be implemented by countries around the world. Examples can be seen in Table 1 .

Source : PAHO. Portfolio of evidence-based interventions [Working paper]. The table was prepared by the authors based on published data and best evidence to support the selection of programs to be included.

This report will address the results and implementation of the Living Healthy: Chronic Disease Self-Management Program (CDSMP) in the Region of the Americas.

CHRONIC DISEASE SELF-MANAGEMENT PROGRAM (CDSMP)

The CDSMP, developed at Stanford University, is one of the most widely implemented evidence-based programs. It was developed to provide self-management skills and confidence to people with one or more chronic conditions, including physical and mental disorders. The rationale for its development was that most people over the age of 40 have comorbid conditions ( 16 ) and that the skills needed to self-manage these conditions are similar ( 17 ). The CDSMP is a highly interactive workshop offered in small groups (of 10–14 people) in the community by trained leaders, 2.5 hours once a week for six weeks, for individuals with chronic conditions. Recently, it has been customized so it can be offered virtually (to accommodate for physical distancing during COVID-19) or through a self-guided tool kit ( 18 ).

Each session of the CDSMP is built on three major skills associated with self-management: action planning, problem solving, and decision making. The specific topics that are discussed and shared in the group workshops are: symptom management, including cognitive and psychological symptoms; exercising; healthy eating; communicating with health providers; and medication management ( 18 ).

The broad CDSMP literature demonstrates that the program promoted reductions in health care utilization, with a saving of US$ 300–400 per participant. Most of these savings were in reduced time in hospital, fewer emergency department visits, and reductions in symptoms ( 19 ). The CDSMP has also demonstrated effectiveness when offered to diverse language-speaking populations: Chinese, Greek, Italian ( 20 ), Spanish ( 21 ), Bangladeshi ( 22 ); and in various countries: Canada ( 23 ), Japan ( 24 ), Australia ( 25 ), Spain ( 26 ), and Mexico ( 27 ). Finally, CDSMP has demonstrated efficacy and effectiveness when delivered via the Internet ( 28 , 29 ) and as a tool kit delivered by mail ( 30 ). The CDSMP has reached more than a million people worldwide, is offered in more than 30 countries, and is available in more than 15 languages ( 18 ). In the Americas, the program is implemented by community-based organizations in Argentina, Brazil, Canada, Chile, Mexico, Peru, Puerto Rico, Trinidad and Tobago, the United States of America, and in the Eastern Caribbean Countries (ECC). Some of the countries’ experiences of program implementation are described below.

IMPLEMENTATION HISTORY IN THE REGION

The Pan American Health Organization (PAHO) adopted the implementation of evidence-based programs in the Region of the Americas, including the CDSMP, because of the broad literature that supports positive results for individuals and health care systems, adaptations available in different languages, and feasibility of implementation in different realities.

During the period 2017–2019, PAHO launched a series of pilot programs in the following countries, which demonstrated interest and had local support for program development: Argentina, along with Programa de Atención Médica Integral (PAMI); Brazil, with support of the Pontifícia Universidade Católica do Rio Grande do Sul; Chile, through the Ministry of Health and the Red de Servicios; Mexico, with support of the Instituto Nacional de Geriatría and the Facultad de Enfermería de la Universidad Autónoma de Tamaulipas (Tampico); Peru, through the Ministry of Health; and in the ECC, through the ministries of health.

In total, 204 self-management community workshops were offered, reaching more than 2 000 persons in three years (2017–2019). In all countries, the programs were offered with the support of PAHO, but changes in government personnel, attrition in the pool of trainers and leaders, and lack of appropriate budgets allocated for self-management support—as well as close-downs due to the COVID-19 pandemic—have created a significant slowdown in the institutionalization of self-management as part of chronic care in the Region.

Despite a compelling rationale and the evidence of both clinical and cost effectiveness, evidence-based programs are far from reaching their potential. The focus on medical treatment rather than on public health approaches to secondary prevention, and the lack of focus on maintaining function and quality of life for older persons and persons with multiple chronic conditions, has made the adoption of self-management programs more difficult in the Region. In this section we highlight the experiences from a selected number of countries. Canada and the United States of America adopted the delivery of self-management support and education as a strategy for persons with chronic conditions much earlier than LAC ( 31 , 32 ).

During 2015–2016, PAHO approached the Ministry of Health of Chile with an introduction to the program and it was decided that the initial pilot would be in one of the health districts of Santiago. In 2017, the health district funded the training of leaders and master trainers as well as some of the program material. However, each municipality in the district was responsible for program coordination as well as participant recruitment and some of the didactic materials needed for program delivery.

Because the pressures in the health centers for delivering health care were great, the regional team began working with community-based partners such as community development officers and the mayor’s office in charge of aging, as well as the División de Organizaciones Sociales, to expand implementation outside of traditional health care settings.

Facilitators of implementation

A health district director fully committed to the program.
Dedicated, paid staff that increased as the program grew.
The program was led by someone with a chronic condition who found the program personally useful and was committed to sharing this with others.
Physicians and other health professionals trained as master trainers so that they could share the program with their professional colleagues and act as champions.
The city mayor declared interest in the program and committed to it by designating a responsible person from the city council.

ECC: Anguilla, Antigua and Barbuda, Barbados, British Virgin Islands, Dominica, Grenada, Montserrat, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines

In 2017, PAHO invited two participants from each country to participate in a master trainer training. Each pair of trainers made a plan for implementation, including targeted populations, age, timeline, budget, etc. The program became part of the noncommunicable diseases program in the ministry of health. Primary health care providers identified people living with chronic conditions and referred them to the program. Additionally, efforts were made to ensure that both health professionals and nongovernmental organizations received information about the program.

Strong support from the PAHO regional and PAHO ECC Office coordinators.
Having one master trainer coordinator in each country. Country coordinators liaise closely with Caribbean (PAHO ECC Office) and regional coordinators.

Mexico and Peru

The most successful implementation, both in Mexico and Peru, was led by two nursing faculty members from Tampico, Mexico, who worked closely with local health districts and with the ministries of health. With support from the university they created La Red de Automanejo (The Self-management Network) ( 27 ). The Network recruited and trained 32 self-management leaders working in community health centers. In 2014, the Network was able to obtain funding from the Government of Mexico’s Consejo Nacional de Ciencia y Tecnología (CONACYT), enhancing the Network with additional nursing schools in Mexico and Peru. Later the Network became part of the PAHO network.

Funding from CONACYT provided both resources and support from health officials.
The self-management program was a perfect fit with the mission of public health nurses working in the community doing health education. The new approach to supporting self-management was transformative and well accepted.
Utilizing nurses already connected to the community health centers made the program sustainable, as it became an important tool for their work and did not represent an additional manpower expense.

Lessons learned from the various pilots: barriers to implementation

Even though each country has its own system to follow, a lot of the barriers identified during program implementation were the same or very similar, and so they are presented together.

The use of health care professionals as program leaders raised the cost of program delivery and resulted in disruption in continuity by frequent rotation of personnel from community health centers to hospital settings. In addition, it was difficult for some health professionals to understand the role of self-management and how it contributed to the control or improvement of chronic conditions.
The use of volunteer lay leaders presented the challenge of maintaining a well-trained and motivated group of volunteers. A volunteer coordinator with time and skills for the nurturing of volunteers became essential for the success of the program.
There was a lack of integration of self-management support programs in the menu of services provided by community health. The Chronic Care Model provides a clear justification for investment in activating patients as co-participants in health, but until this is reflected in the menu of services provided by the public health sector in collaboration with other community actors, the program funding and infrastructure will lack necessary resources.

PUBLIC POLICY CONCLUSIONS AND RECOMMENDATIONS

With the changes in populations’ demographic and epidemiological profiles, policies that can provide long-term and sustainable results to favor healthy aging and management of chronic conditions are crucial. Providing tools for managing individuals’ health is not only an ethical imperative but also an economic one. Evidence-based programs, including those targeting self-management, can be an important resource to promote more years lived in good health, while reducing health care costs. From the implementation history of the self-management program in the Region, it is possible to highlight many facilitators of and barriers to implementation. However, more research is needed to identify the main program’s results in the Region, as well as experiences with other programs that can maintain or improve older adults’ intrinsic capacity and boost healthy aging.

Disclaimer.

Authors hold sole responsibility for the views expressed in the manuscript, which may not necessarily reflect the opinion or policy of the RPSP/PAJPH and/or PAHO.

Author contributions.

EV, MP, and KL conceived the original idea for the paper; MP was responsible for data acquisition. All authors analyzed the data, drafted the paper, critically revised the paper, and are accountable for all aspects of the work. All authors reviewed and approved the final version.

Conflict of interest.

EV, MP, PM, and CM declare no conflict of interest. KL is a partner in the Self-Management Resource Center, which offers licensing and training for the CDSMP and receives royalties from Bull Publisher for books used in the CDSMP workshops.

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Article Contents

Age Differences in Everyday Problem-Solving Effectiveness: Older Adults Select More Effective Strategies for Interpersonal Problems

Participants

Everyday problem-solving task

Dependent variables

Classification of problem type

Strategy endorsement ratings

Effectiveness scores

Email alerts

Affiliations

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Cognitive Decline Symptoms in Young and Older Adults

Causes and Risk Factors

Symptoms and Effects of Cognitive Decline

Very Mild Cognitive Decline

Mild Cognitive Decline

Moderate Cognitive Decline

Severe Cognitive Decline

When Does Cognitive Decline Begin?

Post COVID Brain Fog

How Fast Does Cognitive Decline Happen?

Mild Cognitive Impairment and Dementia

Risk Factors

How to Slow Cognitive Decline

Testing to Confirm Cognitive Decline

Coping With Changes