Choosing Professionals

When I’m 64: Why ADHD Treatment Gets Tougher with Age

Many aging adults with ADHD must jump through hoops to receive the treatment they deserve. Are you one of them?

Older adults driving in a rural area. Those with a late diagnosis can have struggle to find ADHD treatment.

A woman living in the rural South got wind of my research about older adults and attention deficit disorder (ADHD or ADD) and contacted me with a heartfelt plea for help. Marjorie had read about adult ADHD when she was in her early 50s, and quickly recognized that many ADHD patterns paralleled her own life experiences.

Like many adults with ADHD, Marjorie had led a long and winding life with numerous stops along the way, including one as a part-time university professor. She and her husband lived on and managed the family farm.

The Downside of Not Having Access to ADHD Meds

A very resourceful person, she went out of her way to seek a formal diagnosis by a clinical psychologist who was a two-hour drive from the farm. Then, through her network of friends and associates, she was able to find a physician in her remote area willing to prescribe stimulants to her as an adult in her early 50s. As she described it, “a light turned on” the first time she took stimulants. Suddenly she could see the tasks before her, prioritize them, and begin to accomplish each task. Hers was an ADHD success story.

Against long odds, she had found a mental health professional, was carefully diagnosed, and then found a local physician who was willing to prescribe stimulant medication. So began a fruitful partnership between Marjorie and her doctor that lasted many years.

Seventeen years later, however, her success story was crumbling. The physician who had been her prescriber announced her retirement. Now in her late 60s, Marjorie set out to find a new physician, but she could find no one who would consider treating a woman at her age. Some didn’t believe ADHD existed in older adults. Some didn’t believe that she could have ADHD, since she had an advanced academic degree. Others wouldn’t take the “risk,” as they saw it, to prescribe stimulants to an older adult who may experience cardiac or other complications.

[Self-Test: ADHD Symptoms in Women and Girls]

Older Adults Lose Their ADHD Treatment Options

All of this led to her reaching out to me. “What am I to do?” she asked. “Running a farm with my husband is no mean feat. There are things to take care of from dawn to dusk, and I am sinking fast, back into that place of overwhelm and confusion where I lived for so long before I started taking stimulants. Furthermore, my mother lived to age 95. I can’t imagine having to function for 25 more years without the help of stimulants.”

Although Marjorie’s challenge in finding treatment was increased by the fact that she lived in a rural area, this challenge is experienced every day by older adults across the country. The result is that we have a large and growing group of adults in their 60s and beyond who were diagnosed with ADHD in middle age, have benefited from stimulants, and are finding that treatment doors are closing as they enter their older years.

What’s more, adults who aren’t diagnosed until their later years may face a greater dilemma. While some physicians are willing to continue prescribing stimulants to those with a prescription history, newly diagnosed older adults are met with skepticism. “At your age, why are you even worried about ADHD?” many ask.

Find a Doctor Who Knows ADHD

  • If you have younger family members (children or grandchildren) who are being treated for ADHD, contact their care provider for an appointment. This provider will certainly be aware of the highly genetic nature of ADHD and the likelihood that you, like your offspring, could benefit from medication.
  • Become active in your local CHADD group, helping to form a local support group for older adults. There is strength in numbers. With more of you looking for providers, your chances of finding one will increase.
  •  Consider traveling to a larger metro area, where it may be easier to find a provider. Start treatment with this provider with a plan to seek treatment locally once your diagnosis and positive response to medication has been established.
  •  Educate your physician about medication and ADHD in older adults. David Goodman, M.D., hosted a webinar on this topic for ADDitude magazine.

[Your Expert Overview: Choosing the Right Professional to Treat ADHD]

Kathleen Nadeau, Ph.D., is a member of the ADDitude ADHD Medical Review Panel.