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Winter is a challenging season for many older people. Cold weather, loneliness and cost-of-living pressures can take a toll on their physical and mental health. Sarah Purcell looks at what pharmacy staff can do to help their older customers to better health this winter

There are 22.3 million people over 50 in England, 38 per cent of the population, which is forecast to increase by 4.2m by 2045, says Age UK in its The State of Health & Care of Older People in England 2025 report. 

Life expectancy for older ages has stalled, while healthy life expectancy has fallen at age 50 to 20.6 years for women and 19.4 years for men. The more deprived an area, the lower the proportion of life spent in good health. 

Fewer older people report good general health than younger people. ONS Opinions & Lifestyle survey report (2025) found that only 54 per cent of over seventies and 61 per cent of over fifties said their health was good.

More older people struggle with daily activities due to poor health. The GP Patient Survey 2025 found 59 per cent of people aged 55-64 said their chronic condition reduced their ability to carry out day to day activities, rising to 62 per cent in 65-74 year olds. 

Satisfaction with the time it takes to get a GP appointment is the top priority for older people. In 2025, 28 per cent of people 65 plus felt the wait was too long. 

Tom Gentry, head of health policy at Age UK, says: “Conditions that should be managed in the community, such as urinary tract infections (UTIs) and cellulitis, are increasingly ending up as hospital admissions, which is troubling and needs to be addressed. We are deeply concerned at the decrease in healthy life expectancy and the number of requests for social care support that are not being met.”

How pharmacists can help older patients

“Community pharmacies are often the most accessible healthcare setting for older people, offering advice and support without the need for an appointment. Many older patients see their pharmacist more regularly than their GP, which allows pharmacy teams to build trusted relationships and spot changes in a person’s health early,” says Fiona McIntyre, policy and practice lead at the Royal Pharmaceutical Society (RPS) Scotland. 

“Pharmacists can provide tailored support through regular medication reviews, checking for interactions, advising on the safe use of medicines and signposting where needed. They can offer practical advice on nutrition, hydration and staying active.”

Gentry says: “Community pharmacies are conveniently placed and already have good relationships with their older customers. I think they could raise awareness among their older customers of the services they provide, as well as signposting them to befriending services. While they are not a replacement GP service, they can play a large and vital role in older people’s care.”

Hospital admissions among the elderly rise in winter, and pharmacies can play a part here. “Pharmacists play a crucial role in preventing avoidable admission and readmissions over winter by ensuring medicines are used safely, supporting adherence and helping patients manage common illnesses,” says McIntyre.

They can also encourage the uptake of vaccinations. “Pharmacies offer convenient access to flu and Covid vaccinations and can signpost eligible patients to respiratory syncytial virus (RSV) vaccination services. Clear conversations about safety and effectiveness help to increase uptake.”

Pharmacists are key in tackling problematic polypharmacy in older people. “Through structured medication reviews, they can identify unnecessary or duplicate treatments, ensure doses remain appropriate and support deprescribing when safe,” says McIntyre.

Unmet social care needs

The government’s 10 Year Health Plan and Neighbourhood Health guidelines both emphasise a commitment to shift care away from hospitals and into community settings. But the reality is that state-funded care is hard to come by for many.

There were 1.4 million new requests for support from older people in English local authorities in 2023-2024, 68 per cent of all requests to adult social services. In 2023-2024, 368,175 requests resulted in no services provided, while a similar number were provided with universal services or signposted elsewhere, says Age UK. 

Supporting carers

There are 5.8m unpaid carers in the UK, many of them caring for elderly people, and research by Lanes Health for Caring for Caregivers Week revealed that over half say their physical or mental health has suffered because of their role. 

Elizabeth Hughes-Gapper, senior product manager of GOPO Joint Health at Lanes Health, comments: “Unpaid carers play a vital role in our economy, communities and lives of those they support, yet 70 per cent wish there was more support to help them look after their own health.” 

As part of Caring for Caregivers week in June, Lanes Health teamed up with Arlene Phillips as a celebrity spokesperson, alongside wellbeing expert Julie Robinson. The campaign aims to raise awareness of the challenges carers face and highlight practical options that pharmacists can recommend.

Keeping warm and well

Many older people struggle in the colder months and are reluctant to turn up their heating because of the cost. 

“The most important message is that staying warm isn’t just about comfort, it’s essential for your health. Cold temperatures can increase the risk of flu, heart attacks, strokes and even hypothermia. Pharmacy staff should encourage older customers to keep their homes heated to at least 18C. If an older person is struggling to pay their energy bill, it’s essential they receive all the financial support they are entitled to,” says Marios Leptos, director of services at Independent Age. Signpost customers to the Independent Age helpline (0800 319 6789) for a benefits check and more advice.

“As well as encouraging older customers to have their vaccinations to prevent flu or pneumonia, you can also help them keep on top of respiratory infections and recommend over-the-counter (OTC) remedies to help manage these,” says Gentry.

Loneliness and mental health

One in seven older people have symptoms of mental health problems, says Age UK, while one in five aged 55-64 has a common mental health condition.

The percentage of referrals to NHS Talking Therapies for older people is much lower than it should be, with just 6.7 per cent of referrals for those over 65. The percentage of people 65 plus receiving no treatment for common mental health conditions is higher than any other group. Only five per cent received psychological therapy, even though older age groups are more likely to improve through talking therapies than younger adults.

“The first step is to improve awareness among older people. Tell them how they can access talking therapies but be sensitive as older people find it hard to talk about mental health issues and often have a negative view of therapy. Offer resources that can help while they wait,” says Gentry. “Mental health issues are often taken less seriously by GPs in older people, so pharmacists need to be aware of this bias.”

Loneliness is a big issue for older people and often worsens in winter. Age UK says one in 12 older people report often feeling lonely. Loneliness is associated with a 14 per cent increased risk of mortality in older people, and social isolation with a 35 per cent increased risk.

“Pharmacists often see patients regularly and may be among the first to notice signs of loneliness, low mood or cognitive decline. Taking time for a friendly conversation or gently checking in can make a difference,” says McIntyre.

As the number of older people in the UK grows, loneliness looks set to increase. Some 270,000 older people in England go a week without speaking to a friend or family member and these are three times more likely to feel lonely, says Age UK in its Loneliness report.

Nutrition advice

Dr Emma Derbyshire, public health nutritionist for the Health Supplements Information Service (hsis.org), says: “For people over 65, the most common dietary deficiencies are selenium, potassium, vitamin A, riboflavin, calcium, iodine and zinc. Nearly half have low selenium intakes, especially older women.”

How best can you advise older customers about nutrition?

“A food first approach is the right one, but for a range of reasons older people may not eat well. As well as the recommended amount of vitamin D (10mcg), they can combine this with a calcium supplement containing 800mg. It is also worth considering a B12 supplement as absorption of this reduces with age. Fish oil is a valuable supplement for brain and heart health.” She recommends a multivitamin and mineral supplement to help bridge any nutritional gaps.

Registered dietician at the British Dietetic Association, Clare Thornton-Wood, says: “All older people should take a daily vitamin D supplement. It’s best to get omega-3 from food sources such as fish or plant sources including flax or chia seeds, walnuts and soya beans. Calcium requirements increase post-menopause, but ideally get this from dairy or plant-based milks, otherwise a combined vitamin D and calcium supplement.”

For older people who have poor appetite, she has this advice you can pass on: “Consider five small meals a day and ensure they are high in nutrients. Don’t forget drinks – hot chocolate made with milk is a useful source of protein. Think about things you can add – a handful of grated cheese on soups, mayonnaise in sandwiches.”

Tackling incontinence

Bladder weakness and incontinence are common issues among older people, but not an inevitable part of ageing, says Lyndsey Allen, continence specialist nurse at Bladder Health UK. “Pharmacy staff are in a key position to notice people who may be struggling – eg repeated UTIs. Customers may be more willing to talk to them as they consider them less imposing than the GP. Pharmacists can help to improve awareness by putting up posters, leaflets and also including open questions into any interactions they have with older customers in private.”

Allen says it’s important to remember that incontinence is a symptom, not a diagnosis, and therefore a cause needs to be found if possible. “You can help them treat symptoms by encouraging pelvic floor exercises. And when discussing continence pads, talk about importance of skin care and why the right pad size and absorbency level is important.”

Allen says it’s important for pharmacy staff to educate themselves and make sure they know their local services for bladder and bowel incontinence care and ask them about attending staff training, as well as from product manufacturers.