The Holiday season is upon us and the stress experienced by many seniors begins to mount. A lack of money, difficulty paying high energy bills or maybe just being alone as the world and their relatives just seem to pass them by all contribute to the rollercoaster of emotions. As a result, many begin to experience mental health issues that can last through the holidays and beyond. Let us share a blog we first published in December 2018 on this subject.
Last November, we met with a couple in our office who wanted to develop an estate plan. For anonymity’s sake, we will call them Mr. and Mrs. Jones. As we discussed the options available to them, both became somewhat uncomfortable and then they began to fight back tears. The process was halted for a few minutes to allow then to collect their thoughts.
Mrs. Jones addressed what was bothering her. “Well, it’s just that doing this sort of thing brings home the fact that we are mortal and our lives are winding down,” her voice cracking as she looked out the window.
Mr. Jones then added, “Especially at this time of year. We are alone now and our kids are living their lives and the holidays just seem to make our loneliness so much worse. Doing this plan helps us feel better knowing that our kids and grandkids will get what we want them to have but nothing replaces having them around us."
This couple expressed what so many other elderly couples feel at this time of year. In fact, issues like depression are magnified at a time when so many are feeling joyous and happy. It is estimated that over 6 million seniors over the age of 65 are clinically depressed and the holiday season exacerbates this condition.
Today, families are now scattered about the country and busy living their own lives. It is believed that seniors who are retired and the children on their own are happy go lucky with few worries in life. Sadly, this is far from the truth. Holidays are a time of sadness for many as the loss of loved ones and traditions are brought front and center.
"We haven't seen our grandkids in months and my son is so busy with his job in Arizona that even going there doesn't mean we spend all that much time with them," said Mrs. Jones. "So we sit in the house, especially if it's cold because of Ken's arthritis and look at pictures on the mantel. It's really depressing, especially when you realize your own time is limited."
This discussion occurred in our office but is repeated in households, workplaces, and facilities tens of millions of times during the holiday season -- and it should not be ignored.
Depression in Seniors
Depression is more common in seniors than we think, with some estimates showing that 8 to 16 percent of them experiencing clinically significant depressive symptoms in senior living communities or nursing care with one in twenty who live at home having similar symptoms.
But depression in seniors, like most other age groups, does not just consist of emotional complaints. A person may also lose interest in or no longer enjoy activities that they once took part in. They can also experience problems with sleep – either sleeping much less or much more than before. Another typical complaint is one of low energy and frequent intrusive, guilty, or ruminating thoughts. Their appetite may decline, and weight may be lost.
Another typical complaint is that they find it hard to motivate themselves to get started each morning, or, instead, may find it difficult to sit still, continually fidgeting throughout the day. Their concentration may be impaired – they may not be able to focus on what they are doing.
Medical providers tend to miss the symptoms of depression in seniors because they mimic other issues associated with aging. Insomnia, low energy, impaired concentration, and weight loss are chalked up to age rather than the possibility that a mental health problem could be present.
And for some people suffering from depression, they may even state that they feel that life is not worth living or that they're "better off dead." In severe circumstances, they may even contemplate, attempt, or complete suicide. In fact, suicide among this age group is astoundingly high, but that is a discussion for another time.
So how can we help? Here are some thoughts;
Let them talk and listen – Let your loved one or the senior talk. There are many feelings that arise during the holiday season and the best way to help a senior process them is to listen. Encourage them to share memories with you. Most seniors reach a point where their life changes drastically – family members and friends die, some lose spouses. Life becomes about dealing with losses rather than celebrating new events. Allow them to share a photo album with you or listen to music. Don’t discourage tears, allow them to feel what they feel. As we sat with Mrs. Jones, she brought up missing the “smells” of the holidays. Having babies around the house, the smell of baby powder, real Christmas trees, and apple pies baking. “All those things are missing now”, she said. “We don’t even bother to put up a tree or bake anymore, it’s just the two of us. I never thought I would miss the noise around the house but believe me, there is nothing so loud to me than the quiet in our house."
Don’t minimize their feelings - If the senior appears sad, don’t dismiss them by saying, “snap out of it”. What you may end up doing is discouraging them from talking about what they are feeling and the consequences of dismissing their feelings could be serious. Encourage them to share with you.
Encourage grieving – A senior who has just lost a loved one or perhaps this is the first holiday without a spouse needs, in many cases, permission to grieve. In addition, seniors who may have received a recent upsetting medical diagnosis may also need time to grieve a change in their lives. Allow it, encourage it, and support it.
If you feel they are depressed, get help – If the feelings of being blue seem to persist and include changes in their normal behaviors such as low energy, not wanting to get out of bed, increased drinking or misuse of prescription medication to “take the edge off” and even thoughts of suicide, reach out for help. Talk to their medical provider about an ongoing change in mood you are noticing. Should talk of suicide arise, calling the National Suicide Prevention Helpline at 1-800-273-8255 is an excellent choice as they can provide resources and advice in a crisis situation. However, if a senior is actively suicidal, with a plan and a means to carry it out, contact 911. (Note: An example of a plan and means to carry it out is when a senior states they are "going to take an overdose of pills" and in their medicine cabinet are multiple full pill bottles, or "I'm going to blow my head off" and the senior has easy access to firearms.)
It is also a good idea to put together a "game plan" to keep the senior in your life active and busy. Here are some ideas:
Don’t stay home – Go to parties with family and friends. Attend a local senior center and take part in holiday activities such as tree trimming parties, ornament making and taking a trip to see local Christmas lights. Volunteering at a soup kitchen or at another social service program can also help. (See our December newsletter for events that are occurring in our area.)
Watch the food and drink – Many people try to suppress feelings through over-indulgence in eating and drinking. Remember to drink responsibly and do not drink and drive. Also, check with the doctor or pharmacist about medications a senior may be taking and if they interact with alcohol or certain foods.
Stay within your budget – Many seniors feel guilty when they can no longer provide the kind of gifting due to a limited budget. Make a budget and stick to it.
Are you planning to be together with an elderly parent, relative or friend? Here are some things you can do together that cost little or may even be free;
Bake some cookies – wrap them and give as gifts to family and to neighbors. Stopping by at other senior's homes can help them stave off the holiday blues as well.
Shopping – even window shopping. Nothing is more exciting than being in a crowd and just walking around. You meet people and may even make some friends without spending a cent.
Caroling – Many senior centers do Christmas caroling. Join a senior center and meet new friends, not just for the holidays but year-round.
Christmas lighting ceremonies – Check the local papers or if you are computer literate, see what localities are doing tree lightings. These usually come with free refreshments and entertainment and is a good night out.
Check on other senior friends - Chances are that if you are feeling it, so are others. There is support in numbers.
Treat yourself - Give yourself a new haircut or have your nails done. For a special indulgence, get a massage. It feels good but also helps relieve anxiety and stress.
One other issue that can arise around the holidays is the first Thanksgiving or Christmas without a loved one being present. I remember speaking with a widow who struggled with the first holiday without her husband and the "empty seat at the table."
She told me her family tried to make her feel at home by not discussing the loss of her husband. What she decided to do was honor him by doing those things he really enjoyed during the holiday. She bought a gift for him, made his favorite dish and shared stories about him with family and friends.
“Although my family meant well, by not discussing the empty chair was more about their discomfort than mine. What I did helped me tremendously and also helped them deal with unspoken feelings. I never did it again, but it sure got me through the first Christmas without him. It helped me remember him but also prepared me to make new memories with my remaining family and friends. He would have wanted it this way."
So remember, the holidays can be a stressful time for all of us but can be especially taxing for seniors. Encourage them to stay active through some of the suggestions above or ideas you may have for them. What you are aiming for is allowing them to feel a sense of belonging and purpose with the knowledge that they are still loved and valued by family and friends.
This Thursday, December 12, on Connelly Law's Southcoast Seniors Radio Magazine on Providence's am790 WPRO at 4:00 pm, we will have the Executive Director of the Rhode Island Association Living Association (RIALA), Kathleen Tripp and the Chair of RIALA and an Executive Director for Benchmark Senior Living, Linda Silveira on the show who will discuss this very issue and ways their organizations help seniors cope with the holiday season and the myriad of emotions that arise for them. We hope you can join us for this special show.
Don Drake oversees Connelly Law's Community Education Programming. He is a retired licensed clinician in the Commonwealth of Massachusetts with over three decades of experience working with older adults diagnosed with HIV/AIDS, substance abuse disorders, chronic homeless and mental illness. Prior to his retirement, he was the director of a unique treatment program for older adults with histories of mental illness, cognitive disabilities, and addiction at Shattuck Hospital in Boston. He was also a director at Steppingstone, Inc. in Fall River, Massachusetts where he was the clinical trainer, program and curriculum developer for the agency and oversaw treatment programming for older adults. He has over 40 years of human service and law enforcement experience and has worked as an administrator at programs in Boston, Hartford, Providence, and Philadelphia, helping to structure, hire and train staff in providing behavioral and addictions treatments for adolescents and adult clients. Drake also worked as a trainer for the Massachusetts Department of Public Health presenting training on QPR, a suicide prevention curriculum for the general public, the Massachusetts Council for Problem Gambling and the Crisis Prevention Institute, an international training organization that specializes in the safe management of disruptive and assaultive behaviors. He is also a retired professional wrestler who is in the New England Professional Wrestling Hall of Fame. Drake can be reached at Connelly Law Offices, Ltd. at firstname.lastname@example.org