Coping with Elderly Depression During the Holidays

For most of the population, the holidays are the time of year for family get-togethers, traditions, friends and fun. However, for other people, the holidays can stir up feelings of sadness, resentment, or even initiate a depressive episode. For elderly residents in facilities with little or no family who visit, this can be an especially painful time of year for them.

Assisted Living Education reviews symptoms to look for, and also how to help elderly residents cope with depression during the holidays.

Recognizing the Signs

The key to effectively helping your residents through a potentially painful time of year is knowing who they are. Like any other preventative preparation, being familiar with a person’s ‘baseline’ behaviors, disposition, and temperament is crucial in detecting any changes, for better or worse.

These are typical symptoms associated with holiday blues in the elderly:

• Subdued or irritable mood; sadness

• Fatigue, or trouble sleeping

• Anxiety

• Loss of interest in daily activities

• Change in appetite

• Lack of attention to personal care, hygiene

Though your residents may already exhibit some of these symptoms, knowing their baselines can also help determine the difference between their established behaviors or new ones that seem to surface out of nowhere. For example, do they already have a cranky personality, or have they been extra snappy and sensitive lately? Are they able to independently tend to their personal hygiene and care, or have they really been letting themselves go? Do they have an existing anxiety disorder, or has your resident been particularly on edge or asking repetitive questions about future events or possibilities? Distinguishing these behaviors are important factors in your residents’ care.

Anticipate and Be Proactive

With proper planning and program design, it may be possible to interrupt a resident’s descent into a holiday depressive episode. Well before the holiday season or particular event arrives, try to make an extra effort to engage with those residents who may be at risk for experiencing a depressive episode. One simple way to start is with a conversation.

Converse & Interact Meaningfully With Your Residents

Regular, casual engagements with your residents can build lasting relationships. These relationships can help toward stabilizing emotional highs and lows that may be experienced during certain times of year, like the holidays, where residents can feel isolated and lonely if they have infrequent or even no visits from family or friends.

Having a daily conversation with each and every one of your residents may sound like a daunting task, but really, there are plenty of opportunities to make each interaction a more personal and meaningful one. Conversations don’t have to be a one-time, drawn-out event, but they can be an ongoing dialogue whenever you see your resident either in passing, during medications administration, therapy sessions, mealtimes, or other times you may have scheduled contact with them. Though the priority is to complete certain tasks, intersperse questions or comments to get to know them better and help them feel more at ease and welcome in the environment. A simple wave and a smile or a brief question/answer can carry on to the next positive interaction you can make with them.

Conversations and dialogue can come easy for some residents, but others may need a little prompting or encouragement out of their shell, for a variety of reasons. They may have a shy personality, there could be trust issues, or they may have a disorder or cognitive issue that makes it harder for them to openly interact with people. Or, they may present as an ornery curmudgeon who has difficulties getting along with people. In any case, don’t be too invasive too fast; they may shut down on you. A slow approach tends to work best with more reserved or aloof individuals. Start simply, maybe compliment them on their appearance, or make general conversation, comments, or make small jokes if the timing is right. You may have to uphold most of the conversation in the initial stages. Try to get a sense of what kinds of topics or interests they’re willing to open up to, and go from there. Start inviting them to group activities or outings. These relationships may take longer to develop, but are truly meaningful to both you and them once they feel comfortable with you.

Even for residents who have advanced dementia/Alzheimer’s, or other cognitive or verbal limitations, making an effort to personalize their care can make all the difference as well. Find ways to reach them, or engage in their world with them as long as it is safe and harmless. Sing to them, or talk/sign with them; whatever appropriate method of communication seems to work best. Their responses may be different than others because of those verbal or cognitive capabilities, but pay close attention to their behaviors and body language for positive or negative feedback.

This trust-building can also help during times where residents may be having an especially rough moment/day and exhibit noncompliance or act out in some way. Sometimes having a staff member with whom they feel particularly close to can help calm or even de-escalate a situation that may arise.

Get Everyone Involved in the Festivities

Most facilities will decorate and have events correlating with the major holidays, which is a great start to creating a festive environment. If possible, find out which holidays in particular your residents like to celebrate throughout the year, and make an effort to represent those holidays if they aren’t part of the mainstream/regular celebrations. Even just decorating an area where they frequent (a communal room, or even just their hall or room) can help bring some cheer. If the resident(s) are able, they can help explain the traditions with which they’re familiar and stories they recall from their past.

The winter holidays are also a great time of year to invite folks from the community to interact with residents. Local religious organizations, youth musicians, choirs, a capella or other community groups, and even schools can come sing and/or engage with residents and enrich their holiday experience. Reaching out to youth groups or schools is a great way to enliven everyone’s spirits. Whether it’s an in-person visit, or having children write greeting cards for the residents adds a special cheer to the holidays.

If possible (and weather permitting), plan outings to see or participate in holiday events or plays, tree lightings, or even drive them around to see the lights and decorations around the local neighborhood.

Don’t Forget The Down Time

With all of the activities and bustle of the holiday season, down time or quiet time is just as important, if not more so. Even if elderly residents are enjoying themselves with all of the festivities, it is a change from their daily routine, and may be more physically and emotionally taxing on them as well. As we age, it can take us longer to recover from activities, especially those out of our norm, whether we realize it or not. Planning activities for just part or half the day, and also having “normal” days in between allows for better recovery and less stress on the elderly body.

Assisted Living Education & You

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