Joyous as the winter season can be for some — with fresh blankets of snow, a warm hearth, and the love of family surrounding them — for others it can be a time of struggle. Not only do the holidays and cold months often counterintuitively bring some people down, perhaps in part the result of past psychological drama, but they can also trigger persistent depression.
The Holiday Blues and Seasonal Affective Disorder typically manifest in similar ways, but their origins and treatment are different. In our last post we discussed the symptoms of each condition, as well as why they might befall certain residents in your care.
As caregivers, we play an important role in an individual’s day to day life; our close relationships with those we look after allow us to notice changes in mood and behavior, and alert other members of the care team. Keeping everyone in the loop, especially the psychiatric professional who will provide the diagnosis and treatment, gives a resident the best shot at recovery.
Here are some of the ways we can help our senior residents when the black dog begins to growl.
Helping Residents With Holiday Depression
With proper planning and program design, it may be possible to shift a resident’s mood throughout the holidays, and prevent the Holiday Blues from taking hold in the first place.
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.
Have Meaningful Interactions With Your Residents
Regular, casual engagements with your residents can turn into lasting relationships, with positive benefits for the residents. These relationships can help toward stabilizing emotional highs and lows that may be experienced during particular times of year, like the holidays, where residents can tend to feel more isolated and lonely.
Initiating daily conversations with each and every resident may sound like a daunting and time-consuming task, but even keeping it short and sweet can brighten a resident’s day. It’s not necessary to have a long, sit-down conversation, but try to create 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.
Not every individual will be responsive, for various reasons. They may be shy, have trust issues, or they may have a disorder or cognitive issue that makes it difficult for them to interact openly with you. These individuals may take some time to warm up to you, or you may need to change your approach. Gauge how the individual reacts to conversation; you may need to back off and take smaller steps for them to open up. You may be doing most of the talking at first, but over time, you might find it balances out to a more even exchange.
Begin inviting them to group activities or outings, but ever push a resident into something they’re. not interested in doing. Nonetheless, always let them know they’re welcome to join if they want. These relationships might take longer to develop, but for resident and caretakers alike, they can be truly meaningful.
Even for residents who have advanced dementia or Alzheimer’s, or other cognitive or verbal limitations, you making an effort to reach them can make all the difference. Singing to them, talking to them, or signing with them will help these individuals feel connected to other people. Their responses may be different, but pay close attention to their behaviors and body language for positive or negative feedback.
These are all important components of trust-building, which can help you with other times in the long-run. As a trusted staff member, the resident may look to you in times of difficulty or even non-compliance to remain calm or de-escalate a tense situation.
Involve Everyone in the Festivities
Most facilities decorate and have events correlating with the major holidays, which is a great start to creating a warm and festive environment. If possible, find out which holidays in particular your residents like to celebrate throughout the year, and make an effort to have those represented if they aren’t part of the mainstream/regular celebrations. Even decorating a common area or the hall near their room can help bring some cheer. If the resident(s) are able, they can help explain the traditions with which they’re familiar and share stories they recall from their past.
The winter holidays are also a great time of year to invite people 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 bring light to their holiday experience.
If possible, outings to local community events, or even driving around looking at holiday lights in the neighborhood are great excursions as well — but if that’s not doable, reaching out to the community and requesting greeting cards for the residents is another simple way to bring your residents cheer.
Recuperation Time is Important
With all of the activities and bustle of the holiday season, down time or quiet time is crucial. 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 demanding on them than expected. As we age, it can take us longer to recover from activities, especially those out of our norm, whether we realize it or not. Moreover, stress and exhaustion can depress one’s immune response, causing someone to be more susceptible to illness.
Switching things up by having partial or half-day activities with ‘regular’ days in between will allow for recovery, and help reduce the mental and physical tolls the holidays can put on elderly folks.
Treating Residents Suffering From Seasonal Affective Disorder
Many of us are familiar with the term Seasonal Affective Disorder (SAD), but may not fully understand its condition, or even that there are different kinds of SAD. While we mentioned that there is a type of spring/summer SAD, the depression varietal we’re discussing here is fall/winter — the physiological condition coming to bear in the cold months.
For the period that the resident is suffering from SAD symptoms, antidepressants can be helpful, especially if the condition’s pattern is known. If a patient has a history of SAD, the an antidepressant regimen can begin prior to the expected onset of either winter or summer SAD. By starting sooner, the medication will be more effective.
Light therapy has also proven beneficial for sufferers of fall/winter SAD, especially among seniors who dislike taking medications or whom are already on multiple medications. Light therapy is also helpful for elderly who are not as able to go outside for natural exposure to light.
For residents with executive cognitive functioning within normal range, Cognitive Behavioral Therapy (CBT) is another possible treatment as well. What works best for every patient is different, and treatment can sometimes take a while to gain a foothold. In fact, there can be a great deal of trial and error in finding the right cocktail of medications or therapies, depending on one’s personal preference and brain chemistry.
A Light Through the Fog
The resident’s attending or personal psychiatrist/psychologist can determine the best course of treatment, depending on the individual’s needs, cognitive capabilities, and severity of symptoms. Even if the resident is receiving specific treatment from their psychiatrist/psychologist, it is pertinent to keep all doctors, therapists, dieticians, and other caretakers abreast of any adjustments to the resident’s routines, medical or otherwise. This helps maintain consistency and effectiveness of the treatment and resident care.
For residents suffering from Holiday Depression or Seasonal Affective Disorder, it might be a while before they can find their way to the bright side of life again, but always remember: with your care and compassion, you are their light through the fog.
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