Blue Christmas

Courtesy of Aging with Grace

Home for the Holidays
You were just home for Thanksgiving, the start of the holiday season, and spent time with your family. If you are like many Americans, it may have been weeks, months or even years since you have seen some of your older family members. As you and they grow older, holiday reunions grow more and more special each year.

For most of us, the holidays are a time to gather with friends and family, celebrate, reflect on the past and plan the future. For the elderly this festive time can trigger a mourning period for spouses, siblings and friends who are no longer here.

It is normal to feel subdued, reflective and sad in the face of these losses and changes. However, family members or friends may notice that a senior is experiencing the “blues” for a long time and that what they may have thought was simple sadness is actually a serious case of depression.

Some major factors contributing to holiday depression in the elderly are:
• Financial limitations
• Loss of independence
• Being alone or separated from loved ones
• Failing eyesight (and lessening of the ability to write or read holiday correspondence) ?
• Loss of mobility and/or the inability to get to religious services

Depression is not a natural part of aging
Everyone feels sad or blue sometimes, and the stress associated with holidays may stir feelings of loss or separation. However, a person who is sad or anxious around the holidays can in most cases, continue to carry on with regular activities. Such feelings are generally temporary and the individual eventually returns to his or her normal state of mind. However, a clinically depressed person suffers from symptoms that interfere with his or her ability to function in every day life. These symptoms include much more than feeling blue.

When clinically depressed, the affected older person may lose the will to live. These persons begin to question the value of life and may think of suicide. There are often feelings of diminished self-esteem or excessive feelings of guilt. As these symptoms develop, the older person may take to bed or not bother getting dressed in the morning. Appetite and sleep may suffer while lethargy sets in. The person may show little interest in his or her own welfare and little interest in doing things that in the past-brought pleasure.

Recognizing depression in older individuals is not always easy. It often is difficult for a depressed older person to describe how he or she is feeling. In addition, the current population of older Americans came of age at a time when depression was not recognized to be a biological illness. Those who are depressed may fear that their illness will be seen as a character weakness. Dr. Steven P. Roose, professor of clinical psychiatry at Columbia University, gave tips on The Early Show to recognize the signs of depression for loved ones in their golden years.

Sadness is a response to an event, and is temporary. But if a person is very sad for more than a month and starts having problems with sleep, normal activities, appetite, maintaining their weight and so forth, then they are clinically depressed.

During the holiday season, Roose encourages family and friends to give elderly loved ones as much support as possible.* There are many treatment options, including new medications with fewer side effects. Most elderly sufferers will accept psychiatric care, because they realize they need help.

Helen C. Kales, M.D., hears this tale many times each year, from patients who come to see her after their family members notice a serious change in their behavior at the holidays and encourage them to seek help. As a geriatric psychiatrist who specializes in helping older people cope with depression and other mental illness, Kales knows that it often takes the prompting of a family member to help an older person recognize their symptoms.

"One of the big things that happens at the holidays is that families who are coming in from out of town spot these symptoms and changes for the first time. For instance, their parent or relative isn't taking as good care of themselves or their home as they used to," says Kales, a member of the University of Michigan Depression Center. "It's a myth that depression is a normal part of aging, and that you just get old and tired and sad naturally. Normal aging is not associated with depression, and late-life depression is just as treatable as any other form" explains Dr. Kales.

Kales, notes that older people who have experienced mental health problems in the past, and those who have significant physical health problems that limit their lives, face the highest risk of developing late-life depression.

However, even otherwise, healthy elders can find themselves feeling depressed after a serious blow like the death of a spouse, sibling or close friend, or the loss of their social network when they move to an assisted living facility or to live with relatives. "People in their seventies, eighties and nineties may also be less likely to recognize their increased tiredness, loss of appetite, and mood swings as signs of depression, Kales says, both because of other physical problems they have, or simply because of the era in which they grew up."

"They were taught to pick themselves up by their bootstraps and not to cry when things went wrong," she explains. "So it may be really hard for them to talk about having emotional problems or experiencing depression. They may feel like they need to be stoic and power through it."

The bottom line is that families need to keep their eyes and ears open for signs of depression in older relatives, especially at the holidays when they have a chance to get together and spend some time. Moreover, if someone seems to need help, do not be afraid to speak up and reach out.

Brighten the holidays by giving the gift of you
*When you are writing your Holiday gift list keep in mind for anyone, but most especially for the elderly, the best gift we can give our loved ones (and ourselves) is meaningful time spent together. It only takes a moment to create a lasting memory.

Aging with Grace wants you and your family to enjoy the holidays and make it a special time for your loved ones without feeling overwhelmed and drained. With this in mind, they are sharing their tried and true suggestions for great holiday senior gifts:

1. Senior Fast Food Holiday Basket - which contains food items which are quick and easy for the senior and also fast and nutritious.

2. Health and Beauty Basket - an assortment of the vitamins,Tylenol, soaps, hand creams, shampoo, etc.

3. Pre-pay telephone and or cable bill for a few months - the payment will go as a credit on their bill.

4. Large face clocks or telephone with oversized keypads and adjustable volume (pre-programmed of course by a family member with all the most frequently called numbers.)

5. Gift certificates - for the Barber, Hairdresser and/or neighborhood grocery store.

6. Memory Box - filled with pictures and mementos of significant events in the senior’s life.

7. Home Safety Box with Batteries for smoke and carbon monoxide detectors, night lights with built in sensors and don’t forget to include a supply of replacement bulbs.

8. Video tapes of old TV shows such as I Love Lucy, Carol Burnett, Golden Girls, Milton Berle or tapes of old movies. Lawrence Welk is always a big hit!

9. Dinner for One (or Two) Club: prepare several dinners complete with dessert, freeze and place in their freezer for their future use. Be sure to mark what is in each container.

10. Make a “Family Memory” video - this wonderful gift reminds the receiver how much they mean to the family and provides a chance to thank them for all they have contributed over the years.