The holiday season can be a very trying time for seniors due to unmet expectations and a stronger underlying feeling of loneliness and boredom.

The holiday time may remind some of people and events gone from their lives. Advertisements bombard us with expectations of bliss, joy, gift giving and happy family reunions. For the holidays, we expect all siblings to be best friends. We now expect grandpa, whom we haven’t seen in ages, to be all smiles and hugs.

I recently volunteered at a community health fair that screened and counseled vulnerable populations, most struggling with bills for health care and other living expenses. An elderly woman whose son and husband died unexpectedly several years ago in December described the holiday season as “a time of much sadness and intensified thoughts about death and dying. I hide it well; I keep smiling and nobody knows.”

Another attendee worried about affording gifts for her grandchildren and great-grandchildren.

Think of the millions of residents in nursing homes, many with no visitors for years. For them, the holidays can heighten their sense of loneliness and holiday blues.

Indeed, many seniors living with Alzheimer’s dementia are more agitated during the holidays than at any other period. For them, meeting new people and visiting new places can be stressful rather than exciting. So, when your loved ones in their 70s and older appear more withdrawn or agitated during the holidays, ask yourself, “Is this a symptom of the holiday blues? Is it the beginning of unrecognized depression or other medical problems?”

Eating or drinking less than usual, losing interest in what they previously enjoyed, becoming more irritated than usual, noncompliance with medications and sleeping longer than normal could all signify the onset of holiday blues or even clinical depression. Others may complain of decreased energy or concentration, or loss of pleasure in all the celebrations and shopping. Other seniors resort to intemperate use of alcohol and sedatives. Others express a passive wish for death.

What can you do to decrease holiday blues in our elders?

First, lower your expectations. Remember the main purposes of the holidays: gratitude for what we have, altruism to all, spiritual renewal and time with family. Understand that change in environment and sensory overload (e.g., noise) can trigger confusion in seniors with poor memory.

Help seniors maintain their daily routine of activities.

Visit loved ones in nursing homes instead of just sending cards or taking them out, especially if they have memory problems. For seniors who live alone, help de-clutter their homes for safety, including removing expired medications. If it’s time for a medical visit, ask to accompany them. Doing so might help them take prescribed treatments.

Other ways to ward off the holiday blues in our seniors include at least an hour exposure to sunlight or bright light every day, positive reminiscence, maintaining a bedtime routine and cutting down on alcohol. Holiday blues that persist beyond the season may be an early warning of clinical depression or other medical problems that require medical evaluation.

 

Dr. Mukaila Raji is a professor at the University of Texas Medical Branch at Galveston and director of the division of geriatric medicine.