This year, the holiday season – combined with the ongoing pandemic – presents seniors with special challenges. Michelle Starnes, MSW, LCSW, who works with older adults in her role as manager of the LifeBridge Senior Program at Parkview Wabash Hospital, shares some information about the factors that make seniors especially vulnerable to depression right now, and how family members and the rest of us can help them cope.
The pandemic has taken a terrible toll on the nation. More than a quarter of a million people of all ages have died due to COVID-19, and tens of thousands more have had cases serious enough to warrant hospitalization. Some have had difficult recoveries after long hospital stays, and still others didn’t have serious symptoms at first, but have continued to struggle with neurological, cardiac and orthopedic problems months after they first caught the virus.
We’ve all watched the situation unfold and learned to deal with new routines of masking in public, using social distancing, washing hands frequently, and staying home whenever possible to limit community spread of the virus. And if you think limiting the social gatherings, sporting events and other pastimes you normally enjoy has been challenging for you, talk with someone older.
The limitations of life under the shadow of COVID have been especially hard on seniors. People 65 and older are among those most at risk for moderate to severe complications from the virus – especially those who have chronic health issues – and they represent the largest percentage of deaths. They are also at high risk for depression resulting from the loss of the activities that give their lives structure and meaning.
Working/volunteering, going to church, singing in a choir, attending community events and festivals, traveling, gathering with friends and family members – these activities have become rare to non-existent for some seniors as they’ve sheltered at home from the virus. And if they live alone, the effect is to isolate them from the people and circumstances that bring them joy and comfort. They have lost crucial elements of human connection, the ability to hug someone or hold their hand or even have a face-to-face conversation. Even seniors who use technology to talk with friends and family report a sense of disconnectedness.
Causes of depression
Depression is on the rise among the general public, but especially in seniors. For someone older who has been isolated for months on end, coping mechanisms may be wearing very thin, and the arrival of the holiday season may significantly increase their stress level. Because of their stage of life, each person may be dealing with multiple factors, any of which can be pushing them toward depression during this time of tension and uncertainty:
• Mourning the loss of a spouse/family member/friend to COVID or some other cause
• Dealing with chronic illness or worsening health and more limited physical abilities
• Worrying about the health or changing circumstances of children, grandchildren or friends
• Caregiving for a sick spouse
• Experiencing a heightened sense of their own mortality, or a loss of control in their lives
• Feeling excluded, like life goes on for other people but is frozen for them
• Anxiety about keeping enough food, supplies and medications on hand
• Struggling with loneliness, especially those who live alone and now cannot pursue activities
that used to bring them together with other people
• Grieving the loss of family milestone celebrations (birthdays, weddings, graduations)
• Feeling lost without the structure and sense of purpose provided by working or volunteering
• Missing traditional holiday gatherings and being able to share special meals and traditions
with children and grandchildren; missing absent loved ones acutely during holidays
Signs of depression in seniors
The following behaviors and symptoms can signal depression in an older loved one:
- Sleeping more or less than usual, or difficulties falling asleep or staying asleep
- Loss or decrease of appetite
- Worry over the future/fear of death
- Increased substance use
- Physical illness, including digestive issues, frequent headaches, aches and pains
- Increased trips to the emergency room or resisting the idea of seeking needed care
- Expressions of feeling like a burden to family or friends
- Agitation, irritability
- Loss of interest
- Self-isolation, reluctance to talk with those closest to them
- Memory loss or concentration difficulties
- Feelings of helplessness, hopelessness or worthlessness
Offering support
It’s important to support seniors while keeping everyone safe and healthy. First, put yourself in their shoes. Try to understand their perspective. Next, think creatively, figure out how you can engage them and try to incorporate touches of the holiday season when meaningful. There are plenty of ways you can show you care about the seniors in your life and want to stay connected to them:
• Perform tasks to help them out. Acts of kindness are always appreciated! Many people who
become depressed lack the energy to get things done, and then the pile-up of to-do tasks just depresses them more. Pick up groceries for them. Make them a favorite meal and leave it on
their doorstep. (Call to tell them it’s there.) Tackle yardwork or outside household maintenance.
Take their pet to the vet for needed care. Take their garbage cans to and from the curb each week.
Shovel snow off their sidewalk and/or driveway.
• Use Zoom or other teleconferencing platforms liberally. Connect daily or several times weekly. Try to keep things upbeat but not forced. Eat meals “together” and use the technology as a bridge between you and the older adult in any number of ways:
- Set aside story time with the kids. If your senior is a grandpa or grandma, encouragehiT them to read to the kids. Everybody will benefit.
- Bake together. You can still enjoy the experience of talking about recipes, debating the merits of lumps in mashed potatoes, challenging each other not to burn the edges and sharing memories.
- Enjoy music – listen or sing or play – together.
- Work on activities. Try puzzles, craft projects, tree decorating, organizing family photos and more.
- Bring back great ideas from early in the pandemic: drive-by birthday tributes, posting cards and kids’ artwork on seniors’ windows, leaving gifts on their doorstep, etc. When the snow comes, make a snowperson close to their window so they can enjoy it. If you go for a drive to look at Christmas lights, take a video of family members talking to the camera as they share reactions and ask about holiday memories, or use a video chat app for real-time interaction. How about getting the person a big, huggable stuffed animal? In the absence of another person or pet in the household, hugging a stuffed animal can still provide a measure of comfort when a person needs someone to hug.
- Make use of community resources. Senior centers are trying to offer programming with COVID safety precautions in mind. Churches have been reaching out to provide needed supplies and make phone calls to people who are isolated. Local food banks and pet food banks offer drive-up events periodically. You can support local businesses and seniors by ordering flowers/plants, special food items, holiday décor and other gift items to be delivered/shipped directly to the home of the older adult.
- Encourage them to contact LifeBridge Senior Program in Wabash or LaGrange. As part of the LifeBridge program, we offer individual and group therapy – both in person and using Zoom – to help seniors 65 and older share fears and concerns in a nonjudgmental environment, regain perspective and confidence, and learn positive coping skills for dealing with stress. We also offer medication management and evaluations by a doctor who specializes in geriatric mental health.
LifeBridge is accepting new participants. Call 260-569-2111 in Wabash and 260-463-9270 in LaGrange. Or you can email michelle.starnes@parkview.com regarding LifeBridge in Wabash County, or leah.heaston@parkview.com regarding LifeBridge in LaGrange County. If you become aware that someone you know is experiencing suicidal thoughts, please urge them to call the National Suicide Prevention Hotline at 988, or Parkview Behavioral Health HelpLine at 260-471-9440.
