Beat the Blues: How to Help an Elderly Loved One Through the Holidays… and Beyond

Published In Blog

November 19th, 2015

My understanding is that there’s a lot of questions out there as to how to handle the holidays with their older loved ones, particularly ones who have suffered recent losses. Perhaps it’s your loved ones’ first time away from home (because they’ve recently been placed in a long term care facility), or, perhaps if this is their first holiday without their partner, having recently been widowed. Perhaps this is a holiday grappling with some serious loss of function that has hampered your loved ones’ ability to engage in favorite holiday activities (cooking, going to the mall, what have you).

Should You Be Worried About the Holiday Blues?

One of the first questions to get out of the way – what is this “holiday blues” we’ve heard so much about, and is it something to watch out for? To put it in the vernacular – is it really a thing?

The idea itself of “holiday blues,” at least the way it’s popularly understood, is that it’s at base level what us clinicians would term an anniversary reaction, that is to say – it’s triggered by a particular time of year rather than anything external about the holiday season (say, such as the shortening of the days, or the colder weather – but more on that later).

The idea itself seems to be borne of the observation that there’s a paradoxical reaction, at least amongst some of us, to the start of what should otherwise be a happy and joyous holiday season. While it’s supposed to be an exciting, fun time of hanging out with family, going to holiday parties and gatherings (Christmas, Thanksgiving, etc.), and of wall-to-wall “good cheer,” some of us supposedly greet the holidays with a bout of dread, anxiety, and depression. I found this working definition of “holiday blues” here:

“Feelings of sadness, loneliness, depression and anxiety in and around the holidays, caused by loss of family and loved ones through divorce or distance from the childhood home or place where the holidays were most enjoyed in years past.”

For us busy younger folks, with jobs, perhaps young children and relationships – there is certainly quite a bit of stress over the holidays, which obviously can contribute to mental health issues, particularly if the stress becomes extreme. There may be lots of fun and excitement, but there’s stress on budgets (gift-giving), stress on time (parties, gatherings, etc.) and most importantly, there’s all of the expectations – and this idea of reality not living up to expectations is one of the most convincing explanations I’ve heard as to why this holiday blues phenomenon occurs, and why it may occur for both younger and older adults alike.

For the more fortunate amongst us – we have memories of holidays past that are happy, carefree times. For me, particularly when I was a younger person living in my family home – my fondest memories were of getting together with my extended family for the massive Christmas Eve dinners, the furious and disorganized gift-exchange that occurred after (with periodic and typically futile attempts by our elder family members to try and manage the pace of the gift exchange somehow), the huge Thanksgiving feasts, and the togetherness. These are great memories!

Now, of course, the reality is different. I have children of my own, many relatives have passed away (and a few new ones have appeared on the scene!) and my life as an adult is far different than it was as a child. I’ve had to adjust. But still, the idea is, as an adult, I may spend quite a bit of energy trying to make the holidays “perfect” for my kids, to make sure that I get a card for every last person on my list, to try and see (or at least reach out to) every friend and family member during the holidays, and in the end – it just doesn’t quite measure up. Expectation fails to meet reality. Bang. Perhaps this is where “holiday blues” comes in.

But let’s take it to another level – imagine if you’re an older adult family member, and you’re spending your first holidays alone, or in an assisted living facility or nursing home, or, perhaps both! There really is no question – this will be a different holiday for you. No matter how much you may try, there’s no way this will be like the holidays of yore.

One would think that this would spell huge difficulties for our older adult loved ones spending their first holidays alone, in a foreign environment. Wouldn’t they be at greater risk for depression at this time?

What Research Tells Us About the Prevalence of Depression in Older Adults During the Holidays

Believe it or not, the research seems relatively clear, and you can breathe a bit easier. Despite all of the apparently commonsensical wisdom I’m sketching out above – suicides and depression do not appear to rise during the holidays in older adults, or for younger adults either. In fact, there is significant doubt that there is any “holiday blues” phenomenon at all. Instead, the idea is there is a so-called “post-holiday blues phenomenon,” where depression and suicidality seem to peak in January, just after the holidays are over.

This makes a lot more sense, when you really think about it. The holidays are where lots of activity happens. Frequently, this is a time where family comes to visit, friends send cards, grandkids are seen. There are decorations, there’s special food, there’s a lot of excitement. In virtually all facilities for older adults that I’ve ever known of, there’s always at least some extra effort by the nursing staff to make the holidays special for their residents. Volunteers may come out of the woodwork to hold special events and observances (usually at my facility we often have to turn volunteers away because there are so many requests). It’s a fun, busy time.

But then, when the festivities are over, what happens? After New Years, the activity immediately dies down. Everything goes back to normal. It’s quiet. All the visitors, friends, and family go home. Then, for a number of the older adults apparently – depression kicks in.

I’m not immediately aware of any specific studies done on nursing home residents and the holiday blues phenomenon (but I’m guessing studies have been done), but I thought this study was an interesting take on how older adults may deal with the holidays, immediately post-loss of a spouse (which is often a source of great concern for grown children).

They also found no link between the holiday season and any increase in depression or suicidality with their recently bereaved older adult spouses. However – they did find that risk did spike in January (the post-holiday blues phenomenon), but it also rose during the anniversary of the spouse’s death, and also rose, interestingly, in June. Researchers hypothesized the spike in depression in June was explained by the fact that graduations and weddings often take place then (more anniversary reactions!).

So – what’s the moral of this story? First – the holidays by itself do not seem to be a time to be feared for your older adult loved one who may be facing their first holiday season without their significant other, or in a new and unfamiliar environment (nursing home, etc). As long as the holidays itself wasn’t itself marred by a traumatic event (say, losing their spouse on Christmas, perhaps?), it seems that the happy buzz of activity that the holiday season usually brings yields a somewhat protective effect.

4 Ways To Help Older Adult Relatives Through the Holidays

What advice would I have for family members who wish to help their older adult relative get through the holidays?

First, of course make sure you come and visit! Make sure your loved one remains included in the holiday observances somehow. If your loved one says, “no need to make a big fuss over me” or something like that, consider making a bit of a fuss anyways! I’ve seen this phenomenon before, the stoic grandfather or grandmother who discourages family to visit because they don’t want to make life difficult for their kids and grandkids. Obviously, you want to make the effort because you care about them. So do!

Second, unless the holidays themselves for some reason are a particularly sad time for your loved one (e.g., one of the holidays fell close to, or on top of the death of a loved one, or some other personal tragedy), just relax. For the most part, the “holiday blues” phenomenon appears to be a myth and in fact may be a particularly happy time for older adults.

Third (and perhaps most importantly) – if you’re particularly concerned about the well-being of your loved one, make sure you make extra visits and pay extra attention to your loved one in the immediate post-holiday period (January – February). Also target more attention and visits around June. Try and visit during important anniversaries if you can, particularly on the anniversary of the death of a spouse.

Finally, when you’re with your loved one, what do you do? Remember what I talked about in a previous post, regarding reminiscence? As you’re celebrating the holidays with your loved one (father, mother, grandmother, grandfather, etc.), and including them in the holiday tradition, spend some time talking about the memories of holidays past. This will allow your loved one to do some really important stuff – reconnecting with their sense of self, in a really happy, joyous way.

I hope you have a wonderful holiday season!

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