As the holiday season approaches, plans to be with family and friends can make most people feel a sense of cheer and excitement. However, older adults may find themselves feeling isolated and depressed during this time of year. For many older adults, the holidays represent a time of sadness due to the loss of family members and loved ones or an incapacitating illness. The absence of social interaction can also contribute to vulnerable feelings of loneliness. Changes in community or surroundings can be contributing factors. Inclement weather, which tends to keep people indoors, can also be a contributing factor because it makes travel and socializing outside of the home difficult for older adults during the holidays.
Older adults, particularly those with two or more chronic conditions who lack social connections or report frequent feelings of being alone, tend to suffer higher rates of death and disability. Both social isolation and loneliness have been associated with increased mortality in seniors, an increased risk of cognitive decline, depression, higher blood pressure and long-term illnesses. Without loved ones to look in on them now and then, isolated older adults are at higher risk of elder abuse. The holidays are prime time for visiting. Visiting loved ones during the holidays help keep those feelings of isolation, and loneliness in check.
Understanding the conditions and signs can help fight social isolation during the holidays. Some of the most common signs of holiday related loneliness and depression are:
- Further isolation from friends and family members
- A lack of interest in things that used to bring joy
- Sudden changes of disposition, often going from cheerful to mean or sad
- Abrupt changes in eating habits
- A severe lack of interest in social interaction
- A severe change in sleeping habits (such as sleeping too long)
- Frequent verbalizing disdain of the holiday season
Clinicians can probe for potential risks among their patients by asking about family and friends or recent losses. Routine monitoring of older adults through Care Management can raise awareness of signs and a plan may be put together by healthcare providers, social services, family and patients to lower risks for social isolation. Care Managers can also make patients and caregivers aware of programs available for older adults, such as active living programs, seniors centers, or transportation options to be able to attend holiday programs or events. Some patients who express severe anxiety during the holidays or exhibit signs of serious physical and emotional decline may be better served by the clinician referring the older adult to a mental health services organization. Care Managers can observe and document changes affecting chronic illnesses such as hypertension, reduced physical activity, worsened mobility, and increased depression.
Staying focused on positive relationships, connectedness and opportunity for healthy interaction is important during the holiday season. By working alongside patients, their caregivers, and resources in the community or even those found in hospitals or assisted living, Care Managers can help older adults recognize and overcome the holiday blues.
Written by Joseph F. West, ScD on Thursday, 22 December 2016. Posted in Social Isolation, Social Interaction, TCM, CCM