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Holiday Challenges for Older Adults

Advice on how to cope with holiday grief and stress

Lonely woman during ChristmasIn addition to bringing joy, the holiday season can also bring challenges, particularly for older adults and their caregivers. Erin Emery, PhD, a clinical psychologist who specializes in geriatric issues, talked about these issues — and strategies for dealing with them.

Q: What are some of the challenges older adults face during the holidays, and what are the best ways to approach them?

Emery: Older adults, like younger adults, focus on families around the holidays, so any losses in the family often come to the forefront. And older adults, by virtue of having lived longer, are more likely to have experienced losses.

It can help, in these situations, to have some way to honor people who are no longer there: taking a moment of silence, for example, or continuing a tradition in honor of someone who isn't there anymore so that they remain a part of it. The challenge is shifting from focusing on the loss to focusing, particularly during the holidays, on the gift of their life.

Also, holidays are lonely times for many people, particularly for older adults who may not live near their families, because it often feels like it should be a time when family should be around. Many people reason that if they feel alone, going out and seeing other families together will make them feel lonelier, so they might as well stay home.

But that can actually make you feel more isolated and lonely and can perpetuate the distress. Instead, it's better to work on scheduling time with other people or activities you enjoy.

Q: Do you have any advice for caregivers of older adults dealing with these issues? Or for caregivers dealing with their own holiday challenges?

Emery: Many caregivers now are part of the sandwich generation — taking care of their kids and their parents at the same time. So one of the things around the holidays that causes caregiver stress is that they may feel they need to manage everybody and everything, uphold all the traditions and generally make sure everything is just right.

But if you're balancing all of those responsibilities, it's important to cut yourself some slack, realize that maybe offering to host and do all of the cooking might not be the greatest idea, and see how much you can share the load.

So for caregivers of higher functioning older adults, for example, asking for their help in holiday preparations can help. That does two things: It not only offsets the stress for the caregiver but also provides meaningful activity for the older adult, makes them feel more included, and honors the gifts they have to offer.

Q: What about when stress extends past the holiday season? What are some strategies that older adults and caregivers can use to combat stress both during the holidays and beyond?

Emery: There are two sides to your nervous system: the sympathetic and the parasympathetic. The sympathetic side is reactive. It's what gets your blood pressure up and tightens your muscles and causes all the kinds of things you tend to experience when you're stressed out; when people are really stressed, that sympathetic nervous system can be in overdrive.

The challenge, then, is to activate the parasympathetic system, which is the one that brings us back down and helps us to relax. I like to say that you need to give your parasympathetic system a workout. And what that entails can be as simple as closing your eyes and slowing down your breathing. The slowed breath triggers an antidote to the stress response.

Another important strategy is to keep doing whatever you do that brings you joy. That could mean being around other people; or maybe it’s painting or cooking or reading. These things may not take away the fact that it’s a difficult time. But they will bring moments of peace.

Q: When should you seek help?

Emery: If you experience five or more of the following symptoms for two weeks or more, you may have an illness. Talk with a doctor or psychologist about getting help to alleviate your symptoms.

  • Agitation, restlessness and irritability
  • Dramatic change in appetite, often with weight gain or loss
  • Difficulty concentrating
  • Fatigue and lack of energy
  • Feelings of hopelessness and helplessness
  • Feelings of worthlessness, self-hate and guilt
  • Loss of interest or pleasure in activities that were once enjoyed
  • Thoughts of death or suicide
  • Trouble sleeping or excessive sleeping

December 2011