December 6, 2005

Aging Connection

Holiday adjustments important for elders—and caregivers

By Vivian I. Silva
Gerontologist/MSW
Special to the Times

It’s that time of the year again and surely readers have been practicing my last year’s suggestions to reduce holiday stress!

Whether stressed or not, caregivers and elders often face challenging holiday adjustments. Elders and caregivers have expectations based on past holiday experiences. Great effort is spent trying to recreate those experiences and often disappointment is the result. Be flexible and the holiday adjustments may be easier than expected.

Here’s an example: an 81-year-old woman always has her family over for Christmas Eve. The grandchildren look forward to her specialty dish and make sure she knows they can’t wait to eat it. She delights in knowing she pleases them so much.

However, her discharge from the hospital forces a change this year. Her daughter insists dinner will be at her home this year. The daughter works full time but is willing to have all the family over and asks her siblings to each bring a dish to share.

As much as the daughter delighted in having the dinner at her mother’s house each year, she realizes her mother can’t continue with the tradition—at least for this year. She tells her mother, “This year we will have to adjust.”

The mother expressed the loss and sadness she felt. She told me, “I hate to admit it’s too much for me. I’ve always loved entertaining for the holidays.”

Similar situations happen each year and suggestions can help with the transition. Assure them you want to ease their recovery. For example, families can include the elder in the menu planning. If they can help in the kitchen, let them.

The woman didn’t argue with her daughter’s suggestion. She gracefully admitted her idea would be better for everyone even though it wouldn’t be easy to give up entertaining in her own home.

Elders can be helpful by making sure the family member knows their intentions are appreciated. Allow the caregivers to help without giving strong resistance.

Caregivers may have their own internal battle. Feelings of guilt for having to take over are not uncommon. But on the other hand, if they don’t offer to change the holiday tradition, they fear putting the elder at further risk for declining health.

Another client, a 70-year-old male on oxygen didn’t want to leave the comfort of his home. His son and daughter-in-law always host the holiday dinner, but this year he’s announced he’s not going anywhere for the holidays. He wasn’t sure how they’d react.

The man explained to the family why he didn’t want to leave his home. He reassured his son and daughter-in-law by saying how much he’s enjoyed past holidays but just wasn’t up to leaving his home this holiday.

In a case like this the family can bring the festivities to an elder; but make sure the elder wants company. When the family offered to come to his house, the man replied, “As much as I love my family, I’m not up to the noise.”

Perhaps a mid-day visit works better. Maybe staggered visits from family members would also be helpful. And be sure to bring a plate of food for him to enjoy.

The key is to be respectful of an elder’s wishes. Ask him what he thinks would work this year. He might not mention that he’s fearful of incontinence. Perhaps he’s embarrassed he needs the oxygen. Try to engage him in conversation to help understand why he wants to stay home.

Dementia requires special consideration. The traditional environment may not be familiar anymore. The extra noise and activity can be unsettling. Quiet and low-key activities may be better. Plan ahead by providing a quiet space if the elder wants to rest. With or without dementia, expectations for the holiday need to change.

Be alert to the elder’s needs such as when they are ready to leave or when they are ready for company to leave. Make sure the elder won’t be at risk with the extra clutter of boxes, toys, etc.

With thanks for your comments and phone calls this past year, I wish you all a wonderful holiday season.

To submit a question for the “Aging Connection” column, e-mail Gerontologist/MSW Vivian I. Silva at vivsilva@aol.com. To make an appointment with the Geriatric Advisory Program at the Almaden Valley Counseling Service call (408) 975-2988. The next six-week Caregiver Support series starts in January.