Aging, end-of-life expert offers advice for coping with holiday blues

It may be the most wonderful time of the year. But the holidays can also be a time of sadness and loneliness, especially for those dealing with recent death, illness or changes in family life.

Wendy Lustbader, an affiliate associate professor at the School of Social Work at the University of Washington and an expert on how to cope with aging, disability and end-of-life issues, has advice on how to deal with these issues through the holidays.

Lustbader writes occasionally on aging issues at the Huffington Post. In an entry she posted last week, she described talking to a group of elders at Market Heritage House in downtown Seattle about what they missed most during the . Many of the residents were nearing their mid-80s, and they shared yearnings for their parents, nostalgia for homes where they used to gather, and other kinds of sadness that creep in this time of year.

"The mood of the group became warm and convivial as each person thrust aside the curtain of aloneness and took comfort from each other," Lustbader wrote.

Lustbader prompted the conversation during one of her weekly group discussions she leads with the elders, because commiseration can relieve pain. Grief over death or estrangement of loved ones, homesickness, money woes and other sorrows can make it hard to muster holiday cheer.

"If you are having a rough time during the holidays and you're forced to be cheerful, it creates ," she said. "But if you can say who you are missing or what you're going through, then you aren't so alone and you might be able to enjoy yourself a bit."

Lustbader offers some advice below for coping with bereavement, illness, homesickness and other issues during the holiday season.

For those mourning a death in the past year, what might make things easier as they go through the holidays for the first time without their loved one?

It's important for people to realize that the first holiday season without a loved one is the hardest. Accordingly, many people choose to break with their longstanding traditions and do something totally different, like take a trip out of town or spend the holiday volunteering at a soup kitchen. For those who choose to go forward with enacting holiday traditions the way they always have, building in some kind of acknowledgment of the loss is essential. For instance, setting aside time during the holiday dinner for each person to speak about their memories of the person can be enormously comforting.

Injuries, illnesses and grief can make preparations for the holidays too exhausting. Any suggestions on how people should modify their plans?

Here again, the key is not to pretend that everything is fine. Those who don't have the energy or spirit to meet traditional expectations – like baking a certain kind of pie or putting up the decorations everyone expects – should tell the truth of their feelings. It's better to say, "I just don't have it in me this year" than to force oneself to put on a performance. In fact, altering the tradition calls attention to the loss or the difficulty, and this allows others to be respectful toward those who are having a hard time in the midst of the festivities.

Some people can't make it home for the holidays. What can they do to not feel homesick?

Homesickness is like any other grief – we feel better when we talk about it. Getting together with other people who are far from home is especially helpful, because of the shared understanding. Those who can't go home again, due to parents going through a divorce or the family home finally being sold, also need to give voice to the loss. It doesn't matter how old we are. These feelings are universal and can run deep in us.

How can holiday festivities be made more enjoyable for aging family members who face physical and cognitive challenges?

It is helpful beforehand to try to put yourself in the shoes of your older relative. For example, at gatherings a hearing aid often doesn't function well with so many conversations going on at once. Planning to take turns sitting off in a corner with someone where there is less commotion may provide much welcome relief, as well as the pleasure of individual attention. Similarly, bringing someone to the gathering who resides in a care facility may require advance planning about strategies for handling the front stairs, preparing the right food items, and being sensitive to the rush of emotion that may arise as the person is flooded with memories. For those with cognitive challenges, having someone posted by this person's side at all times during the gathering can keep anxiety to a minimum for everyone. Thoughtfulness pays off in creating an experience that will be cherished.

How can families deal with difficult decisions that are looming, such as whether it is time to urge an older relative to move to a supported living residence or care facility?

Sometimes families do take advantage of being together over the holidays to broach complicated subjects about an elder's care situation. Recognizing that there may be several perspectives on what is best is a useful first step. Agreeing to disagree and putting the emphasis on hearing each other out, rather than competing for control, is an approach that tends to reduce conflict. The holidays can be better spent scouting out possibilities and exchanging ideas, rather than allowing old issues and past tensions to get in the way of hashing out the options.

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