By ROBERT JUMPER
Tutiyi (Snowbird) and Clyde, N.C.
Make a point of visiting a rest home or nursing home during the holidays. I know that sounds like an admonition, but it isn’t entirely. It should be a reminder and an incentive for compassion during this season of giving.
Visiting elderly family members who have been institutionalized is an emotionally draining experience. The feelings may range from fear to sadness to guilt. After all, this loved one might have been an integral, active part of a family and now has lost the ability even to manage their personal affairs or physically navigate outside the walls and fencing of a care center. For the elderly, the sense of pride and dignity may be lost to a sense of depression. Those feelings of depression and sorrow can be deepened by loneliness and isolation.
Imagine being a thriving part of a family and community. You are in constant demand. You are engaged and contributing. But as you grow older, your ability to engage and participate begins to wane. You make fewer trips out of your home. You particularly curtail night activities because you don’t see as well in the dark even with glasses and vehicle headlights. Your reaction time is not what it used to be, so you are fearful of driving. As time passes, your mind and motor skills deteriorate to the point where you don’t want to be out of your home unless someone picks you up and drops you off. Then, the time comes when even moving around the inside of your home is dangerous because of feeble limbs, lack of balance, and loss of memory. Every moment and movement bring fear of an injury or something worse. But it is next to impossible to give up the illusion of independence and the sense of freedom.
Then, after losing so much, the elderly face the choice of risking serious injury or death or being institutionalized. Many times, the choice is made for them either by their families or the government. The decision is a gut-wrenching one for elders and for the families involved in making the decision. Some families work with their family members to put off the decision for as long as possible, either moving their elders in with them or taking turns living with elders at their homes. My wife and her family would take turns staying over with their parent, who needed 24/7 care until his mental and physical condition deteriorated to the point of needing professional nursing care. Then, they made the heartbreaking decision to commit him to nursing home care. In this case, family members continued to make regular and frequent visits to the nursing home, along with members of his church family, to reduce the hurt and disorientation that he felt because he had to leave the life he had known for the better part of a century.
Many elders are not so fortunate. When they reach the stage of being institutionalized, they are either alone or distanced from their families. As good and as attentive as caregivers are in these facilities, they are no substitute for the feeling of love and familiarity that comes with relatives or long-time friendships. We have already heard the leadership of the hospital system talk about the staffing issues in our elder care facilities that have been a long-term challenge for our tribe and indeed across the region. Even if caregivers want to fill in the gaps that are left behind when elders don’t have anyone else, they simply do not have the time and resources to do it.
So, we often hear in the holiday season, especially from our tribal leadership, about their visits to these elder care facilities. One vivid mental picture is the way they describe some of the residents. It is one that I have seen first-hand as I have visited nursing homes. There will be hallways spotted with elders in wheelchairs, sitting alone, many with blank stares as they see you come in. Others may be talking to themselves, weeping, or jerking in a fitful sleep. Still others will try to engage you, a stranger, in conversation, just to have a moment of contact and human interaction.
The Centers for Disease Control (CDC) reports that 14.2 percent of U.S. adults aged 65 and older have depression. 1-5 percent of older adults in the general community have major depression. 11.5 percent of older adults in hospitals have major depression. And 13.5 percent of older adults who require home health care have major depression. Some of the risk factors for depression in older adults are substance abuse in family members, history of elder abuse, physical dependency, and financial dependency.
“Major depression” is defined by the Oxford Dictionary as “a mental condition characterized by a persistently depressed mood and long-term loss of pleasure or interest in life, often with other symptoms such as disturbed sleep, feelings of guilt or inadequacy, and suicidal thoughts”
One nursing home group further describes the risks for depression in seniors as loneliness, immobility, lack of independence, lack of purpose, fear of the future, and substance abuse. “Many seniors live alone, with limited means to get out and socialize. They have lost spouses, friends, neighbors, doctors, and other associates. As a result, they are highly susceptible to feelings of loneliness and isolation. While some have family nearby, perhaps even living with them, seniors often miss the people in their peer group with whom they shared past experiences and regular conversations. Even if friends are still alive, going out to see them can be increasingly difficult. “(Barclay Friends).
The CDC says, “Those who have chronic diseases are more prone to suffer from depression. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Seasonal Affective Disorder (SAD) is a type of seasonal depression that occurs only during a specific time of the year, such as the winter months and remits thereafter. SAD, also called winter depression or holiday blues, is now recognized as a common disorder among older adults. The following are some signs that a senior may be suffering from depression: persistent sadness, trouble falling asleep or sleeping too much, decreased socialization, loss of interest in usual activities, excessive worrying, irritability, feeling worthless, helpless, or hopeless, changes in appetite, crying spells, and trouble focusing, remembering or making decisions.”
Among the top ways to combat the holiday blues; spending time and providing support, listening to your loved ones, avoiding isolation, and keeping holiday traditions. “Isolation is a cause of holiday depression in seniors, especially those who live alone or in an assisted living or skilled nursing facility. Valentin Bragin, psychiatrist and author of Conquering Depression in the Golden Years, said seniors need to feel connected to others during the holidays. Assisted living facilities usually have special events, meals, and entertainment for seniors. Those who live at home can spend the holidays with family or friends. ‘The key message is to not stay home alone during the holidays,’ Bragin said. ‘Stay active and look for places where people celebrate holidays together.’ Even if loved ones are far away, phone and video calls are a great way to feel connected.” (AMADA Senior Care).
The mission statement of Tsali Manor states, “To maintain our program to a level highly visible in our community where older persons can receive the assistance they need in order to live with dignity and choices in their homes and communities for as long as possible.”
From the Cherokee Indian Hospital Authority website about Tsali Care Center, “Regardless of their physical condition, residents at the Tsali Care Center are offered a wide range of opportunities to enjoy life. Movies, parties, outings, and religious services are just some of the activities available. The joy of dining is not overlooked as our dietary staff prepares healthy meals and snacks designed to meet each resident’s nutritional needs. Family and friends are always welcome at Tsali. Throughout the year, loved ones are invited to special events and outings. Families are also encouraged to personalize resident living areas with favorite items and belongings from home. We are a custom experience that promotes community, safety, and dignity for you and your loved ones.”
From the Mountain View Manor (Bryson City, NC) website, “We believe that quality extends far beyond an individual’s medical treatment or needs. Our commitment to provide quality care includes serving the physical, personal, spiritual, social, and recreational needs of our residents. To provide this service we assess the total needs of each individual and create a plan of care designed to meet those needs.”
From Skyland Care Center (Sylva, NC), “Our favorite aspect of Skyland Care Center is that we are all one family. We treat every one of our residents with the same love, kindness, and respect that you do. Whether a resident’s stay is short or long-term, we ensure quality care that you notice first-hand. The saying ‘Home is where the heart is,’ and at Skyland, our hearts are always right here.”
Our elders need us all the time, but especially at this time of year, that may be so dark for so many of them. Sending or bringing gifts to them is nice and appropriate, but the real gift that they are looking for is you. Spending time with family, friends, or anyone who will pay them attention is better than any material gift you may offer. Your presence is the best expression of love you can offer and it is the best present.
As we end 2024, I would like to thank the Ugvwiyuhi, Taline Ugvwiyu, and Dinilawigi for their ongoing financial and governmental support of the Cherokee One Feather and for being advocates of free press. And special thanks and blessings to Scott and Sheena (they come as a set), Brooklyn, Dawn, and Indica, who are the heart of the newspaper and weekly provide the community with information that they wouldn’t see otherwise. And most of all, I appreciate you, tribal members, community, and readership, for your continued support and engagement. I hope all of you have a safe, happy, healthy, and blessed Christmas and New Year!
