As the temperatures fall and snowy conditions send people indoors, those who are limited in their ability to withstand the weather and the gloom of winter are more likely to suffer from the isolation that comes with it. Checking in on that elderly neighbor or family member may not only brighten their day, it might even save their life.

The elderly, which are classified as anyone over the age of 65, are more susceptible to the changes that come with the winter months. Less sunlight, more aches and pains plus fear of falling on slippery conditions, drives them inside and away from social interactions.

“The elderly, are more prone to

ambulatory dysfunction. They’re more prone to hip fractures and other co-morbidities that typically younger patient populations or younger populations are not accustomed to. So the elderly are more prone to falls to start off with the basics,” said Dr. Sunkesula Krishnasai Kaus Sagar, a Family Medicine physician with Geisinger in Lock Haven.

“You want to try to protect our elderly population from exposure to snow and black ice and the cold, to diminish their chances of the risk of falling,” he added.

Sagar suggested that someone might pick up an elderly neighbor’s or family member’s groceries or medication or drive them to their car or drive their car to them prevent them from having to walk in hazardous conditions.

He also addressed Seasonal Affective Disorder or SAD which can affect anyone, but particularly the elderly who are more likely to be avoiding going out.

“(It) can definitely cause our elderly population, due to lack of sunshine, hence the lack of interaction with their friends, to tend to get a little bit more depressed than they otherwise would, because the days are shorter, they’re more likely to be more depressed, more likely to feel feelings of isolation. So especially when there’s winter storms and they can’t get out or see their friends, they tend to experience isolation and loneliness a lot,” Sagar said.

“So it’s kind of important to check in on our elderly ones, just to make sure that you know their emotional needs are also addressed as well,” he said.

Kati Lorson, PA-C, Geisinger physician assistant, Lock Haven, also addressed what might trigger SAD in the elderly.

“The fact that the winter is associated with the cold, dreary, it is dark more often, this can lead people to feel more depressed because they’re not getting the warmth and sunshine and being able to enjoy the outdoors that they like to,” Lorson said.

“As with any form of depression, patients might start to decline doing things that they previously enjoyed, maybe like spending time with their friends, isolating themselves away, speaking on the phone less. They may have more of a sad aspect, or just appear to not be acting like themselves,” she added.

In addition, the elderly sometimes can experience an increase in aches and pains during the winter months.

“We often hear elderly and other patients stating that their pain is worse, secondary to the cold. And so with that in consideration, you know, families should be aware that they might not be as interested in leaving the house to go do things, so planning a day in and spending time with them might be more beneficial,”

Sagar explained that there are different signs to look for that signal someone is depressed. In the medical profession they are known by the pneumonic device SIGECAPS, with S for sleep, I for interest, G for guilt, E for energy, C for concentration, a for appetite, P for psychomotor and S for suicidal questions.

“Are patients experiencing more or less sleep? If there’s any changes in the type of sleep that can kind of give us a hint, How are their interests? Are they showing reduced interest in what they usually find interest in? How about pleasurable activities, like games or board games, or watching their TV shows…where they’re not even showing any interest in that? That’s something that we look for too,’ Sagar said.

“Feelings of guilt or worthlessness — that’s the G in SIGECAPS. Are they experiencing more fatigue than usual? Loss of energy? Is that something that they’re going through? How about concentrating with the CAPS? Are they having any difficulty focusing or making decisions? Appetite is also something that we screen for. Are they having significant weight gain or loss? Are they having any increase or decrease in their appetite that can kind of give us a clue as to whether there is a depression that is flaring up or not? Also psycho motor, the P…are they more agitated, or are they slowing down? And of course, the s. We cannot address depression without addressing suicide. Are they having any thoughts of death or suicide? So we typically ask all these questions in the medical facility, and that can kind of gauge us whether you know they’re Seasonal Affective Disorder is flaring up or not as well,” he said.

In addition to the psychological effects of being isolated at home, there are the safety issues inside the home that can also be discovered by checking in on the elderly.

“When it comes to the routine blizzards we have, we have to worry about electricity. We have to worry about heat, making sure that their heating is working appropriately. What kind of heating devices they’re using. If they’re using, you know, those portable heaters, making sure that the carbon monoxide detectors are working, just in case there’s a fire, or just in case there’s any hazards that can set off with a furnace that’s operating incorrectly. Just to make sure that they have adequate heating sources and they’re safe in a safe environment,” Sagar said.

“Also, what is their plan of action when it comes to power outages? When there’s a power outage, what do they have loved ones that they can go to, food, water, shelter,” he added.

Snow storms also bring sidewalks that need to be cleared and cars that need to be dug out.

“The elderly, of course, with shoveling and the snow, tend to over exert themselves,” Sagar said.

“Helping our elderly with shoveling snow, limiting the access to snow and black ice…goes a long way,” he said.

The elderly often do not want to accept help, so how do you approach the situation while still allowing them their dignity? Sagar posed a solution, coming from his experience as a son and not as a physician.

“If my mom is refusing help, well I’ll make it look like I’m not helping her. I’m helping me,” he said.

“So if my mom is at home, I’m just gonna make up an excuse to go to her house and make it look like I need her help instead of her needing mine. That’s what I would do as a son. I would phrase my answers in a way where, like, ‘Hey, Mom, I just want to make sure that your heater works as well as my heater, because I don’t think mine is working well, can I just come over?’ ‘OK, Mom I’m just grocery shopping right now. Do you just want me to drop something off for you? Is there a list of groceries that you want that I can help drop off?’ Or, ‘Hey, Mom, can I shovel your driveway? I need the exercise,'” he said.