The Holidays and Dementia

The holidays are a time when family and friends often come together. But for families living with Alzheimer's and other dementias, the holidays can be challenging. Take a deep breath. With some planning and adjusted expectations, your celebrations can still be happy, memorable occasions.

Check in with the person with dementia...

• In the early stage, a person with Alzheimer’s may experience minor changes. Some may withdraw and be less comfortable socializing while others may relish seeing family and friends as before. The key is to check in with each other and discuss options.
  
• Plan the holidays together, focusing on the things that bring happiness and letting go of activities that seem overwhelming or stressful.
  
• For people in the middle or late stages, consider rethinking holiday plans. Everyone is unique and finding a plan that works can involve trial and error.
  

Familiarize others with the situation...

• The holidays are full of emotions, so it can help to let guests know what to expect before they arrive. If the person is in the early stages of Alzheimer's, relatives and friends might not notice any changes. But the person with dementia may have trouble following conversation or tend to repeat him - or herself.
  
• Family can help with communication by being patient, not interrupting or correcting, and giving the person time to finish his or her thoughts.
  
• If the person is in the middle or late stages of Alzheimer's, there may be significant changes in cognitive abilities since the last time an out-of-town friend or relative has visited. These changes can be hard to accept. Make sure visitors understand that changes in behavior and memory are caused by the disease and not the person. You may find this easier to share changes in a letter or email that can be sent to multiple recipients.
  

Adjust expectations...

• The stress of caregiving responsibilities layered with holiday traditions can take a toll. Call a face-to-face meeting or arrange for a group discussion via telephone, video chat or email for family and friends to discuss holiday celebrations. Make sure that everyone understands your caregiving situation and has realistic expectations about what you can and cannot do. No one should expect you to maintain every holiday tradition or event.
  
• Be good to yourself. Give yourself permission to do only what you can reasonably manage.
  
• Let others contribute. Have a potluck dinner or ask them to host at their home. You also may want to consider breaking large gatherings up into smaller visits of two or three people at a time to keep the person with Alzheimer's and yourself from getting overtired.
  
• Do a variation on a theme. If evening confusion and agitation are a problem, consider changing a holiday dinner into a holiday lunch or brunch. If you do keep the celebration at night, keep the room well-lit and try to avoid any known triggers.
  

Involve the person with dementia...

• Build on past traditions and memories. Focus on activities that are meaningful to the person with dementia. Your family member may find comfort in singing old holiday songs, watching favorite holiday movies, or looking through old photo albums.
  
• Involve the person in holiday preparation. As the person's abilities allow, invite him or her to help you prepare food, wrap packages, help decorate or set the table. This could be as simple as having the person measure an ingredient or hand decorations to you as you put them up. (Be careful with decoration choices. Blinking lights may confuse or scare a person with dementia, and decorations that look like food could be mistaken as edible.)
  
• Maintain a normal routine. Sticking to the person's normal routine will help keep the holidays from becoming disruptive or confusing. Plan time for breaks and rest.
  

Adapt gift giving...

• Encourage safe and useful gifts for the person with dementia. Diminishing capacity may make some gifts unusable or even dangerous to a person with dementia. If someone asks for gift ideas, suggest items the person with dementia needs or can easily enjoy. Ideas include: membership in a wandering response service with identification bracelet, comfortable clothing, favorite foods and photo albums.
  
• Put respite care on your wish list. If friends or family ask what you want for a gift, suggest a gift certificate or something that will help you take care of yourself as you care for your loved one. This could be a cleaning or household chore service, an offer to provide respite care, or something that provides you with a bit of rest and relaxation.
  

When the person lives in a care facility...

A holiday is still a holiday whether it is celebrated at home or at a care facility. Here are some ways to celebrate together:

• Consider joining your loved one in any facility-planned holiday activities
• Bring a favorite holiday food to share
• Sing holiday songs and ask if other residents can join in
• Read a favorite holiday story or poem out loud

Source: Alzheimer's Association. Provided in partnership with ERS Parish Health Ministry, Dementia Inclusive Cincinnati and Episcopal Church of the Redeemer.