Celebrating the holiday season when your loved one has dementia

Holiday gatherings bring joy to family and friends, to celebrate traditions of the season.  But there is also added stress when dementia is added to the equation.  In this article, we will explore some strategies to cope with new challenges caregivers may face with these get-togethers. Here are some situations and suggestions to consider when planning to visit friends and family during the holiday season.

Understanding the disease process

Every individual with dementia is just that, an individual experiencing a disease based upon their own personality and disease progression. Understanding where they are in the disease process, and their particular needs, is an important component in a successful gathering.

Individuals in the early stage of a dementia may still be social, able to recognize family and friends, and carry on a conversation. An individual with mid-stage disease may have increasing problems with language, judgement, reasoning and memory, requiring more assistance with every day tasks such as eating and dressing.  Those with late stage disease may have less mobility, limited language skills (both speaking and understanding) and have difficulty eating or swallowing.

Preparation is key

Consider the following preparation:

• Take with you everything the individual might need during your holiday visit with friends and relatives.  Such as medication, change of clothes, hygiene and incontinence products, snack and bottled water.
• Talk to you friends and relatives in advance.  Explain the current needs your loved one is experiencing. 
• Suggest to friends and relatives they talk to the individual alone or in small groups.  Larger groups can be overwhelming.

• Keep to your loved one's schedule.  If you are staying at a hotel, consider a "break time" so the he or she may rest. That may mean time to nap, have a snack or watch their favorite television show. But a break may make the time more successful.
• If you are staying at the house of your family member, again, it's okay if they need a rest.  Too much conversation can be challenging and tiring for the person with comprehension and memory difficulties.

Meal time

We all love a holiday meal (or most of us do anyway). Food choices for the dementia patient can be extremely difficult.  Consider the following:

• Help them fill their plate at family gatherings
• Instead of asking about a food choice, make a statement about one food at a time. For example "Mom, I'll put some mashed potatoes on your plate." then "Let me put some turkey on your plate", etc.  Too much information or questions at once can be overwhelming.
• Don't overfill their plate.  Small portion sizes, cut in bite size pieces if they can no longer use a knife.
• A spoon is just fine to use as a utensil (and often much easier for those with arthritis).
• Fingers are also just fine. But avoid putting food such as mashed potatoes and gravy on the plate.  You can always put it in a separate bowl and help them eat enjoy it separately.
• Messes happen.  Sometimes the individual isn't as neat as they used to be.  Keep plenty of napkins nearby. 

"I want to go home."

Holiday parties, or any large gathering, can be difficult for an individual with dementia.  They may become increasingly confused and disoriented, even if they have been to the place many times before.

If they become anxious and want to leave, first try quietly talking to them in a low soft voice. Don't yell and try not to become angry yourself as difficult as that may be at the time. This may only serve to agitate the person more.  Take a deep breath and try and reassure them they are alright.

Walk them into a quiet area and continue talking to them quietly.  The quieter and calmer you are, it will help your loved one calm too.  Don't try and rush back into the party.  Plan on sitting with them for awhile. 

Things to consider when behaviors occur

• Are they hungry
• Are they tired and in need of a rest
• If the party is loud, is that agitating them.  If there language skills are limited (especially understanding conversation.  This may be particularly challenging for them.

Sometimes  you need to consider leaving.  Of course this may not seem like your optimal option, but removing the individual from the situation, even to take them for a short drive, may help them relax.  If staying in a hotel, as suggested earlier, consider taking a break and allowing them to rest. 

Holiday Traditions, new and old

Whatever your holiday traditions, engage the individual in celebrating the holiday.  If you have a Christmas tree, talk about the tree and the ornaments.  Let them help you put some ornaments on the tree.  If your religious traditions include prayer, if they are able, encourage them to join you in prayer. These small acts may help create new memories for you and your family, long past the holiday at hand.