Aged to Perfection

Most of us can agree that the holiday season often ends up feeling frenzied and hectic.  We’re fully aware of which season it is, we’re mentally prepared for the change in routine and all the additional activities and events that come with the season, and even still, we seem surprised each season that it’s frenzied and hectic.

Imagine how much more this feeling is magnified for those who have dementia.

The frenzied holiday season feeling may have different causes for you versus your loved one who has dementia, but it is important to acknowledge that the stress is still present regardless. For you, the stress may come from trying to fit too much into too little time—shopping, wrapping presents, decorating, baking, cooking traditional meals, attending extra events, etc.

You might think that someone with dementia is exempt from all this stress, and indeed, they may be blissfully unaware of some of those holiday elements. They may not have a shopping list to attend to, and they may not be worried about decorating or baking, but the holiday season can be stressful in other ways.

For someone with dementia, the ability to preplan and mentally prepare is inhibited.  They are not able to reassure themselves that “this is December, and this month tends to be hectic, but it’s just temporary.”

When someone with Alzheimer’s has very limited short term memory, they will not be able to remember your explanation that the change in routine is due to the holiday season. For example, the day program they typically attend two days weekly is cancelled for Christmas Day, Boxing Day and New Year’s Day.  Not attending day program for a few weeks will feel disorienting. They will need constant reminders of why and how the routine has changed.

Keeping track of events and holiday gatherings may be challenging or impossible. Looking at a calendar and interpreting what is happening today versus tomorrow versus next week is quite abstract and becomes difficult when someone’s brain is impacted by dementia. A calendar is of limited use when someone has trouble remembering which day it is today.  Someone with dementia may not be able to keep track of additional holiday gatherings and events.

Familiar environments suddenly look different now that decorations, trees and blinking lights have been added. For some people, decorations will feel comforting and bring memories of holiday seasons of the past. For others, the sudden change in their familiar environment may feel disorienting.

Likewise, large gatherings can have a disorienting effect. Even when it’s gatherings of family and friends, large groups can be overwhelming for some people. Too many of these gatherings over a short time period can increase someone’s stress level.

People with dementia are often highly sensitive to the emotions of others around them.

If you are highly stressed or feeling frenzied, they will pick up on that emotion and respond to it.  If the context is not entirely clear to the person with dementia, they may even conclude that you are stressed or frenzied because of them.

While your loved one may not be keeping track of the shopping list and cooking for the family gathering, they are still experiencing the holiday frenzy, just differently than you are.  Be aware of what may be contributing to their stress or disorientation and try to reduce those factors as much as possible.  Since you do have the ability to pre-plan, you can mentally prepare yourself for the holiday season knowing that your loved one may have stronger or different reactions than usual because of disrupted routine or change to their environment. Just being prepared for different behaviours, reactions, or functioning levels can make a huge difference.

For more tips on how to support someone with dementia through the holiday season, please click here.​

Do you ever find the holidays overwhelming? There are lights and music, decorations and crowds, shopping and cooking, parties and dinners, rich food and alcohol, late nights and busy days— sometimes it feels like you need a holiday to recover from the Christmas season!

If we feel overwhelmed during this season—and we are cognitively well, our brain is fully working—then imagine how overwhelming the holidays may be for someone who has dementia. Someone with dementia may not remember what “Christmas” or “the holidays” mean because they become abstract terms. 

Here are 6 holiday tips to help a loved one with dementia through the holidays!

Beware of Decorations

You see an impressively life-like St. Nicholas welcoming people to your front hallway, but what does your loved one with dementia see? Is she concerned about “the man in the hallway who isn’t having dinner?” Life-like or oversized decorations can be confusing or even scary to someone with dementia. Consider from their perspective how the decorations could be misinterpreted.

Flashing lights draw a mixed response. Some people with dementia are mesmerized by flashing lights; others become alarmed or agitated. Keep consistent bright lighting in all rooms. Dark rooms with candlelight or just the tree lights may be fearful for someone with dementia.

Remove all ornaments that are not edible but look like real food. Fake gingerbread men or houses, fake candy canes or apple ornaments should all be avoided. Someone with dementia may not realize that it is just an ornament and may attempt to eat the decoration.

Have a Quiet Room

You want to include your loved one who has dementia, but you also need to provide a space where they can retreat and have some peace and quiet. People with dementia typically interact best in small groups or one-on-one. If a loved one with dementia is attending a large family gathering, set up a separate room—well lit with comfortable furniture—and recommend that family take turns visiting that person, one at a time. This allows for quality interaction in a way that best matches your loved one’s needs.

Maintain Routine

Routine is often the first casualty of the holiday season. We stay up late at night, we don’t eat meals at the usual time and we often stray from our usual, healthy diet. Remember how you felt last January after eating heavily and having your routine interrupted? Now imagine someone with dementia. The person with dementia cannot rationalize why they feel different, all they know is that something doesn’t feel right.

As much as possible, keep routine familiar and consistent. Try to maintain regular meal times (even if that means eating separately from the party), and try to limit intake of rich, sugary foods or excessive alcohol. Respect nap times and bedtimes—sleep is as important as ever! By maintaining routine as much as possible, your loved one may be able to better handle the surprises that come with the season

Forewarn Family

If family members live at a distance, they may be visiting for the first time since the last holiday season. Your loved one may have changed significantly since last holiday season. Advise family and friends in advance so that they know what to expect. Request their assistance in making the holidays easier for your loved one, and outline exactly what you need them to do. Here are some suggestions:

• Please do not ask “do you know who I am?” this causes undue stress. While she may not be able to name you, grandma knows you are an important person whom she loves.
• Please be aware of the fact that mom now needs to take some time away from the crowd. She finds noise and groups over-whelming. We will have a Quiet Room set up and we invite you to visit mom one at a time in the quiet room.
• Please do not encourage alcohol consumption by saying “it’s only one drink!". Dad is now on a medication that does not react well to alcohol and he will not enjoy the event as much when he is trying to process the alcohol.

Set Realistic Expectations

Set realistic expectations for your loved one by limiting the number of events they attend. No more than one event or activity in a given day; only a few in a week with recovery time between events. Step back and try to asses what is realistic for your loved one. Maybe a dinner with 50 people will not be a successful event, but attending a hymn sing would better match your loved one’s preferences and current abilities.

Your loved one will not be able to suddenly do more or handle more because it is the holiday season. If anything, their coping abilities may be taxed and they may become agitated or stressed more easily than usual. Be realistic when scheduling the season.

Select the Top Priority

What is more important—that your loved one attend every event and every tradition is followed in detail, or that your loved one has a merry Christmas feeling loved and happy?

If the top priority is your loved one having a wonderful Christmas season, then focus on the elements that create that sense of joy, peace, and love for them. If you really analyze it, you’ll realize it has nothing to do with decorations or traditions. It has everything to do with family and interaction.

If you are stressed because of holiday prep, your loved one will feel that stress and not enjoy the season. A person with dementia would rather have you slow down, match their pace, and be patient than present a tray with 15 varieties of home-baked cookies that stressed you out! 

Your loved one with dementia might enjoy singing a few familiar Christmas carols (because the words of those favourite tunes tend to stick), rather than feel the pressure of keeping up with an animated conversation at a cocktail event.

What will make your loved one smile? When will they ssem most at peace? What will have them feeling safe, secure and love? Aim to focus on those elements and your loved one will have truly blessed Christmas.