One of the best ways to avoid the winter blues is to get out and be active while enjoying some of the beauty of winter. Winter walking is great for physical activity as well as providing relief from cabin fever. Winter walking must be taken seriously though and approached carefully.

Over 12,000 Ontarians land in the hospital each year from falling on the ice. Half of these falls occur in January or February—apparently the two most slippery months of the year. One-third of those falls happened to people who were age 60-79 and resulted in an average hospital stay of 7.6 days.

What you might not expect to find out, is that another one-third of those falls happened to people who were 40–59 years old, and their average hospital stay was 3.6 days. Fall prevention, especially in the winter, is not just an issue that affects the elderly. Winter safety is important for any Canadian who is willing to venture out into the cold!

Here are some basic safety tips to keep you and your loved ones safe this winter.
 

Footwear: good quality winter boots are essential! They need to be waterproof and insulated, have a thick and non-slip tread, have low and wide heels, and be light in weight.
 

Ice grippers: you can attach ice grippers to the bottoms of your boots for added grip on hard-packed snow and ice. Warning: the grippers are terribly slippery on smooth surfaces like tile, stone, or ceramic. You should always be seated when attaching the ice grippers to the bottom of your boots.
 

Hip Protector: wear a hip protector when walking outdoors. A hip protector is a lightweight belt or pants that have shields to guard the hips to give you added protection should a fall occur.

Carry sand: carry a small bag of grit, sand, salt, cat litter—in your pocket or purse so that if you must cross a particularly icy section you can sprinkle some grit first.

Cane or Urban Poles: use a cane, a set of Urban Poles, or ski poles to help with balance. Attach an ice pick to the end of your cane or poles for added stability.

Buddy System: walk with a friend or family member. Canadian winters are unpredictable and for your safety, you should always walk with another person. Let others know which route you will be taking and when you expect to be home again. 

Resort to the Indoors: in the truly Canadian winter storms, exercise indoors. Utilize an indoor walking track where there will be no ice or snow for you to battle.

Triple Vitality: enroll in the one-on-one exercise program offered by Warm Embrace Elder Care—right in the comfort of your own home! You can remain safe and warm at home while still maintaining your fitness and mobility.

Have a safe and happy winter!

When you think of family caregiving which words come to mind? 

What creates the difference between the first column experience and the second column?  How can family caregiving be both frustrating but joyful, a burden and a blessing?

Here are 4 survival tips to take your family caregiving experience away from the first column and into the second column.

1. Take care of yourself

It may sound trite, but self-care is crucial.  If you don’t care for yourself, you’ll have nothing left over to give to anyone else.  You need to allow yourself time to refuel. How you re-energize will be unique to you; there is no right or wrong answer.  Maybe you exercise, or take a warm bath, or play an instrument, or read a book.  It doesn’t matter what you choose to do; it matters that you take time for yourself and prioritize your own self-care.

2. Allow yourself to be "off-duty"

It is not reasonable to expect yourself—or anyone else for that matter—to work or be on-call 24/7. And yet, when in the midst of family caregiving, people often hold themselves to an unrealistic standard of doing it all, all of the time. You need time when you are not “on-call”.

This includes elderly spouses who have assumed the caregiver role and who live together. It can be tough for the caregiving partner to feel “off-duty” when they are at home together with their partner who requires care. Respite care is critical to help both halves of a couple remain healthy—both physically and mentally. 

Feeling “off-duty” also applies to family members who are receiving constant phone calls from their elderly loved ones.  They need time when they can turn off the ringer and not field any phone calls—a timeframe when they are “off-duty” from repeated calls.

3. Enlist support before a crisis emerges

All too often people will say: “Dad won’t accept help from anyone else, so I have no choice!”  Then a crisis occurs and it is Dad who has no choice—he must accept help from another source because you, the family caregiver, are now experiencing your own health issue related to burnout.  Sure enough, Dad does accept the help, although it might have been a smoother introduction to care had it not been a crisis situation.

It will be a kinder transition for your father to accept outside support in a graduated care plan, rather than abruptly. With advance notice and the luxury of time, caregivers can be selected to match your father’s personality and preferences. In a crisis situation, you might have no choice but to get a caregiver—any caregiver—in place the same day.  A more ideal match could have been made with advance planning.

Best of all, your burnout can be prevented in the first place! It is far easier to prevent burnout by providing support early on than it is to recover after burnout has occurred. 

4. Protect family roles and relationships

Caregiving can upset the long-ingrained roles and family dynamics.  A husband who is suddenly thrust into the position of caring for his wife may feel ill-equipped for the role of the family caregiver. He doesn’t feel like a husband. . . he feels like a caregiver.  And she doesn’t feel like a wife. . . she feels like a patient. Their interaction as husband and wife has been interrupted and they begin to interact as patient and caregiver, which may start to stress their marriage.

It is important that key family roles and relationships are preserved. That couple needs to continue to feel like a married couple.  A parent and child need to preserve their mother-son relationship.  It may be best to let certain elements be provided by a professional caregiver so the family relationships can remain intact. 

Family caregivers are SO important to the health and well-being of their loved ones.  It is crucial that their health and sanity are protected.  If the family caregiver burns out, then there are two people requiring care! 

The only way to survive family caregiving and find the positive is to take care of yourself, have time that you are "off-duty", get help in place before it's too late, and aim to protect family roles and relationships for as long as possible. 

Your parents recently moved into a retirement home and you were relieved they’d now have three proper meals per day. With your mother’s progressing dementia, she hadn’t been cooking for quite some time.

There's only one problem.

Your mom has been bringing her purse to the dining room where she stashes extra food!  She takes it back to their room and hides the food and you’ve been finding it in various states of science-experiment decay!

What is happening?

In the past, this might have been called “hoarding”.  But

 “hoarding” has a negative connotation and is quite different than what is happening to your mom.  A more suitable term might be “collecting”.

Her new behaviour is not unusual and it makes sense when you consider what is happening in her brain. 

The drive or instinct to gather is a hard-wired human instinct.  Humans have been hunters and gatherers for millennia.  We have the instinct to gather food beyond what we immediately need to prepare for future hunger.

In modern society, most of us are blessed enough that we don’t have to worry about our next meal. With 24/7 grocery stores, we have access to food at any time.  But for your mother who has dementia, that option is not as viable.

First of all, she likely grew up in an era where stores were not open 24/7.  Secondly, she may feel particularly vulnerable that she has no way of accessing food at any given time—she likely cannot drive, she likely wouldn’t know how to get to the closest grocery store, she might not even have access to money to purchase food.  Her instinct to gather food that is available actually makes perfectly good sense.  She is gathering food because she doesn’t know where her next meal is coming from.

For many people, the holidays can be hard enough as it is. But if you have lost a loved one in the past year(s), then this holiday season might be particularly difficult.

Below are the top 5 strategies to help you survive this season.

1. AVOID COMMITMENTS

Decline invitations for events that aren't particularly meaningful for you personally. For invitations that you would like to accept, only make conditional acceptances—you will attend IF you are feeling well that day, and don't commit to bringing or contributing anything. 

Schedule personal time for yourself. You will need periods of personal rejuvenation to give you the strength to socialize. Grief is a roller-coaster and unfortunately, you cannot predict when you will feel like socializing, and when you would prefer to be alone. Grant yourself the freedom to make last-minute decisions based on how you are feeling at the moment, rather than feeling locked into any specific commitment.

2. REDUCE DECISION-MAKING

You may feel like you are in a fog; everything is cloudy. Even simple decisions have become laborious. The holiday season is full of decisions to be made. This year, offer yourself the relief of reducing as many of those decisions as possible. Ask a trusted loved one to help you with decisions, or remove yourself from stressful situations that require decision making.

Avoid shopping. Shopping is rife with decisions—from the moment you arrive at the mall and need to find a parking space to the point where you’re selecting a check-out lane, you are forced to make decisions that are exhausting. It's okay to take a year off from gift-giving. Selecting gifts (even when shopping online), can seem unbearably overwhelming. Maybe you’d like to give gifts at a different time during the year when you don’t feel as stressed. 

Even the small decisions add up. Decisions that seem inconsequential —which wrapping paper to use, where to string lights, red sprinkles or green—can begin to accumulate and feel overwhelming. By eliminating as many of these details as possible, you will be reserving your strength for the more important elements like seeing people who are important to you and allowing yourself to heal as you grieve.

The people who love you most will understand and they will likely be relieved to know that you are sparing yourself the stress of shopping and wrapping. They will feel honoured that you trust them to understand.

3. ACKNOWLEDGE YOUR EMOTIONS

This holiday season needs to be about you and the others most affected by your loss. Remember—it is okay to cry. It is okay to not be as merry or joyful as others around you. Acknowledge to yourself how you are truly feeling at a given moment, and grant yourself the freedom to react to those feelings in whatever way you need. 

Crying is allowed, even at happy moments. You will not ruin the holidays for anyone else by shedding tears. Smiling and laughing are also allowed. You may feel moments of joy or happiness; enjoy those moments and savour them. You don't need to feel guilty for having happy or sad moments.

You might discover that there are certain times of the day or week that are particularly difficult for you. Allow yourself the freedom to take that time as personal grieving time, and let others know that those times are challenging for you. Your feelings will fluctuate, and that is expected. Acknowledging those feelings and allowing yourself to experience the range of emotions will assist you in your journey of healing.

4. ENLIST THE HELP OF OTHERS

Enlist the help of others, both for holiday-specific tasks, and just daily living tasks. Delegate anything you can—grocery shopping, cleaning, running errands, cooking, etc. Others may offer to help, but they don’t know what to do specifically.

It may also be helpful to let others know how you are feeling so that they don’t inadvertently pressure you. Let others know about your preferences. Family and friends will not know if you prefer to do holidays exactly as you previously did, or if you want everything to be different. Either option is perfectly fine, just let others know what is best for you this year.

5. HONOUR YOUR LOVED ONE

It's important that you acknowledge the loved one who has passed away in a way that is meaningful to you. There are countless ways to do this, and they can be as unique as you and your connection to your loved one. Select something that is meaningful to you.

For instance, incorporate parts of traditions that were meaningful to your loved one—favourite foods or music or decorations. Create new traditions that include elements of your loved one’s personality or values. Light special candles, hang a meaningful ornament, play an important song, watch a favourite movie.

If you’re ready, you might 

decide to look through photo albums, create a scrapbook, read/write letters, etc. Create something tangible in honour of your loved one—sew a quilt, paint, write poetry, carve wood, weld metal, blow glass, whatever your medium is you can create an expression of love.

Honouring your loved one may take many different forms and may change from year to year. The important part is that you and your family always know that your loved one was—and still is—a vital member of your family.

Grief is a journey. It is not a race. It cannot be fast-forwarded or skipped. Although you may be comforted in knowing that your loved one is in a better place, that does not take away your pain. Your grief demonstrates the love you had for that person, and the way you grieve will be unique—just like your relationship with that person was unique. Although the journey is difficult with many ups and downs, it is a healing process.

May you find peace and comfort this holiday season as you respect your own personal needs and honour the person you miss so dearly.

It’s no secret that the holiday season has become increasingly stressful this year for several reasons. In the midst of all the wild events happening in our world, there's still this pressure to orchestrate a picture-perfect holiday dinner.  As we all scroll on Pinterest boards for inspiration, we adding more tasks to our to-do lists for the perfect Instagram worthy Christmas party.

While some people may enjoy making detailed desserts that look like a Martha Stewart display or the hours of Christmas shopping, many others find it stressful. According to the mental health charity called, Mind, at least 1 in 10 people struggle to cope with the pressure of having the "perfect Christmas."

I am sure if you ask your grandparents what Christmas used to be like, I’ll bet they would tell you a different story.  If they were of the generation that lived through the depression era, you can be certain that there was very little—if any—Christmas shopping to be done.

Let's take a pause, a breath and reflect on what matters the most. This holiday season doesn't have to be stressful, you can change that by adopting these three tips inspired by our elders.  

1. Focus was on being together with loved ones and participating in activities together. 

Rather than rushing around trying to have everything in perfect order, focus on doing fun things together as a family. You can play board games, share funny stories around the dining room table, bake homemade goods together, watch funny and heartfelt Christmas movies, and so on. If you can't be with your family physically this year, you can always connect online.

2. Simplicity is key

Decorations were much simpler years ago! Popcorn was strung and used as a garland hung outside for the birds to enjoy. Fruit featured prominently in décor—orange peels were used creatively as little baskets, or peels were dried and cut into shapes. These simple traditions are low-cost and allow everyone to focus on quality time together, rather than stressing about fancy décor.

3. Take a breath and slow down

Perhaps this year you can slow down the pace of the holiday season by practicing the art of saying no. You don't have to do it all, you don't have to host a family dinner again, and most of all it doesn't have to be picture perfect. Be present, slow down, and enjoy the everyday moments. Enjoy your fresh cup of coffee an extra five minutes, read your favourite book in the evening snuggled in a warm blanket, cuddle your furry friend, or whatever helps you to slow down from the holiday rush. 

What I've learned from our clients is that there's something special about holiday traditions. Maybe it's time to slow down and revert to some time-honoured traditions from your grandparents’ era.

In 2014, a number of organizations across Canada came together to promote a campaign called Fall Prevention Month. During the month of November, this campaign encourages organizations and individuals to come together to coordinate fall prevention efforts for a larger impact. The goal is to collectively raise awareness about fall prevention strategies and to help everyone see their role in keeping older adults safe, active, independent and healthy.

How do falls impact seniors?

Unintentional falls are the leading cause of injury for Ontarians aged 65 and over. About 20 to 30% of seniors experience 1 or more falls each year. 

Falls cause:

• 85 % of seniors' injury-related hospitalizations
• 95 % of all hip fractures 

• 50% of all falls causing hospitalization happens at home

• Over 1/3 of seniors are admitted to long-term care following hospitalization for a fall

• The average Canadian seniors stay in the hospital 10 days longer for falls than any other cause
• Falls result in chronic pain, reduced mobility, loss of independence and even death 

Recovering from a fall can be very difficult and with an increasing number of falls, it is important we take measures to prevent them.

How can you prevent falls?

The good news is that falls are preventable injuries! There are five key factors that caregivers and seniors should consider in order to prevent falls.

Eyesight – Vision is an important part of balance and good vision helps to prevent falls. Your elderly loved one could be experiencing vision loss or a condition, such as macular degeneration which is not a part of normal ageing. Everyone who is over the age of 65 should have their vision checked every year. 

Your home – If you have clutter on your floors or stairs, it increases the chance of tripping and/or slipping. Make sure cords, scattered rugs, pet toys, books, etc. are in their proper place. Also, if your home is dark it increases the chance of falling, especially on stairs. Make sure to create a space that is well-lit! 

Exercise - the most important thing you can do to prevent falls is to stay and remain strong! Walking, fishing, gardening, tai chi. Light yoga – whatever you enjoy! – do it to increase activity levels. At Warm Embrace elder care, our caregivers can help encourage and motivate your elderly loved one to stay active through our program called Tiered Exercise Program.

Medication – Some medications cause dizziness on their own, or when mixed with others. It’s important to properly manage your health! Always take medication as directed and ask your pharmacist to review them if you are taking more than 2 medications.

Eating a healthy diet – Vitamin D and calcium help to keep strong bones. A diet to include more greens, lean protein, and less sugar will help you in remaining strong. You may want to talk to your doctor about supplements or other alternatives. 

Most of all, don’t do it alone!

It takes a community to prevent a fall and we all have a role to play. Here at Warm Embrace, we have a wonderful team of caregivers who can help you and your loved one to remain safe at home.

Do you know a senior who has suffered a serious fall? Likely you do, since approximately 30% of seniors who live in the community suffer a fall each year. The consequences of a fall can be quite serious—injury, hospitalization, even death from complications.

Did you know that falls are the cause of 90% of all hip fractures, 50% of all injury-related hospitalizations in seniors, and the 5th leading cause of death in the elderly?! These numbers also double when a senior has dementia. So, it is extremely vital in keeping seniors strong and steady on their feet.

Why do seniors fall in the first place?

“Falling isn’t as much about slips and trips. It’s about the failure to recover. Slips and trips happen at all ages” (Dr. George Fernie). There are various external factors at play that contribute to slips and trips; such as:

• Loose carpets/rugs
• Poor lighting
• Unstable chairs
• Steep stairs
• Poor footwear (e.g. slippers)

While some falls can be attributed to tripping—such as tripping over floor mats, pets or curbs—other falls seem mysterious. The person will report that they just went down and we're not sure why. In many of those mysterious cases, the fall is due to internal factors such as:

• Visual and hearing deficits
• Vestibular dysfunction
• Cognitive impairment
• Neuropathy (abnormal sensory feedback)
• Low blood pressure
• Edema/swelling
• Pain and foot drop
• Weakness and tightness
• Decreased flexibility
• Slowed reflexes and balance disorder 

What can we do to prevent falls?

Get rid of all the external factors that cause slips and trips! Ensure that your living space has no loose carpets or rugs, the lighting is bright for increased visibility, all chairs are sturdy with armrests, everything needed is on the main floor (no stairs), and that proper footwear is worn in the house.

Improve balance and stability!

“She says she wants to keep living in her home. We say it starts by keeping her on her feet” (American Academy of Orthopedic Surgeons). The number one key to fall prevention is staying active! Physical activity has shown to mitigate the deathly consequences of falls – just walking, gardening or housework is enough for an elderly loved one.

However, when your elderly loved one refuses to do regular exercise the best option is to increase their base of support.

To remain balanced, there must be a stable base of support—the wider the base of support the more stable it becomes. The base of support is the invisible box that can be drawn around your feet when you are standing. Added to this is our centre of mass—which is approximately where our belly button is located.

When someone’s centre of mass is in the middle of their base of support, they are perfectly balanced. When their centre of mass begins to reach the outer edge of their base of support, they are more prone to falling.

For example, a ballerina narrows her base of support to be only one square inch when she is en pointe. Her balance is quite precarious because her base of support has been reduced. The only way that she remains upright is by perfectly hovering her centre of mass over her base of support.  She is constantly adjusting to ensure that her centre of mass doesn't sway too far aware from her base of support.

In the case of a frail senior, their feet may ache or have bunions, causing that person to only walk on the edges of their feet, which reduces their base of support and their balance. Instead of using the full surface of their foot, they have reduced their base of support more like a ballerina.  As well, the senior’s posture may be more forward-leaning, pushing the centre of mass to the outer edge of the base of support, causing instability. A senior will not likely be crouching down to touch the ground for support, the way a football player does.

The best way to create a strong base of support is to use a walker. The four wheels of the walker expand someone’s base and provide the necessary support. Much like a football player, a well-balanced senior using a walker is less likely to fall than a senior who is precariously balancing on sore feet. If their posture is forward-leaning then the walker extends the base of support ensuring that the centre of mass remains in the middle of the base of support.

Encourage the seniors in your life to carefully assess their centre of mass and base of support to ensure that they are as safely balanced as possible. Every fall that is prevented is a great success and ensures a longer and healthier life for that senior. 

You’re worried about your parents and you think they could use more help.  You suggested home care, but they wouldn’t hear of it.  They told you: “we’ve managed just fine on our own this long, we don’t need any help.” What they're really saying is that they don't want to face change. That's because change is scary.

Change is scary for all of us, at some level. Each person has a different tolerance for change, and it might take a lot more change to scare some people than others. But if you introduce a drastic enough change, eventually, any of us would feel trepidation about that change.

It’s little wonder then, that for seniors in their 80’s or 90’s, the thought of even a small change can be quite scary. After eight or nine decades, they are likely pretty set in their ways. They want things done a certain way; they want to keep their environment the same. As long as everything remains the same, it feels more manageable. It might help your parents to understand that home care is all about reducing the amount of change that your parents will experience. 

Warm Embrace caregivers are trained to match each client's specific preferences. 

Caregivers DO NOT barge into a client’s home and just take over. Caregivers DO wait to be invited in, and they ASK permission to proceed. They ask how that particular client prefers the laundry or housekeeping to be done. They cook from the client’s recipes or directions to match their particular tastes.   They help to keep clients’ lives consistent.

Homecare is one of the best prevention strategies for one of the biggest possible life changes: admission to a long-term care home.  Moving to long term care is a HUGE change—absolutely every single element of someone’s routine is changed. From the time they get out of bed, to when they eat, and whether they wear pyjamas to breakfast—everything is adjusted to match the schedule of the long-term care home.

Homecare ensures that individual clients maintain their own personal routine, they maintain their home, they maintain familiar comforts.  Caregivers match clients, rather than clients matching caregivers.  It reduces the amount of change they must experience.

Since home care is completely client-focused, each client calls the shots. The client decides what they’re doing each day and how they want things done and in which order.  It is very empowering for seniors to get to make all the decisions that impact their own day-to-day living.  Homecare grants this level of autonomy and independence.

Help your parents see that home care will ensure the least amount of change and help to maintain the lifestyle that they know and love. 

Maintaining good mental health requires just as much attention and care as maintaining good physical health. In reality, mental health is a continuum, a scale that ranges from mental wellness to serious mental health challenges. When someone experiences drastic stress in their life, their mental distress level rises.  It is important to have adequate coping mechanisms in place to help reduce one’s mental distress level and maintain mental wellness.

The Canadian Mental Health Association defines mental wellness as “a state of well-being and the ability to function in the face of changing circumstances.” This includes handling stress and loss, relating to other people, and making decisions.

Dealing with stress though is not an innate trait in humans; it is a learned behaviour.  Whether good or bad, we learn coping skills from our environment.  Adding positive and healthy coping skills to our lifestyle is crucial to maintaining or gaining back mental wellness. 

Depression is not always something that you can control—it may be related to a specific situation or it could seem to appear for no apparent reason.  Depression may be triggered by loss—loss of a loved one, an important role in life, a job, loss of health or independence.  Any of these losses create increased stress.  Without coping mechanisms, someone’s mental distress level will climb and they may experience depression. 

Depression after any type of loss is likely due to situational depression, and having the right coping skills will be highly beneficial.  It is important to note that clinical depression is an illness that many people experience regardless of their coping skills.  In either case, it is important that you speak to a doctor.

The Canadian Mental Health Association recommends a few key coping skills to help maintain mental wellness.  By implementing these coping methods when you are feeling your mental distress level begin to climb, you may be able to maintain a higher state of mental well-being.

1. Read and Research

The more you know about depression and mental illness, the more empowered you are to protect your own health. You don't have to do this alone! Research can be overwhelming, ask someone you trust to help you learn more about mental health. 

2. Change Your Thinking Patterns

Many depressed people have negative and anxious thought patterns.  Learning to redirect your focus can improve your mental health. A great tool is to journal your thoughts and to track how you got to that negative thought. Remember to celebrate your successes; focus on your achievements rather than focusing on what you are unable to do. 

3. Ask for Help

Requesting help is not a sign of weakness; rather, it requires the courage to reach out to others when you are in need.  Create a support system of caring people whom you can call when you are feeling low.  Have a list of 5 close friends you can count on; if one person doesn’t answer, you have 4 more names you can call.

4. Use Problem Solving

Determine which problems are stressing you, explore possible solutions, try a new solution (as the same old solutions will yield the same old results), evaluate the effectiveness of your new solution, and focus on the progress of your problem solving rather than on the problem alone.

5. Exercise

When you are depressed, the last thing you may feel like is exercise, but the results make the effort worthwhile.  Exercise increases the blood flow not only through your body but also to your brain.  Increased oxygen flow to the brain improves mental functioning and mood. Your endorphins are also elevated through exercise.

6. Eat and Sleep

Eat a properly balanced diet, even if you have no appetite.  Aim to maintain a regular schedule where you eat healthy food at regular intervals.  Sleep on a regular schedule as well.  Ensure that you get enough sleep, but do not oversleep.  Most adults need an average of eight hours of sleep nightly.

7. Enjoyment

Schedule yourself time to rejuvenate.  Prioritize activities that bring you peace and pleasure.  This may include: meditation, being outdoors, various hobbies, caring for a pet, having a massage, etc.

8. Socialize

Do not cut yourself off from social connections during these difficult times. Social isolation only perpetuates depression.  Socialize with close, caring friends who are compassionate and supportive. If you can't meet with your close friends, you can try to connect online through video calls. 

9. Relax Your Standards. 

Many people experience anxiety and stress because they are holding themselves to unrealistic standards.  Determine to not expect more of yourself than you would expect of anyone else.  Be kind to yourself—sometimes, we are hardest on ourselves!

10. Laugh!

A sense of humour can go a long way.  Sometimes, laughter truly is the best medicine.  You don't even have to wait for a comedy act to come to town; through the internet, you can search for endless comedies on YouTube and select comedies that suit your particular sense of humour.

If implementing these coping skills does not improve your sense of mental well-being or if you are currently experiencing other symptoms as well, you should see your doctor.  Medication may be appropriate for you, or there may be a physical explanation for the mental distress you are experiencing.  Your doctor can advise you best.

It is important to know that help is available.  You do not need to live in a state of mental distress.  To learn more about healthy coping strategies and ways to reduce stress, please visit the Canadian Mental Health Association.

Locally, in Waterloo Region, we are blessed to have Here 24/7 — a  service that is available 24/7 to assist with addictions, mental health, and crisis situations.  The number is: 1-844-HERE247 (1-844-437-3247)

Does your family have any Thanksgiving traditions? Do you share memories of years past, and do you share what you’re grateful for this year?

If you have family members who have dementia, there are ways to make these traditions more inclusive and enjoyable for them too. 

The wonderful thing about stating what you’re thankful for is that the answer can’t be wrong!  No matter what you are thankful for, no one else can say that the answer doesn’t count. This is a great conversation starter for someone who has dementia.  It does not depend on factual memory, there is no right or wrong answer, and any answer can spark new discussion.

To make it easier for your loved one who has dementia, be sure to provide an example.  It can be a lot of pressure to ask them first—“What are you thankful for?”  Instead, you can start, and then ask “are you thankful for anything granddad?”

To keep the conversation going, you can encourage reminiscing, but be careful to avoid making grandad feel that he has to justify his answer.  Here are some examples that might echo someone’s automatic response, but are not recommended, followed by an example that is more dementia-supportive.

NOT Recommended:

Granddad responds: “I’m thankful for you!” and you respond “and why are you thankful for me?”  Your intent is to keep granddad engaged in the conversation, but instead, it may feel like he has to justify his answer.  That can add stress and pressure to granddad and he may be less likely to answer any other questions if he has to justify his response.

SUPPORTIVE:

You can affirm his answer by saying “why thanks Granddad, and I’m thankful for you too! I’m grateful we’re having Thanksgiving dinner together with you tonight.”  You have affirmed granddad’s answer and kept your response in the present moment so granddad doesn’t have to rely on recent memory. 

If your granddad’s short term memory is highly impacted, he may have clearer memories of his childhood and he may often talk about his childhood.  He may state that he’s thankful for his mother or his younger sister, both of whom have long since passed.

NOT Recommended:

“Granddad your mother has been dead for nearly 30 years.  Surely you have something to be grateful for today.”  This response tells granddad that his answer is wrong, and it shuts down further conversation.  It eliminates the opportunity for reminiscing and revealing his state of mind or thought process. It may also rip open the wound of grief if granddad has briefly forgotten that his mother is deceased and he may grieve her as though it is a new loss.

SUPPORTIVE:

“oh yes Granddad, your mother was a very special woman.  Do you have a favourite memory of her?”  This response validates Granddad’s answer and opens up the opportunity for more conversation.  The follow-up question is completely open-ended—he can say “no” he doesn’t have a favourite memory and that’s okay. If he is reminiscing and can remember something special, he is free to share.  You might be amazed where the walk down memory lane can lead!

When encouraging someone to reminisce, aim to keep your follow up questions open-ended or opinion-based. If you ask fact-based questions it can feel like a test with an inferred right or wrong answer.

NOT Recommended:

A fact-based question might be: “your mother always baked pies for thanksgiving. Do you remember what type of pie she baked?” There is an inferred right or wrong answer and it feels like a test. 

SUPPORTIVE:

Instead, ask opinion questions that cannot be right or wrong.  “your mother always baked pies for thanksgiving. Did you have a favourite flavour of pie?”

NOT Recommended:

If Granddad responds “I liked mother’s strawberry pie at thanksgiving” and you know that his mother did not make a strawberry pie, do not correct him!  It is NOT helpful to say “oh granddad, that can’t be right. Your mother only ever used fresh fruit from the farm. She made strawberry pies in June with fresh strawberries from the field.  At Thanksgiving, it had to be apple or pumpkin.”

Your response may be factually correct, but does it really matter?  How does it make granddad feel to be corrected? It tells him that his answers are incorrect and will likely shut down further conversation. Is the purpose of the conversation to exchange correct facts, or is the purpose to help granddad reminisce and share positive memories in a loving environment?

SUPPORTIVE:

“Your mother’s strawberry pies certainly were delicious!  Wasn’t there a time when you were a little boy and you stole the pie out of the window where your mother left it cooling?”  You validated your grandfather’s response about strawberry pies without correcting his response. To keep the conversation going, you’ve supplied more information to possibly spark his memory. 

This is a story you’ve heard him tell many times before, and each time his face lights up with a mischievous grin—just like he’s 9 years old all over again!  You’re giving him the gift of remembering a story that he loves to tell, and instead of testing his memory, you spark his memory and let him tell the details of the story as he remembers it.  If his details differ from the last time he told the story, it doesn’t matter. What matters is that he is the star of the moment, telling his story the way he remembers it.

When you're together with family this Thanksgiving, and you have the opportunity to reminisce with family members who may have dementia, aim to provide supportive responses that keep the conversation going. 

Remember that the purpose of the conversation is not to exchange factually correct information.  The purpose is to share quality time with loved ones, validate their feelings, and share a moment of open love and trust.  You may just be amazed at the memories that surface!