If you’re attending holiday gatherings with a family member who has dementia, then you probably have a lot of questions. Can your family member with dementia still enjoy the gathering? What special changes should you or others make to help your family member? What’s OK to say to them and what’s not OK?
Holiday gatherings may be challenging for someone with dementia for a few reasons:
— They may feel sad because of changes in their own abilities and routines.
— Their caregivers may be overwhelmed and notably stressed.
— A person with advanced dementia may experience confusion and agitation and have trouble communicating.
[SEE: Early Signs of Dementia.]
Should You Include Someone With Dementia in Holiday Dinners?
Involving a beloved family member in traditional holiday gatherings is still important if it’s viable, says Angelina R. Sutin, professor in the department of behavioral sciences and social medicine at Florida State University College of Medicine in Tallahassee.
“Holidays come with lots of traditions and routines and expectations that have been formed over decades, generations even, and there is an expected way that things will be,” says Adria Thompson, a speech language pathologist and faculty member in the Eastern Kentucky University college of education and applied human science.
Weighing the importance of traditions to your family — exactly where, when and how an event should happen — with the adaptations that might be necessary for the comfort and participation of a loved one with dementia, is an important step.
“We need to consider, do we want them to come to a holiday event because we would be sad if they weren’t there,” Thompson says. “Or do we want them to come to a holiday event because they truthfully and honestly would enjoy it?”
April McKenna, vice president of talent and organizational development and a certified dementia practitioner with Agemark Senior Living, knows personally and professionally the experience of helping a loved one with dementia to feel comfortable at a holiday family event. Her father lived with dementia, and the family had to adapt family gathering plans as his dementia progressed.
“Meeting them where they are — emotionally, physically and mentally — creates a holiday experience that is gentler for everyone, even if it doesn’t follow tradition or look the same as it did in the past,” McKenna says.
[READ Dementia Home Care: Safety, Daily Tips & Caregiver Self-Care]
Planning the Event: Manage Expectations and Time
Thinking ahead and planning can make a holiday family gathering more manageable for a loved one with dementia.
Have conversations with caregivers ahead of time
If you’re the host, chat with the person’s caregiver in advance. The best question to ask: What should you know ahead of time to help make the family member with dementia as comfortable as possible?
“Some people are living with symptoms that others don’t have, and there are people who are in very mild stages that are undetectable by other people. There are others who are living in the advanced stages that affect every area of their life,” Thompson says.
Consider special meal preparation
Find out if the family member has any special meal concerns. They may need easier-to-chew foods, or they may have a smaller appetite. For McKenna’s father, the priority was having foods that he enjoyed and was comfortable eating.
Adapt meal and event timing
Consider hosting a lunch instead of a dinner, and try keeping the event shorter overall instead of making it an all-day affair.
“That’s so you’re not in the typical window of so-called ‘sundowning‘ syndrome, also avoiding the distress that often comes when everyone is more tired,” says Teepa Snow, a dementia care specialist in Efland, North Carolina.
Sundowning or sundown syndrome is a confusion or anxiety that can overcome a person with dementia around the time of sunset.
Plan for a quiet space
Everyone needs a break sometimes, especially around the holidays.
“For people who are hosting, it can be really helpful to think about that ahead of time and designate a space in their house that’s quiet, that is calm, and perhaps has music or some aromas that are pleasing that someone with dementia can go to and rest for a little while if they start to feel overwhelmed,” Thompson says.
Consider safety
Make the gathering safe for your loved one. Clear pathways and consider keeping the gathering on one floor to avoid the need for someone to go up and down stairs. Be sure areas are well-lit and free of trip hazards.
Rethink the entire event
Think about bringing the celebration to where your loved one with dementia lives. This may involve having smaller groups of people to see them and having a couple of gatherings over a weekend instead of a huge family event.
[Read: Caregiver Burnout and Strategies to Help]
Prepare Guests: How to Communicate Changes
If other guests haven’t spent time around the family member with dementia recently, they may have many questions about the best way to interact without confusing their loved one.
“Make sure family and friends understand the situation and what to expect, especially if there have been significant changes since the last visit,” advises Elizabeth Edgerly, the senior director of community programs and services at the Alzheimer’s Association.
It may also be helpful to record your loved one with dementia to share with other family members ahead of time, so they aren’t completely caught off-guard by changes. Let them know that changes in behavior and memory are caused by dementia and not reflective of the person.
For children who will be there, let them know that the person with dementia might ask the same question repeatedly but that’s normal.
Tips for introductions
Immediately introduce yourself to the person with dementia in a non-condescending way:
— “Hey grandma, it’s [your name]. I’m so glad to see you”
— “I bet you didn’t expect to see me, [your name], here today.”
“It’s not that someone with dementia forgets that someone they love ever existed. It’s often that they can’t think of their name on the spot or they look different,” Thompson says.
Avoid testing someone with dementia with questions like “Do you know who I am? What’s my name?”
Simplify the Meal and Table Setting
A family member with dementia may have changing visual and spatial abilities, as well as safety concerns to consider as you set up the meal space.
If your loved one enjoyed meal or event preparation in the past, get them involved in safe, manageable tasks. This may include folding napkins, rinsing vegetables or helping with simple decorations, Edgerly says. Yet don’t push the involvement if it’s not their forte.
“Dad was never really involved in the decorating or meal planning,” McKenna says. “We joked that his role was always to ‘pay for it and show up.’ While we didn’t include him in preparation, we focused on ensuring the experience was comfortable and joyful for him.”
Here are several ways you can think ahead and ensure a safe, dementia-friendly gathering:
— Use brightly-colored plates and tablecloths, which can be helpful if your loved one has had any vision changes.
— Check food and drink temperatures as the family member may not be able to sense if something is too hot.
— Simplify both the setting itself and the meal choices. “It’s important to still give the person with dementia independence to make choices. When asking them to make a choice, it can be helpful to narrow it down to two things at a time, such as ‘Do you want this or that?'” Sutin advises.
Navigating Dinner Conversation
Dinnertime conversation may be overwhelming for a family member living with dementia. Or, they may be happy to take part in friendly banter. Here’s how to make dinnertime chit-chat easier for everyone at the table:
General conversation tips
— Encourage family members to not talk over each other, which can be confusing.
— Avoid putting the family member on the spot with direct questions.
— Resist the urge to correct inaccurate details. In some cases, therapeutic lying may be the kindest option.
— Try to eliminate extra background noise, such as a loud TV or a dog barking.
Focus on feelings, not facts
One of the most important things to remember is to keep the conversation in the present moment.
“It’s natural to be curious about what someone with dementia remembers and what they don’t. But in a holiday gathering now is not the time to be testing them. They want to enjoy the minute, the moment with you,” Thompson says. “A less confrontational way to get them reminiscing (is) with statements like, ‘I remember you telling me about Christmas with your grandmother’ or ‘I remember you telling me about that vacation we took to Florida.’ That way, they can engage with the story if they have the details but it doesn’t put them on the spot.”
Finally, acknowledge that your loved one with dementia is there and part of the group.
“Don’t talk about the individual as if they aren’t there or ignore them,” Snow advises.
Self-Care for Caregivers
Of course, the caregiver for a family member living with dementia is a major part of that person’s experience. However, the caregiver may be feeling burnt out, tired or overwhelmed. Here are a few ways you can provide support for any caregivers present:
— Ask before and after the dinner how you can help them.
— Try to seat the caregiver on the dominant side of the person living with dementia.
— Offer to give them a brief break.
— If a caregiver usually hosts a holiday gathering, offer to have it at your house or another family member’s house instead.
— If you’re the caregiver, Thompson advises making a list of things you do throughout the day that don’t need to involve you specifically. For instance, this may include returning an item to the store, picking up prescriptions or going to get the mail. When people ask if you need help, you can share your list and they can volunteer for a specific task or tasks.
— Before and after, consider caregiving support groups, which can both help you prepare for and recover from a family holiday gathering.
Wrapping Up the Day
Stay flexible and compassionate if you’re bringing a family member with dementia to a holiday gathering. Don’t feel discouraged or take it personally if you have to shift plans, McKenna says
Then, even if going to the family dinner works out well, consider something smaller, like a post-meal dessert, in a quieter, more comfortable environment. “Taking them on a drive to look at Christmas lights while enjoying a scoop of their favorite ice cream can be enjoyable and a new memory you create for yourself,” she says.
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Hosting a Holiday Dinner When Your Loved One Has Dementia originally appeared on usnews.com
