The holidays are right around the corner. This time of year might be stressful under normal circumstances, and even more so with COVID-19.
But for many people with Alzheimer’s Disease or other types of dementia, the holidays can be a particularly confusing and disruptive time in terms of changes in routines, and people who may be perceived as strangers visiting. For both the person with dementia and their caregivers, the joy of family visits and gatherings is often intermingled with feelings of loss over declining abilities.
Several strategies may help navigate this time.
• Planning for the holidays is key. Involve the person with dementia in the preparations. Opening holiday cards together might help trigger long-term memories. Hanging ornaments on the tree and stirring the Christmas cookie batter can provide a sense of purpose and satisfaction.
• Try to avoid over-stimulation with elaborate holiday displays of blinking lights and large decorations that can lead to disorientation. Lighted candles and decorations that might be mistaken for edible treats should be avoided. Alcohol should be restricted.
• You might wish to limit the size of gatherings or number of visitors if your loved one is easily confused and agitated. Advising your guests ahead of time that the dementia sufferer might not remember them will limit the distress caused by “do you remember me?” questions.
• A phone call or video chat with the visitor in advance might provide a happy anticipation to the arrival and might facilitate recognition. Schedule visits at the best time of day for the individual and limit the duration of gatherings to what you feel your loved one can tolerate. Realize that dementia sufferers can fatigue easily, which often manifests as more confusion.
• Maintaining a routine is important; this provides an anchor in the here and now. Visits should be held in the person’s most familiar surroundings. For a person residing in an assisted living or skilled nursing facility, however, the increased activity of other residents’ friends and relatives visiting can lead to disorientation. Use your best judgment whether your loved one feels more safe and secure with structured activities in the facility or at an outing with friends and family.
• Gifts for someone with dementia should account for their impairments. For instance, an electric coffee maker or teapot that turns off automatically, calendars, or medication holders are items that many people with dementia can use to help them adapt to their illness, particularly in early stages. Less practical but more emotionally gratifying gifts can be family photo albums, familiar music, recordings of church sermons and gift certificates for a hairstyle or manicure. Avoid items that are breakable or irreplaceable.
• Finally, if you are a caregiver, do not forget to reserve time for yourself. Set limits on events (and stick to them) to keep from being overwhelmed. Despite the challenges of dementia, the holidays can still be a rewarding time for you and your loved ones.
Paul Mazzeo, M.D., is a board-certified neurologist with Coastal Neurology and sees patients in Okatie and Beaufort. He is medical director for the Beaufort Memorial Memory Center in Okatie.