Winter Holiday Season Caregiving Tips for Families with Loved Ones with Dementia

'Tis the season to be jolly. Or is it?

While those facing Alzheimer's disease or a related illness in their family might question the sentiment, experts say that it is possible to not only keep the cheer in the holidays, but also to savor them.

Some suggestions you might want to consider from the Alzheimer’s Support Organization:

·  Communicate concerns. In advance of the holidays, be candid with family and friends about your loved one's condition and your concerns, and enlist their support. In cases where resentment brews because one family member assumes the primary caregiving role, use this season of giving as an opportunity to discuss sharing family responsibilities and to strive for family togetherness.

·  Set realistic expectations. Consider both what the individual with dementia is capable of and what you, as a caregiver, can handle given your demanding role. Then, put celebrations into manageable proportions. This can help decrease stress and head off feelings of depression that stem from unrealistic expectations, both for you and your loved one.

·  Select appropriate activities. Be mindful of the individual's current mental condition and do special things that they can still appreciate. Engage your loved one in singing and dancing since these abilities tend to remain intact longer. Involve them in some rituals—whether it is lighting the menorah, decorating the tree or baking cookies. Try to spark memories by bringing out family photographs or heirlooms. But do not demand mental performance by asking them to name people, places or other facts. Rather, help stimulate memories by offering descriptions as you present each object.

·  Pare down traditions. With round-the-clock caregiving, it may not be feasible to juggle all of your religious and ethnic observances. You can still keep traditions alive; just reduce their number to avoid feeling overwhelmed and frustrated. Ask your loved one which traditions to choose; it is another way to involve them. Even though they may not recall later on, making the effort reinforces the fact that you care what is important to them and will make you feel better as a caregiver.

·  Adapt family gatherings. Since crowds, noise and altering routines can aggravate confusion and other behavioral problems, revising your get-togethers may be in order. For example, instead of entertaining the whole clan, limit the number of attendees at a holiday dinner or spread out several smaller gatherings on different days. Mark a calendar with upcoming visits to make your loved one feel special.

·  Stick with familiar settings. Because new environments can increase disorientation and pose safety concerns, discard restaurants or relatives' houses in favor of your own home. Likewise, if Mass is still important to your loved one, consider how they can participate. For example, take your loved one to an earlier, less crowded service; if they are unable to go to church, watch a Mass on TV or ask clergy to make a house call.

·  Head off problems. Avoid alcohol, which may cause depression, increase the risk of falls and add to the loss of brain cells. Try to schedule holiday activities or visits earlier in the day before the potential for sundowing - behavioral problems that typically occur toward dusk among those in the middle stages of dementia. And, in preparing for holiday celebrations, do not re-arrange furniture or create obstacles-both are accidents waiting to happen.

·  Limit holiday decorations. Decorations can still adorn your home, but in moderation. Hang cheerful ones that recall memories and family traditions. Do not overdo the ornaments on a Christmas tree. Remember that hauling out a lifetime of garlands, religious items and wall decorations can clause clutter and over stimulation, which can intensify disorientation and agitation. Ensure, even more than usual, that decorations do not block pathways or pose potential fire hazards.

·  Re-think gift giving. Devise ways to include your loved one, depending on their capabilities. You might take them to a store to buy presents, and offer extra guidance. Or, you can buy the gifts for them and wrap them together since many individuals with dementia like handling paper. In giving presents, pick ones appropriate for someone with the disease. Instead of something material, try things that are simple, personal and sentimental. For example, photographs and heirlooms provide the opportunity to reminisce—a gift in itself.

·  Welcome youngsters. While it is important to include children, it is just as vital to consider their feelings. Address the fear factor by helping them have special moments with their relatives. If their loved one uses inappropriate language or easily becomes angry during the visit, explain that this behavior is not personal or intentional; it is part of the disease. Youngsters' excitement about the holidays can be contagious. Singing songs together can strike a chord for someone with dementia. Or having an elder teach dominoes to children is a good way to foster interaction and make your loved one feel they have something to offer.

·  Join a support group. A forum to express feelings and socialize can help overcome sadness for both caregivers and individuals in the early stages of dementia. Unfortunately, the incidence of depression ranks high during and after the holidays. Consult with a healthcare professional if you detect warning signs of depression: tearfullness, poor eating habits, withdrawal, inability to sleep, and physical complaints.

·  Enjoy yourself. The greatest giftat the holidays: time. Ask a family member, friend or healthcare professional to keep your loved one company so you can relish some respite—time for some holiday shopping, a walk in the park, checkers with an old friend or whatever present you want to give yourself.

Contributing author Steven Mattingly is the Executive Director of Pacifica Senior Living in San Leandro, CA.