Fran Vandelli, dementia care expert at Bupa Care Services Richmond Villages in the UK, shares guidance about activities and other measures caregivers and family can take to help make the holiday more dementia-inclusive.
An estimated one in three people will care for someone with dementia in their lifetime. If you’re one of the many people around the world celebrating the holidays with someone living with dementia this year, it’s important to know how to support them whether they’re joining you in your home, or you’re taking the festivities to them.
Wherever you spend this holiday season, here is some advice, drawing on my years of working in dementia care and my role at Bupa Care Services, on making the most of a special day and reducing any potential stress.
1. Keep things familiar
Although Christmas is a time for celebrating, remember that excess noise, people, and decorations can be a strain on someone living with dementia. Maintaining a familiar routine can reduce loved ones’ feeling overwhelmed or confused, helping everybody to relax and make the most of their time together. Create a low-key Christmas Day plan but also think about back-up plans in case any part of the day becomes difficult.
To help minimise any stress, reduce the number of visitors at any one time, as smaller groups of people make it easier for your loved one to follow conversations whilst helping to limit any distress from any recognition issues. Try to keep visiting for at most two to three hours and keep noise levels low.
2. Take things slowly
From decorating over a few days to introducing guests one at a time, it can make a real difference for your loved one. Remember, gauge their reaction to see if anything’s upsetting them. Try not to get disheartened if they become upset and see if you can adapt things to make them feel more comfortable.
If you notice a change in your loved ones’ reactions, move them to a quiet, familiar, safe place to help them relax if they’re tired, overwhelmed, anxious, or agitated by anything.
3. Create calm
A person living with dementia will take longer to understand and digest information and keep up with the conversation or what’s happening. Dementia also impacts concentration, so although it’s tempting to go all-out with decorations, there’s a chance that anything too modern or bright could be distracting for someone living with dementia. Instead, opt for traditional, simple decorations and try to keep Christmas jumpers neutral and classic. If you have special Christmas crockery, having simple table dressings in a colour that contrasts with the crockery can help your loved one focus on eating the meal and feeling part of a special day.
Reduce the risk of accidents where you can – all it takes is a few simple adaptations. For example, if you’re protecting furniture from spillages by covering them with blanket throws – try to choose a plain and simple throw that’s well-contrasted with the flooring colour. If your loved one can clearly see the floor and the furniture in the room, it can help to reduce the number of bumps and falls if the area feels unfamiliar to them. Also, try to keep rooms clutter-free to reduce the risk of trips and falls – fractures and hospital treatment can have a devastating effect on older people, especially those living with dementia.
Don’t forget that your loved one may be naturally intrigued by things they don’t understand. Be accepting of any breakages or spills that may happen as a result of their curiosity – they can’t control their condition, but you can control your reactions. Keeping calm will help everyone feel more secure and enjoy the day more.
4. Get your loved one involved
Christmas is often a time when people feel nostalgic. With old songs, films, and radio programmes so easily accessible, it’s a great opportunity to bring the family together and share the experience quietly, or join in, if the feeling takes you! Try playing some old Christmas songs you may have listened to together as a family and see whether your loved one smiles or even starts to join in singing. Music can be especially powerful, as well as a great tool to promote relaxation.
If your loved one is in the later stages of dementia, playing music they enjoyed from around the time they were 15-30 years-old is likely to get the best reaction. Just like you, your loved one has their own personal music tastes so it’s important to include their favourites.
Start music slowly and quietly to give them a chance to get used to the change in environment. And remember, there may be unwelcome memories that your loved one associates with Christmas. Remember to be cautious and sensitive to their reaction to avoid unnecessary disturbance.
Consider involving your loved one in the tree decorating process, whether helping to hang the baubles or asking them where they think they would look nicely placed.
If your loved one can still get involved with some of the simpler tasks such as sending Christmas cards, ask them if they’d like to write their messages or want to dictate their good tidings.
5. Think about food
Though Christmas is an indulgent time for many, be mindful that a full plate can be daunting for older relatives and therefore could be even more off-putting for someone living with dementia. So where you can, let your loved one eat independently, providing adapted cutlery or adding grips to help make things as easy as possible for them.
If they usually use crockery that has been adapted for them – like plates or bowls with raised sides or placemats to help avoid slippages. Keep these included to use with their Christmas dinner. These visual and sensory clues can signal that it’s time to eat.