Supporting a loved one with dementia during the holidays

Shannon Paul-Jost is a Clinical Nurse Specialist of Gerontology at Interior Health. “One good rule of thumb is to focus on shorter stretches of quality time, rather than quantity,” she says. She also offered these tips:

Before a visit or outing, check in with your loved one. How are they feeling? What is their mood like? Don’t hesitate to change plans if they seem uninterested in going or if they are having an off day—when they just don’t seem like their normal self.

Keep gatherings small and turn off background noises like TVs. Those with dementia and cognitive impairment may have trouble following and responding to cross-conversations at a table or in a room. Extra noise can make it difficult to hear.

Try to schedule events and activities in the morning. Having a good night’s sleep can help someone feel more resilient in the morning, and tolerate noises, sounds, lights and activity better. Activities scheduled in the morning or early afternoon also will not interfere with any "sundowning" symptoms that the individual with dementia may experience. (See Visiting a loved one with dementia in long-term care for more on sundowning.)

Do a health check. It’s also a good idea to check health conditions such as blood pressure, blood sugars and bowel health, before venturing to an outing. Addressing any health concerns in advance will make the activity more enjoyable and may prevent any distressing health events.

Keep visits and outings short. Aim for 3-4 hours at most per visit or outing and avoid outings that occur day after day or back-to-back. Take your cues from your loved one. If they’re becoming agitated or restless or look tired, it might be time to go home.

Be sure they’ve taken medications well in advance. Giving medications well in advance of a scheduled activity will ensure the medicine is working at its peak. For example, if they experience pain, give medication for pain 1-2 hours in advance so it is in full effect while out.

Ask for help. If you want to enjoy festivities, but are unable to bring your loved one, ask a trusted person to stay with them. This could be a relative, friend or neighbour who knows your loved one well. Or, you may be able to access Adult Day Services or IH’s Home Health clinicians.

Mind your self-care. Caring for a loved with dementia at any time of the year can be challenging. Explore Interior Health’s at-home and community services, or call 1-800-707-8550 to access seniors health services.

Non-profits like Family Caregivers of British Columbia provides support to caregivers as well. Your local seniors’ wellness or outreach centre, and other government funded program, offer information and resources.

Jennifer Schellenberger is a practice lead in recreation therapy at Interior Health. She supports recreation therapy programs and teams at four long-term care homes in the Central Okanagan. With residents in various stages of dementia and cognitive impairment in care, the recreation therapy team modifies holiday activities and programs so all residents can enjoy themselves.

Jennifer shared these tips for family members visiting a loved one with dementia living in long-term care:

Get in touch with the care home before you go. Find out what kind of day they’re having before you visit. “We strive to communicate with the family to let them know if their loved one is feeling good, or having a tough day,” says Jennifer.

Decorate their room. Bring in subtle, warm decorations to bring some holiday cheer to their room. If you’re not sure what you can bring, consult with the home’s administration.

Read to them. If your loved one is in the later stages of dementia, or is non-verbal, bring a book to read to them. Alternately, you can sit quietly with them, listen to music, do a simple activity or craft together, or watch a TV program. Some individuals respond to singing Christmas carols even if they are not able to speak.

Bring hand lotion. Some people with dementia enjoy gentle massage. Bring a bottle of hand lotion and gently rub their hands. Or treat them to a mini manicure.

Bring children to visit. Young children can bring energy, animation and joy to visits. Many children are accepting and non-judgmental, and bring an innocence to conversations. To prepare for your visit, you can explain to them, ahead of time, that grandma or grandpa might not be very talkative, or may repeat questions.

Related Stories@IH: 10 ways to fight stigma against dementia

Understand they may not know it’s the holidays. Those in later stages may not be aware it’s the holiday season. While visits at this time of year may feel extra special to you, spending any amount of time visiting can benefit you and your loved one. You might bring in an appropriate festive treat to share, or a photo of the festive season from years gone by.

Keep sentences short, ask simple, yes/no questions. Open-ended questions can be confusing and frustrating for someone with cognitive impairment. We also have a natural tendency to ask, "Do you remember…?" Jennifer recommends not asking this as it may confuse or befuddle your loved one.

Don’t try to correct them or challenge their reality. If your loved one says something that might not make sense to you, such as "Where is my mom?" Jennifer suggests going along with them. If they appear to be at ease, you can even ask them a question about their mom, such as, ’Was there something special your mom made for the holidays?’

Be aware of sundowning. Those in later stages can sometimes start wandering mid-afternoon. They might check for exits, pace, or start looking for something or someone. “For this reason, we aim to keep stimulation very low in the afternoon, as that can be triggering,” explains Jennifer. Planning visits in the late morning or early afternoon might be more enjoyable for your loved one.

Here are a few other articles that might help you supporting your loved one or a senior during the holidays:

• Visiting someone with dementia over holidays? Here are 10 tips (Alzheimer Society of Canada)
• Holidays and special occasions (Alzheimer Society of Canada)
• Holiday Hints for Alzheimer's Caregivers (National Institute on Aging)
• Reducing Loneliness in Seniors During the Holidays (AgingCare.com)
• This holiday season, give outside the box to an older adult in your community (CanAge)

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