Dementia May Require Doing the Holidays Differently.

The holiday season is upon us and as we make preparations for our family gatherings we face those ever present questions. Do we involve our loved one with Dementia in our holiday festivities and if so, how? Do we invite them to our family celebrations or do we visit them at their residence? Do we have a large gathering or invite only a few guests? The most important question of all, how do we engage our loved one(s) and ensure their enjoyment over the holiday?  

Holiday preparations are stressful enough without having to consider all these uncertainties. We don’t like asking ourselves these questions as the answers are complex and sometimes provoke feelings of guilt. 

A growing number of people have seniors within their lives who now face physical and mental impairments. These difficulties have changed them and their roles within the family. We want to involve these loved ones in special family gatherings but we don’t know how other guests may receive or respond to them.  We, ourselves, may not know how to interact or engage our loved one(s) during family events. Further complicating matters, we may not have the time to meet their special needs while tending to the multiple demands of hosting a family gathering.  

One obstacle necessary to overcome is the feeling of guilt.  You are not alone in making these tough decisions. Most people, at some point in their lives, will be tending to the needs of family member(s) with memory difficulties or Dementia. Balancing their care needs with the needs of other guests can be challenging. It is alright to question yourself as to what is feasible for you to do and what is not. 

When making such decisions we often focus on what cannot be done, resulting in feelings of guilt.  Guilt is an emotion that strips you of your strength, resilience and energy. 

We, at Harmony Caregiving, encourage you to re-direct your energy and focus on what can be done to make the holiday season a special one for your loved one(s) with Dementia. 

This article includes checklists designed to help guide your decision as to whether or not to invite your loved one(s) with Dementia to a family gathering or event. 

The first step involves planning your festivities well in advance. Consider all financial, social and emotional resources. that you and other family members have to offer. 

When Planning Your Family Events, Take into Account

• Financial costs involved (e.g., transportation; entertainment; food; Caregiver or Health Care Aide costs, if needed).

• Estimate the amount of time involved in planning, shopping, preparation, cooking, travelling and tending to other family and guests. Be careful to not underestimate time involved by each of your family members. Factor in you and your families level of stress and amount of energy needed to complete tasks.

• Create a timed schedule to coordinate your plans for the event. It is always better to overestimate the time involved to complete tasks and errands. Keep in mind the principles of ‘Murphy’s Law’, that whatever can go wrong, will go wrong, at least in regards to timing.

• Determine whether your gathering or event will be large or small. Under ten people is small over ten is a larger gathering.

• Assess the supports within and outside your family that our available to assist you with preparation and on the day itself.  

• Ask yourself how much individual time can you spend with your loved one. Individual time spent with your loved one on that special day will be the most tender and appreciated of gifts.

• Determine the length of time you can accommodate them (e.g., for a few hours or several days?).

Evaluate your Loved One(s) Cognitive Abilities, Special Needs and Preferences

• Is your loved one with Dementia able to communicate their needs to others? 

• Are they able to engage with others on a social level? For example, can follow a conversation. Can they understand social cues and what is going on around them? 

• Are they able to recognise other guests and family members and where they are?

Consider your Loved One(s) Emotional Level of Functioning and Personal Temperament  

• Are they social or reserved? Are they responsive toward others?

• Are they prone to anxiety? 

• Do they experience emotional outbursts or exhibit uncontrolled anger? 

• Do they engage in difficult to manage behaviours?

• How do they respond in unfamiliar or environments they may not remember?

Assessing your loved one’s level of Dementia and their cognitive, emotional abilities is vital as it assists in determining whether they will be comfortable and engaged in the family event.

It’s also important to evaluate the needs of other family members, guests in attendance. A flare up in temper or resistance toward others can scare others, particularly children. If you anticipate these sorts of challenges it is highly advisable that you have a Companion or Health Care Aide present to monitor the response of your loved one. These trained people can serve to prevent such situations and quickly de-escalate such situations when they do arise. 

Safety and Personal Comfort of your Loved One; 

• Do they have safe reliable and comfortable transportation to and from the event?

• Do they need companionship while being transported? This is a particularly important question to ask oneself. Depending on one’s level of Dementia, your loved one may not have a memory span longer than a few minutes or understand the concepts of time or travel. Without these they may feel lost and scared while on route to and from your family gathering.

• Do they require special equipment to be mobile (e.g., a cane, walker, wheelchair). Is your home accessible to them if physical disabilities or limitations exist? It is suggested that you walk through your home or event site and do a safety check. Look for possible obstacles that could injure your loved one. You may need to close access to various parts of your home as some individuals with Dementia have a tendency to wander.

• Assess their risk of falling. Will they have to traverse any unfamiliar or challenging terrain? (e.g., a slippery walk or driveway; uneven road surface; climb stairs) to reach your home. Just prior to your loved one’s arrival visually scan your home for anything that they can trip over, (including your lovable furry family members).

• Does your loved one have any visual impairments? This is not limited to whether they wear glasses or not. Individuals with Dementia may suffer from visual impairments we may not be aware off. Some of the more common visual , difficulties include those involving depth perception, peripheral  and or central vision limitations, interpreting/recognizing objects and following objects that move. 

• Do you have a chair that they can sit down in and rise from comfortably. Ensure that the chair does not move and has stable arm rests. These arm rests can prevent your loved one from falling out of the chair and assist them when sitting or rising to a standing position.

Concerns with Toileting your Loved One with Dementia:

• Is your loved one able to easily access and use your bathroom?

• Does your bathroom have the space to accommodate their special equipment and another person to help them?

• Does your loved one need direction and or assistance when using the bathroom?

• Can they communicate when they need to use the bathroom? It is advised that you bring along a spare change of clothes and undergarments in case of any toileting accidents.
• Do they have difficulty sitting or rising from the toilet? If so, does any one in your family have the skills and physical strength to assist them. Seniors can fall just by trying to sit down and missing the toilet seat. Health Care Aides receive special training to help position and lift your loved one from the toilet. 

Dietary, Medicinal and Dining Considerations for your Loved One: 

• Do they require any special food preparation (e.g., needing their food cut up into smaller bites or pureed, do they require fluid thickeners to assist them with swallowing). Do they have any allergies or foods they must avoid. 

• Determine in advance what medications your loved one takes, how they are administered and at what time(s) they are taken.  If administering the medication is complicated do you have anyone to assist? Are there any foods or beverages that they must avoid as a result of the medication? 

• It is customary to have a glass of wine or a little alcohol at family events, however alcohol and medications do not mix. Alcohol can lead to medication side effects,  uninhibited behaviours and even further impair your loved ones memory. To help include your loved one in family toasts it is advised that you serve them non-alcoholic wine or beer. 

• Do they require monitoring and assistance when eating. Can they chew and swallow their food or are they at risk of choking?

• Can they use utensils or do they need help being served food and being fed.

• Does your loved one require companionship and guidance when sitting amongst other guests when eating. Do they require frequent monitoring. Do they need assistance to converse with others around them. 

The above check lists can be overwhelming to review. When a loved one has advanced Dementia it affects multiple areas of their lives and greatly impacts the level of care that is required.

Our hope is that the checklists allow you the opportunity to more fully appreciate the challenges that may now be involved. They are meant to help you plan ahead and remedy such challenges before they arise.

Having your loved one join a family gathering may involve a great deal of advance preparation and assistance. Should you have the resources and the time necessary, inviting your loved one for a family gathering can be a most wonderful gift for both you and them. On the other hand, if you decide having them for supper, may be too overwhelming, we want you to take comfort knowing that people living with dementia can still experience wonderful moments with you during or after the holidays, and in fact, there are many benefits to having a smaller celebration in the comfort of their own apartment or room instead.

Harmony Caregiving can assist you in whichever ways you need, when choosing to include your loved one in a family celebrations. Whether you have come home for the holidays and/or hadn’t seen your loved in a while, and are concerned by the difference that dementia has had on them, know that you do not need to do this journey alone. Please reach out to Harmony Caregiving and together we can help ensure that you and your loved one have all the care supports you all need to ensure they are well taken care of this holiday season and throughout the year.

Our Certified Health Care Aides and Dementia Care Nurses are well trained to assess and assist your loved ones with their needs prior to, during and after the holidays. Dementia is a progressive disease that our team understands well, and we are open to support our clients and their family members with 24 hours a day care services, 7 days a week, 365 days a year. You are welcome to call Harmony Caregiving at 780–328-3917 for a complimentary consultation anytime.