Including Loved Ones Living with Dementia at Christmas

by, Dr. Al Power, ChangingAging Contributor

Recently, I was interviewed for an article at Chabad.org about tips for including loved ones living with dementia in Chanukah celebrations. With Christmas fast approaching, it seems appropriate to review a few of those tips here for your upcoming family gatherings.

1. Pick a good time of day for your loved one to join the event. Some people tend to do best earlier in the day; others later on. Try to accommodate the time when your loved one is at her best, as this is a stressful—though joyful—time of year for many.
2. Decide on a good length of time for the visit. For how long should your loved one attend the gathering, and at what point might the level of activity become tiring? Think about the various activities you have planned and try to accommodate the times when the person can be most relaxed and engaged.
3. Prepare other family members. Other relatives, particularly children, may need some pointers as to how to communicate best with the person and how to understand her expressions. This will decrease the risk of reacting in a manner that might embarrass or upset the person. It will also help keep the noise and commotion to a reasonable level.
4. Optimize your verbal and nonverbal communication skills. Asking questions can be frustrating to a forgetful person and constantly puts her on the spot. It is better to offer observations and other statements that enable the person to respond as she chooses. This way, she can set the parameters and level of detail in her comments, and need not be “right” or “wrong.” Also, we should always be aware of our body language and nonverbal communication, as it is often more apparent to the person who has difficulty processing spoken words. Keep in mind all of the other good communication skills—sitting face-to-face, at eye level; not “talking down” to people, but with well-paced language, allowing time for processing and response. Go with the flow of conversation that is offered by the person. If a person seems stuck repeating a statement, it may mean that you haven’t really heard or acknowledged what they are truly telling you. Remember that such people often express their ideas through emotion and symbolism, rather than facts and logic. Understand their perspective rather than trying to impose your own.
5. Preserve important rituals. Rituals bind the present experience to durable memories and provide meaning for the person in the context of the Holiday. Involve your loved one to any extent she is able—setting the table, saying grace, helping with food preparation, giving advice about various aspects of the event, or simply being the “official food taster.” You might also engage in reminiscence about gatherings past, but if those memories are not durable, focus on creating meaning and joy in the present moment.
6. Empower at mealtime. It is a rare person who cannot partake in foods that are a traditional and meaningful part of the Holiday, but the person may need to have the food presented in a way that enables her to be most successful. Pre-cutting meat, using appropriately weighted silverware and glassware, and plating food in a manner that optimizes visual recognition will all help empower the person to participate successfully in the meal.
7. Share the music of the season. With the success of the film Alive Inside, I don’t think we have to convince anyone of the power of music to connect and engage people who live with changing cognition. Both Christmas carols and secular holiday songs will invoke powerful memories and can often create a sense of identity, joy, and peace.
8. Leave space for emotions. Holidays can often invoke powerful emotions—thoughts of people and places from the past. It is not uncommon for any of us to shed a tear around such important gatherings, and people living with changing cognition are no exception. It is important not to pathologize such expressions of emotion simply because of a diagnosis of dementia, and not to try to stop the person from expressing her feelings. Helping a person to process emotional memories through validating comments—or simply silent handholding—can be therapeutic.
9. Have a “Plan B” in mind. Create some flexibility to accommodate any unexpected changes that arise. If your loved one becomes “frazzled” by the level of commotion, be sure she has a quiet space to which to retreat, or else an early ride home. And if traveling to your house is too difficult for your loved one, a specially planned gathering at her place of residence can create a meaningful day within a safe, familiar space.
10. Don’t be afraid to take the “leap.” If you can overcome your concerns about “what if,” and move forward with some planning, intention, and also flexibility, you can create a memorable gathering for all.

Merry Christmas!