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Dementia and the Holidays

5 Strategies for Surviving the Holidays

Caring for a loved one with Alzheimer’s or any other form of dementia can be quite a struggle on a daily basis. But add the busyness and activities of the holidays and many caregivers find themselves at their breaking point. The change in routine and added visitors can be very stressful on someone with dementia and result in an increase in difficult or combative behaviors. So how does a caregiver not just survive but maybe enjoy the holidays while care for the one they love? And how can we help visiting family and friends make their time with your loved one more enjoyable?

Here are some tips on how to make this holiday less stressful for yourself and your loved one.

Understanding the Broken Brain Syndrome

This is the term I prefer to use rather than Alzheimer’s disease or dementia.  Because I know what all caregivers do, that it doesn’t matter what the diagnosis is – the real struggle is in the day to day living with someone who’s thinking and reasoning ability is impaired – someone who’s brain is broken. And because Alzheimer’s and other dementia disease processes effects each person differently, their brain’s will be broken in different places and therefore their abilities will vary greatly.

Knowing how and where your loved one’s brain is “broken” can help you find ways to “work around” the broken parts and enhance the working parts. The Alzheimer’s Association website (www.alz.org) has a great resource called the “Interactive Brain” (http://www.alz.org/alzheimers_disease_4719.asp). This fabulous tool can help caregivers understand how the different parts of the brain work, interact and how disease impacts ability. As you understand where the control center for each key function is located in the brain you will have a better understanding of how the disease is impairing your loved one’s abilities. It helps to explain why they are able do some things and not others and give you a clue as to what is still working and why.

So here are some tips for you and your family to use to work around the broken parts.

Don’t ask but Do tell

Memory, speaking and the ability to understand speech are the first areas of the brain that “break”. The ability to recall names and find words becomes increasingly difficult so conversation can be quite a challenge for someone with Alzheimer’s or dementia.

As family and friends come to visit this holiday season encourage them to talk to your loved one and not to ask them anything. Be sure you or they introduce themselves and PLEASE leave out the “remember me?” comment. They probably don’t which is really stressful and embarrassing for them, so don’t ask. Encourage guests to talk to your loved one in a quiet, calm voice, speaking slowly, using simple sentences and vocabulary. Don’t ask any hard questions – any question that requires more than a simple yes or no answer is a hard question. Then wait and listen for what they might have to say – it might not make sense to you but it does in their understanding of the world. Your loved one will feel connected and cared for while not feeling the stress of having to make conversation.

Eye Level

As people lose the ability to remember names and their surroundings the world becomes a scarier place. Having someone stand over you or even worse come up from behind you can be very frightening. Encourage your visitors to greet your loved one face to face and preferably at eye level or lower. When speaking with your loved one have them sit next to them in a chair or kneel down in front of them. Also be aware of getting too close – this may be your beloved grandmother – but to her you might be a complete stranger. Our primal brain is in charge when we feel fear so when the other takes a lower or more submissive position and keeps their distance it sends a message to this part of the brain that they are not a threat. So wait until you establish a connection before reaching out for that hug.

Quiet space

If you are having a lot of visitors in your home try to have a quiet place for your loved one to sit. In my house people gather in the living room and dining room but we have a den with a TV for those who need to get away from the crowd. This quieter space is still accessible but away from the noise and activity of the party. People can have quiet conversations or just sit and watch the classic holiday movie or the football game I’ll have on TV.

Same time Same day

It may be the holidays to you but to someone with a broken brain, who still has a primal sense of time, today is no different than any other day. As caregivers know, maintaining the same surroundings and routine help keep their loved ones calm and happy. It is important that you maintain as much of their routine as possible and especially so during this busy time of year. So if the holiday dinner party has you eating later than usual, plan to feed your loved one (even a simple meal) at their usual time. They can enjoy a second meal at the party if they are hungry, but don’t insist when they remind you that they have already eaten. The same goes for bedtime and other daily routines. It can be quite a challenge to maintain regular routines but when you don’t, know that your loved one will remind you just how important this is to them.

Consider Respite Care

Most assisted living facilities and nursing homes will offer respite care for caregivers. You can make arrangements for your loved one to stay at their facility for just a day or up to five days/nights.  For a daily fee the facility staff will care for you loved while you travel for the holidays or other events. A nursing home or skilled nursing facility will have a more hospital look and feel but will have the staff to handle all levels of care. Assisted living facilities will have more of an apartment or hotel feel and are better for those who are more aware of their surroundings and require less skilled care. Fees and availability will vary greatly by facility so you will want to shop around to learn your options. But this can be a lifeline to give the overburdened and stressed out caregiver a needed break even just for a day.

Summary

Working with your loved one’s ability and limitations always makes for an easier caregiving day. The holidays can present quite a challenge for caregivers as they juggling holiday festivities while maintaining the routine and structure their loved ones need. And while there is no holiday from the job of caregiving, holidays are made for spending time with your loved one. So remember to enjoy the time while they are still here with you.

I hope you found this helpful. Please be sure to send me you questions and comments by clicking on the Comments link at the top of the page.

So until next time – take care of yourself and know that there is

…help for the journey

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