Wednesday, December 5, 2012

A Happier Holiday for Dementia Caregivers

Finally, the Holiday season is here. You’ve completed all the preparations, the company has arrived, turkey’s in the oven and now you’re ready to pick up Mom from the Happy Trails Assisted Living Home. Mom’s been living there for about six months—well, at least since her Alzheimer’s disease became too progressive to keep her in her own home. Won’t she be surprised when her three out-of-town children, their spouses and all four of the grandchildren burst onto the scene.

As you and your mom walk in the door, you’re assaulted by rap music from the living room, the smell of something burning, every light on in the house—including an overly bright Christmas tree—and suddenly the four darling grandkids come bounding in to welcome Grandma with shrieks of laughter. Grandma’s knees buckle and she slowly crumbles to the floor. What went wrong?

You need a holiday survival guide to get you through this, or any other holiday, when your loved one has dementia or Alzheimer’s disease. Holidays and special occasions can bring mixed emotions for family members caring for aging parents, an ill spouse, relative or family friend. Many family caregivers feel so weary and overwhelmed with daily duties that the thought of “enjoying the holidays” creates only sadness, depression and resentment. Here are a few suggestions to ease the stress of the holidays, and turn a potential nightmare into a real celebration.
  • Turn down the volume on voices. Avoid TV background sound with no one watching. Instruct all your guests, particularly the children, to give Grandma their soft voices. Help them understand that she can’t hear anybody if everyone is talking at once.
  • Refrain from having visitors come to the person all at once. Trying to recognize too many faces at once, and the sounds of multiple voices, can be extremely confusing. Avoid over-stimulation and over-tiring by eating earlier in the day.  Schedule travel plans to avoid long travel for your loved one or back-to-back arrivals and departures for visitors. 
  • Keep those lighted decorations within bounds. Blinking lights and large holiday displays may leave your loved one feeling less than serene.
  • Involve the person in familiar activities, such as sharing blessings or toasts, or even helping with their favorite activities, whether baking cookies, raking leaves, polishing the silver or playing a simple game.
  • Include easily recognizable music that’s soothing to the person with dementia. Because most people tend to retain vivid musical memories from the past, your best bet is offering traditional holiday music, uplifting choral groups or even big band sounds from the 20s, 30s and 40s, the era when they were young. Assist your loved one to locate the right chair so the music will be audible, but not overwhelming.
  • Holiday stress can also be reduced by passing on host responsibilities to others. In some cases, having the celebratory gathering at the assisted living or skilled nursing facility can be very helpful for a person in the later stages of dementia. Sometimes, the facility provides the meal; otherwise, bring your own family favorites. This arrangement avoids both travel and dislocation for the person and keeps the celebration in a familiar environment.
  • Gifts should be appropriate for the loved one’s dementia level. recommends that for Early Stage Dementia, when individuals may be aware of their problems, choose gifts that enhance independence (tickets to a musical or sporting event), a fruit basket, or family photo albums. Middle Stage Dementia, where more assistance is required, you can try gifts that focus on their mental level of organization. Picture books of historical places, nature or celebrities or taped religious services and music from their former church are just two examples of gifts that work for a person with a short attention span. Late Stage Dementia, when the capacity for comprehension is severely limited, requires uncomplicated and comforting gifts, such as memory boxes made up of old photos and momentos, stuffed animals or dolls, hand and body lotion, lap robes or warm footwear to help circulation.
  • Develop your own healthy self-care plan long before the holidays begin. You can get a holiday boost by following some of these tips: Allowing for “good enough”—email those Christmas cards or have your holiday meal catered, if your budget allows.  Be free from the “shoulds.” I should be happy. I should invite my friends over. I should carry on my usual holiday plans.  Extend compassion to yourself. Take time for regular breaks, meditation and leisure activities. Add special treats to your own holiday gift list—a manicure, a movie, a massage. Plan ahead and ask for help. Rely on professional home care providers to step in and provide a variety of services from respite care and transportation to light housekeeping and meal preparation.
Family caregivers who self-sacrifice and extend love to another need not run themselves ragged from the strain of care at holiday time. Setting priorities and following a few sensible tips will free you considerably from the anxiety and stress associated with any holiday.

(An excerpt from "The ABCs of Caregiving, Part 2: Essential Information for You and Your Family," House of Harmony Press, 2014.)

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