By +Angil Tarach-Ritchey RN, GCM
Alzheimer's Reading Room
1. Involve your loved one in the preparation. You can give your loved one small tasks such as signing holiday cards, hanging ornaments on the tree, assisting with holiday baking, and cooking, sorting decorations, flower arranging, table setting, and household chores, such as folding laundry, and dusting.
Plan their involvement during family gatherings.
Peeling vegetables, stirring ingredients, folding napkins, helping set the table, passing out gifts, can all benefit you and your loved ones holiday experience.
Leaving a loved one with Alzheimer’s sitting alone or without appropriate activity and inclusion can evoke distress, sadness, or behavior problems.
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2. Make sure you have all medications and supplies filled and ready for the holiday season.
There are medication management pharmacies that can simplify obtaining and dispensing medications. They deliver, coordinate multiple physicians’ orders, verify orders monthly, and prepackage individual dosages, including over the counter medicines and supplements.
Also have a full supply of any incontinence products, or medical supplies available, so you do not have to get supplies at the last minute.
3. Evaluate the environment where you will spend the holidays. If you spend the holidays at home and your loved one lives with you, they are familiar with their surroundings and have a bedroom to rest in or retreat to, when they need relief from activity.
If you’re loved one is visiting your home or another family member’s home you will need a bit of preparation.
Make sure the environment is barrier free, and safe. Remove throw rugs, and reduce clutter, for persons with balance or ambulation problems. Keep a change of clothes available for any mishap with spills or incontinence. If there are special diet needs, including the texture of the food or drink, make sure the host or hostess is aware, or plan to bring your loved ones meal and/or drinks.
4. Prepare a quiet area in advance. Excessive stimulation can lead to anxiety, irritability, and exhaustion.
Plan for quiet rest, and a nap. Frequent breaks from the chaos of a house full of people can prevent anxiety, and exhaustion. If your loved one starts to appear anxious, take them to the quiet area before the anxiety escalates. Monitor facial expressions throughout the day as they often mirror underlying emotion. Fidgeting, hand wringing, picking at clothing or skin, pacing, and general restlessness are common signs of agitation.
Providing soft music and familiar items in the quiet area, as well as a soft and gentle massage can reduce the anxiety.
If your loved one is on medication for anxiety, you may want to pre-medicate before the holiday activities begin -- if the doctor’s order is as needed. If there is an anti-anxiety medication ordered and it hasn’t been given prior to agitation, make sure you give the medication at the first sign of anxiety, as it could take up to an hour to be effective.
5. Think about holiday traditions in your loved ones younger years and incorporate those into the holiday season. Alzheimer’s patients are able to recall long term memory much easier than short term memory. Was there special music, food, decorations or activities that were enjoyed years ago? Are there photo albums or stories from holidays past? This can often be an activity to be shared between your loved one and younger family members.
Photos and stories often provoke a memorable conversation of how grandma or grandpa enjoyed the holidays years ago.
The activity of sharing with the younger family members creates new memories. Are there old radio programs or music that can be found on UTube to initiate conversation and memories? Did your loved one enjoy music and singing? You can initiate a sing-a-long of their favorite songs of the past.
Many Alzheimer’s patients who can’t carry on a conversation retain the ability to sing or read. Are they able to read Christmas stories to the younger ones? A quiet break in the day with a Christmas story read to the family can be a much cherished activity.
6. Reduce embarrassment. Alzheimer’s patients are vulnerable to embarrassment, especially in the earlier stages of the disease.
If incontinence is a problem, be discreet, and don’t announce planned toileting or change of incontinence products. Educate the family prior to the events not to say things like don’t you remember, or I just told you that.
The fact is each time an Alzheimer’s patient repeats themselves, they believe they have only said it one time. So family members need to respond as if it’s the first time. Redirection can work wonders, so redirect your loved one to another area of the home, or to an inclusive activity.
If you find yourself getting impatient, ask another family member to take over involvement while you take a break, or ask someone to involve your loved one in a simple activity. You may need a quiet break as much as your spouse or parent.
Do not put a “bib” on your loved one during meal time. Either change their clothing prior to the meal, or plan on changing after. “Bibbing” an elderly person can initiate comments from younger family members in particular, like “why does Grandma where a bib?” We do not know the specifics of what an Alzheimer’s patient can or cannot understand.
It is extremely important to provide dignified care no matter how advanced the disease is. Do not belittle your family member with comments or actions that would make them feel like a child or present them as such. They are adults with a disease, they are not children.
7. Plan for help. Additional help can relieve the caregiving responsibilities with the holiday frenzy. If you have family members to provide respite ask for help, and schedule it. Have a family member provide care while you shop, attend to preparations, or just rest. If a family member is unavailable, private duty homecare can help wonders.
Caregiver’s can attend family functions with your spouse or parent so you can be relieved of the caregiving duties and just enjoy family. They can also bring your loved one to and from a family function for a specific time period. As an example, if you know the holiday events will be too chaotic or lengthy, you can have a caregiver bring your loved one to only the dinner portion of the event, and return home with them until the event is over and you can resume care.
Caregivers can also help your parent prepare for the holidays by assisting with sending cards, baking, shopping, decorating, and wrapping gifts.
If you think you cannot afford holiday care, plan it as part of your gift giving budget. This will not only be a gift to you, but to your loved one as well. Relieving tension and stress, as well as enjoying the holidays as the family member you are and not a caregiver, can bring a memorable and joyful holiday that will be much more meaningful than a traditional gift. Most agencies offer gift certificates. Ask family members to purchase care certificates in place of material gifts.
The Alzheimer's Store offers a wide variety of products including memory stimulating activities that can be given as gifts or purchased for holiday activites.
8. Understand that holidays’ are frequently a very lonely and depressing time of year for the elderly. They can get lost in the shuffle, and their feelings disregarded. Many have lost spouses, and friends. Recent losses are particularly difficult, including the loss of independence.
It’s important to take the time to include the elderly in your holiday preparations and plans.
Understand and take time to validate their feelings and initiate conversations about the positive memories they have. Begin a new memory by including a remembrance of a lost loved one. Whether that is taking flowers to a cemetery, making an ornament with their loved ones photo, or including a favorite past time of their loved one in the holiday activities, it will validate their feelings of loss.
When it’s a loss of independence, concentrate on engaging your loved one in simple decision making or tasks that can easily be accomplished. Thank them for their contributions and add simple compliments. Let them know that you understand loss of independence is difficult, but you are there for them, and will help them with what they can no longer do.
Do not take away independence by doing things for your loved one they can do for themselves. You want to maintain as much independence as possible for as long as possible. I always say, if you don’t use it, you lose it. Don’t contribute to the loss.
Preparation and these simple tips can make everyone’s holidays something great and memorable. These tips can apply to most family gatherings and functions. Keep the list handy for future reference and make all events the best they can be!
*Angil Tarach-Ritchey (RN GCM) is a National Expert in Senior Care, with over 30 years in senior care and advocacy. She is a registered nurse and geriatric care manager, author, speaker, and consultant. Angil is the author of Behind the Old Face: Aging in America and the Coming Elder Boom
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