7 Top Tips For A Dementia Friendly Family Christmas.

7 Top Tips For A Dementia-Friendly Family Christmas.

Written by Kirsty Porter  • 18 December 2016 •

Nurse and Aged Care Enthusiast 

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It’s Christmas again, and everyone wants to know, "What are we doing about Dad?”

 

David has Alzheimer’s Disease and has been living with this disease for 4 years now.   He is getting really frustrated with his dementia symptoms these days, especially now that he needs more help from Lora.  Lora is David's dedicated wife, loving best-friend and is the 'glue' in the family, holding everything together.  But now, people like to refer to her as his carer.  They both resent the word ‘carer’ because it makes them feel so pigeon-holed, and arguably they have been caring for each other well over 50 years now.

 

As for David, well he becomes overwhelmed quickly and can be agitated with too much noise.  Surely this Christmas with the family will be too stressful?

 

And then there is the issue of eating.  

 

Using a knife is now a mystery and the blasted spoon just creates more mess, as David’s hand to mouth co-ordination has weakened, especially when it comes to soup. Lora doesn’t mind assisting David, in fact, it’s quite a lovely bonding and quiet time for them, but she doesn’t want to embarrass him and he feels, well, different when she helps him to eat in public.  

 

Lora is so completely overwhelmed to play the pigeon-holed carers role this Christmas, when all she'd like to do is just have a break and relax.   So, she has given herself permission to simply disengage from the family this Christmas all together.  She feel's it’s just too much for the family to understand or know what to do.  Anyway, after last year’s disaster of David just wandering off, maybe staying at home with David might be best.   It’s just too much.

 

In the past, David and Lora used to host their family’s Christmas, but while their lovely eldest daughter has taken on the hosting this year, David and Lora are still hesitant to go.  Their daughter is desperate for them to attend Christmas day, but their two sons have some major concerns, especially as there will be six grandchildren under 10 years old running around the house. What to do?

 

Indeed, what to do?

 

Frustrated that there is just not enough information on this subject, I’ve written this blog for David and Lora, and for similar families planning a Christmas that wants to include, but doesn’t quite know how, a family member living with dementia.  (Click here to read the difference between Alzheimer's and dementia).

 

I’ve spent some time with the experts (people living with dementia), asked them some really tough challenging questions, trawled the length and breadth of the internet researching just what it means to get through a Christmas family celebration while dealing with the throws of dementia.

 

While each family will face individual circumstances, these are my top 7 suggestions while planning for Christmas day with a loved one who has a dementia disease.   Be sure to tell me what you think at the end of the post.

 

 

  1. Change your expectations

It is tough to alter family traditions or break from them completely, but rather than everyone turning up on Christmas day try having smaller groups of family visit, maybe four at a time.  This might be easier in the lead-up to Christmas.  These shorter and more intimate sessions will foster quality time together and create opportunities for meaningful one-to-one activities, like addressing envelopes, baking, wrapping presents or decorating a tree.  Choose activities that will invoke traditional reminiscing and conversation in a natural way.  

 

Alternatively, if going to a larger family lunch or dinner, it is important to arrive at a time best suited for the person with dementia, and arrange lunch to suit their daily routine, that is consistent with any other day. This is important as maintaining a daily routine minimises anxiety and agitation, especially if feelings of hunger are difficult to vocalise or recognise.

 

 

  1. Its all about inclusion not exclusion

While planning a Christmas day that is inclusive of a person with dementia, it is important to recognise their limitations and abilities.   Focus on what they can do, not what they can’t. Excluding them because of their limitations will only encourage stress and an innate sense of loss. But, for example, being included in the cooking process such as pealing or washing vegetables is a valuable and supportive family inclusion activity.   It maximises feelings of independence, which is important for inclusion and a feeling of belonging.  

 

Also, it's important to remain flexible.   As different people progress through dementia symptoms uniquely, the family needs to be aware of individual responses in larger group situations and caters for that; such as creating a 'break-out' space and routine 'break-out' times.   A 'break-out' time is time for two to three members of the family enjoying each others company in a quite focused environment.  And for someone living with dementia, these break-out times and spaces are a crucial intervention, even more so during larger family celebrations.   This is also a perfect opportunity to share the care.  

 

 

  1. Moods are contagious

People with dementia have a unique and uncanny tendency of heightened emotional contagion. Emotional contagion is when emotions are transferred between people in confined spaces, and it is quite amazing to see people living with dementia (and children alike) ‘feel the room’. Therefore, plan Christmas day ahead with allocated rest times for everyone and prepare ‘break-out’ spaces to encourage one-to-one time and conversation. In this time, mix the generations up a bit and encourage children to have quality time with their grandparent in a quite space. They might sing, play with a balloon, move about the garden, sort cards or even look at an old photo album.   Finally, be aware of emotional triggers that may cause confusion or anxiety, this can be as simple as delaying their usual eating times or being distracted by background music.

 

 

  1. A space that works

Allocate an accessible and inclusive space designed for the person with dementia.   There are some important points to add here when creating a dementia friendly space. Getting it ‘right’ will enhance the mood and will invoke a calming response.

 

dementia friendly room

 

 

Here are some ideas I’ve found to be effective; 

⇒ Natural Lighting, no flashy Christmas lights,

⇒ Decrease obstructive clutter,

Cover patterned chairs with a block-contrasting colour. Anything patterned such as bed spreads, plates, food condiments, chairs, table clothes, etc., all create a confusion about what the object actually is and that might lead to uneasy feelings,

Well labelled rooms, such as: ‘toilet’ & ‘bedroom’,

An all white toilet needs to be defined. Sticking a coloured or contrasting tape to rim of bowl will define the boundaries of the toilet – for sitting or standing. This will further reduce the risk of a fall. (Communication between family members is important so that the toilet seat is left in the same position to avoid further confusion),

Remove tripping hazards; rugs, cables, toys, etc,

Soft or textured furnishings,

Smell or sound, such as music, that works to calm not distress. (Important to note here that excessive noise has the most significant and damaging impact),

Safe access to outside, with glass doors marked or taped to clearly indicate if they are open or closed, and

Coloured tape on all steps.

 

  1. The Table

The absolute key here is CONTRAST! Again, no overtly patterned table clothes or crockery.

dementia-friendly christmas

 

If you’re going for a bright block coloured tablecloth, white serving dishes would be best. Make sure the food in the serving dish looks like the food it is. For example, ensure the potatoes look like potatoes; the meat looks like meat and so on. Don’t change the look of the food with sauces draped on top, keep them separate. Allowing for autonomy during food selection is not only a personal pleasure but a fantastic socialising experience. Again, for this top tip, patience and time allocation is key here.

 

It’s all about perception and how the person with dementia perceives what that food is. If they recognise the food then the food will most likely be eaten. The same is true in reverse, and being hungry might be a trigger for excessive anxiety, stress and feelings of loss.  

 

Here are some other hints and tricks I’ve learnt;

 

Use bright red or blue crockery that contrast well with placemats, serving dishes and food.  Patterned plates may be distracting and might serve only to confuse what food is presented, 

Consider a buffet table for food. It de-clutters the table and at the same time encourages independence and social inclusion as people move to and fro, 

⇒ Plain coloured tablecloth or plain table surface,

Cutlery that allows independence or finger food – but important that EVERYONE does the same thing to prevent alienation. This could make mealtime quite fun, especially for the children,

Important that edges of objects on the table are well defined,

⇒ Non-slip placemats,

Don’t mix two foods in one serving dish – this can create confusion,

food dementia

No sharp edges on tables, chairs and other furniture,

Use familiar serving objects and utensils,

Chair must be comfortable and accessible with good back and arm support,

Ensure there is no pretend food, even if it’s for decoration,

Good lighting above table,

Plants and flowers add positive sensory stimulation through their natural colour, texture and fragrance, and

If you’re a big group – more than six, consider having more lots of smaller tables.

 

  1. Appropriate Conversation

It’s important to be patient while talking to someone with dementia.   People with dementia can hear what you’re saying, but just need a little bit more time to process and respond to you.  Give them time.  

 

On this point, a well known advocate, Kate Swaffter, who lives with dementia (see her blog here), advises people to avoid starting a conversation with “Remember when…” as it can be disastrous and upsetting for someone who really can’t remember when. Ask leading questions or topic focused conversations that will encourage natural reminiscing that will spearhead real meaningful engagement.

 

Finally, during table conversation, it’s important that people don’t talk over-each other as this can be very distressing and difficult to follow. You can tell if this is happening by the 'zoned-out’ expression.   Take the time to engage in one-on-one conversation at this point, offer to walk to the buffet table together and gently remind people to be aware of the impact it’s having on their loved one.

 

 

  1. Gift Exchange

Gift exchange needs to be a calm experience – completely impossible if there are wonderfully excited kids.   I’ve been told this is a particularly tough time of the day and my expert says with laughter, they prefer to be doing something else.

 

Gift exchange with someone living with dementia might involve a smaller group just a little away from the crowd. However, just watching the children laugh and play with toys is quite a gift on its own for many people living with the symptoms of dementia.

 

Gifts that are reminiscent of childhood memories are particularly valuable but the time spent together doing a meaningful engaging activity together, like a big sing-a-long is worth its weight in gold!

 

And lastly, wrapping paper works better when it’s simpler as it will be recognisable as a gift.

 

 

 

So the major keys when preparing for a dementia-friendly family Christmas is to first adjust the family’s expectations of the day, ensure the routine is easy and recognisable, and finally understand their limitations while encouraging independence, as these inclusive activities are sure to have positive and a lasting emotional impact long after the memory loss.

 

Ultimately, plan Christmas day so that the family remains connected and relationships are supported while everyone is adjusting to the changes facing their loved one. In that, what creates laughter will also create connectivity.

 

Share the care, keep it simple and focus on the love.

 

cognitive footprint modelWishing you all a safe, magical and wonderful Merry Christmas from Australia! Looking forward to new and exciting developments in 2017!

AGEING BETTER TOGETHER

Kirsty Porter
Founder

The Age of Senescence
Photos: Pixabay.com & adapted by Kirsty Porter.
THE VIEWS AND OPINIONS ARE MY OWN.

NO ROYALTIES WERE RECEIVED FOR PUBLISHING THIS ARTICLE.

AUTHOR NOT AFFILIATED WITH COMPANIES MENTIONED IN THIS ARTICLE.

 

PLEASE LIKE, COMMENT OR SHARE.  

WOULD LOVE TO HEAR YOUR THOUGHTS AND EXPERIENCES ON THIS ARTICLE.

 

Kirsty is the Founder of the new blogging site The Age of Senescence that explores new innovation in global ageing and aged care.  Kirsty is also the creator of The Umbrella Dementia Cafe in Blackburn, Melbourne.  After successfully hosting two cafe sessions in 2016, there is now some considerable excitement surrounding its sustainability in 2017.  The cafe is in its creative development phase - see how she is progressing on her Dementia Cafe webpage and Facebook page.

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Literature resources for helping children understand dementia.

 

I’ve researched and found some excellent books helping children understand dementia and Alzheimers;

 

1. ‘Weeds in Nans’s Garden.’  By Kathryn Harrison (recommended)

 

2‘What happened to Grandpa.’  By Maria Shiver (inspirational change agent)

 

3. ‘Still my Grandma.’  By Veronique Van Den Abeele & Claude K. Dubois (award winning book)

 

4. ‘Wilfred Gordon McDonald Partridge.’  By Mem Fox  (an oldie but a goodie - I have this one for my own children)

 

5. "Why did Grandma put her Underwear in the refrigerator?”  by Max Wallack and Carolyn Given.  (Written from a 7 year old's perspective)

 

Literature resources for helping children understand dementia.

 

I’ve researched and found some excellent books helping children understand dementia and Alzheimers;

  1. ‘Weeds in Nans’s Garden.’  By Kathryn Harrison (recommended)
  2. ‘What happened to Grandpa.’  By Maria Shiver (inspirational change agent)
  3. ‘Still my Grandma.’  By Veronique Van Den Abeele & Claude K. Dubois (award winning book)
  4. ‘Wilfred Gordon McDonald Partridge.’  By Mem Fox  (an oldie but a goodie - I have this one for my own children)
  5. "Why Did Grandma Put her Underwear in the Refrigerator” by Max Wallack and Carolyn Given. (Written from a 7 year old's perspective)

 

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2 Comments on “7 Top Tips For A Dementia Friendly Family Christmas.

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