By Kirsty Porter
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 his wife, Lora.
David also becomes overwhelmed quickly and can be agitated when there is too much noise.
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?
This scenario may be all too familiar for some of us this Christmas.
Here are 8 top tips when planning a dementia friendly family Christmas this year.
1. Consider the size of the group
People living with dementia (a cognitive disability) are highly likely to be experiencing sensory changes, so consider how the number of people in one room can affect the noise levels. Lots of sounds coming from different directions and at different volumes can be quite overwhelming. In the lead up to Christmas, try to have smaller family groups rotating throughout the day. Shorter and more intimate sessions will foster quality time together and create opportunities for more meaningful one-to-one activities, like addressing envelopes, baking, wrapping presents, playing a game, looking at old photos or decorating a tree. Consider activities which are inherently traditional to your family and are full of opportunities for reminiscence.
2. It’s all about timing.
Routine and timing is super important, especially if you’ve planned for a larger family lunch or dinner. It’s important to arrange arrival and eating times best suited for the person with dementia and ensure the time you all sit down to eat is consistent with any other day. Maintaining a daily routine can minimise anxiety and agitation, especially if feelings of hunger are difficult to communicate or recognise.
3. Inclusion not exclusion
To maintain meaningful social and loving relationships, always incorporate engaging activities that match the current ability levels for your parent or partner experiencing dementia. If there is anything the COVID pandemic has taught us, the importance of social connection and a sense of belonging are essential to our well-being and quality of life.
Excluding someone because of their limitations will only cause stress, confusion and an innate sense of loss. Alternatively, being a part of the cooking process, such as peeling or washing vegetables, is a valuable and supportive family inclusion activity. It maximises feelings of independence, which is important for inclusion and a sense of belonging.
Finally, be flexible and patient. As people progress through dementia symptoms uniquely, communicate with the family about mum or dad’s individual responses to different activities, be patient and adapt quickly.
4. Moods are contagious
People living with dementia have a wonderfully unique and uncanny tendency to ‘feel the room’ – this is called emotional contagion. I love this concept so much. Emotional contagion is when emotions are transferred between people in confined spaces, and it is quite amazing to see people living with dementia accept or reject a space based on this concept.
If the room is inviting, loving and familiar then you’ll probably be happy to move around that room too! Look at the room objectively; consider reducing clutter, increasing reminiscent objects and having easy recognisable background music or smells. These room considerations are therefore enjoyable for everyone in the room, not just for those living with dementia.
5. The ‘Here & Now’ space
I call this a ‘Here & Now’ space because it’s an essential environment for anyone who needs a break from the chaos of family and to be just in the moment. I know you know what I mean! Get this right and it might just be a permanent feature of your home. Create or set aside a single-focused-environment where one or two family members can sit together in a quiet area of the house enjoying ONE, just one activity.
For someone living with dementia (or anyone really!) including a here & how space during your family celebration is crucial. Be 100% clear about what one thing the space is intended for: music, reading, reminiscing, tasting or hugging, yes hugging. Cuddling up on the couch and listening to birds sing is an excellent here & now break out pastime. This is also a perfect opportunity to share the care in the family.
If you want more on creative positive environments for people with dementia, check out the Social Care Institute for Excellence. They have brilliant videos to show you how to improve home environments.
6. The Table
The absolute key here is CONTRAST! Definitely no overtly patterned table clothes or crockery. As we get older, or develop dementia, our perception of depth can be affected.
So, it’s important you consider the contrasts on the table too. Use a bright block coloured tablecloth if you have white serving dishes. Similarly, make sure the food on the serving dish is recognisable. For example, you wouldn’t put mashed potatoes in a white bowl or plate. If the food is unrecognisable, it’s unlikely to be a preferred choice! Also, don’t change the look of the food with sauces draped on top, keep them separate. If it’s safe to do so, allow for autonomy when selecting food. It’s a real pleasure to serve yourself and also doubles as a fantastic socialising experience. Again, patience is key here. Lastly, don’t underestimate the opportunity to set the table together, stories will come.
7. Appropriate Conversation
It’s important to be patient while talking with someone with dementia. People with dementia can often hear what you’re saying, but just need a little bit more time to process and respond to you. Take the time to wait for an answer or use encouraging language.
Finally, during table conversation, its important people don’t talk over-each other as this can be very distressing and difficult to follow. I like to use the ‘Zoom’ call analogy to master this technique; pretend you’re in a Zoom video chat where everyone takes turns in talking and listening. Take the time to engage in inclusive one-on-one conversation at this point, if it looks like it is getting too much, 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.
Lastly, my big tip when chatting with someone with dementia is, never ever start with “Do you remember..?”. Can you imagine how upsetting this would be if you truly couldn’t remember? If someone asked me that question about my own life events, I know I’d be a bit cranky. Instead, use the word ‘recall’ or influence a story by showing photos, playing with familiar objects, enjoying a 1:1 activity or begin conversations with leading questions.
8. Exchanging gifts
This is a tough one. Can exchanging gifts really be a calm experience? Provided you are aware and mitigate negative non-verbal reactions, it can be a hugely enjoyable experience. The noise levels are super important with this part of the day and be patient with each other as you open presents. No matter how old you are or what cognitive changes you live with, opening presents is a very nostalgic experience and should be enjoyed with a healthy dose of laughter (especially that of children), a little bit of mess and lots of love. Of course, 1:1 time exchanging gifts can be an incredible bonding experience too; I personally recommend this top tip for a more intimate experience – it’s worth its weight in gold.
Share in the Christmas spirit this year and add your own top tips below. Your tip might just be the one idea someone is really looking for
About the author
Kirsty is a Registered Nurse, Founder and CEO of the Umbrella Dementia Cafés. After successfully hosting her first café sessions in 2016, she saw a massive need to create social groups for families experiencing dementia. Kirsty now leads a team who support four dementia café locations, together facilitating over 230 cafés both face to face and online.