A leading community and aged care expert has released tips on how to create happy memories for those with dementia this Christmas.
People mostly associate the festive season with joy and good cheer, however it can be particularly stressful for those with dementia or memory loss - a condition affecting more than 400,000 Australians.
“Christmas can be a busy and hurried time, with the pressure for everything to be perfect sometimes creating tension and pressure for the whole family,” said Tracey Silvester, Executive Manager at Envigor Home Care.
“Stressful and unpredictable situations are already unwelcome for a person with dementia or memory loss.
“Christmas, with all its expectations and ideologies, adds a level of complexity to these situations that often put a strain on the capacity of a person with dementia to manage their already challenging symptoms.”
Ms Silvester has offered some timely advice for family members trying to create great memories of Christmas for everyone, especially the family member with dementia.
Provide food that is easy to eat
We know how important food is at Christmas to creating those amazing memories. Imagine how overwhelming that table full of food is for a person with dementia. Instead of all the work associated with creating a huge feast, it can be helpful for the person with dementia if they are able to access a lot of snack and finger foods.
Place a range of snacks around the living and dining areas (or wherever your guests are going to congregate) for everyone to enjoy. This allows the person with dementia to walk around, digest food and engage with others in the process, even if they are distracted from eating at times.
Providing finger foods also means that if the person has difficulty with cutlery they can still eat their food with dignity. Finger foods are also great for kids meaning that the person with dementia isn’t made to feel out of place when they are eating.
Make the portions small and the food on the soft side
In line with the suggestion to provide finger foods, also remember that some people with dementia may have difficulty with swallowing or chewing their food. Providing them with smaller portions that do not require as much effort to chew and swallow will mean they are more likely to eat. Keeping the texture of the food on the soft side also assists with chewing and swallowing. Smaller portions of food are also less overwhelming for the person with dementia to manage, especially when confronted with a pile of food on a plate.
Finally, if you don’t see the family member very often, check with their main carer about whether there are any foods to avoid or if there are foods the person should have.
Use social cues to ‘announce’ meal time has started
Because orientation to time can become an issue for people with dementia, they may not realise that it is time to eat or that the meal service has commenced. Starting the meal time by saying grace or proposing a toast will bring focus to the start of the meal and might be a helpful cue for the person with dementia that it is time to eat.
Help the person get started with their meal and pay attention to the light
Depending on the progression of the person’s cognitive decline, they may not recognise everyday items that are commonly on a table such as cutlery. Putting the knife and fork in their hands may prompt them to remember what to do with the utensils. Encourage everyone else at the table to commence eating, as this will sometimes also trigger a memory of the purpose of the utensils.
As we age, our eyesight deteriorates. For people with dementia, not only has their eyesight degenerated, so too has their ability to make out shapes and light and dark. Not that it is an issue here in Australia, but making sure there is adequate lighting at the table will assist the person with dementia in identifying where their plate is on the table and what food is on the plate. Using a plate that is a contrast in colour (especially red) can also assist as it supports the person to distinguish between the tablecloth and the plate. It might also be a good idea to position the person with dementia at a seat around the table where it is easy for them to leave the table to go to the toilet.
Conversations – make them happen by keeping them simple
Let’s face it, who wants to have a conversation about world peace at Christmas anyway. For a person with dementia overly complex subjects coupled with the confusion associated with being in a room full of people can be distressing. People may find conversation with people with dementia challenging because of their short-term memory issues
The goal here is not to highlight that the person with dementia is having difficulty remembering things. Using short sentences, avoiding complicated words, and not repeating things multiple times (no matter how much you might want to) will give the person with dementia the time to process the initial topic of conversation.
Christmas is actually a great time to have conversations with a person with dementia because it is naturally a time of year that can trigger memories for that person that have otherwise been suppressed by time and circumstance. Drawing on long-term memories is a way the person with dementia can meaningfully participate in a conversation and is also a way for family members to learn more about their lives.
The only downside to remembering things from the past is that Christmas can also trigger sad memories, especially if the person with dementia has lost their spouse. It is difficult to avoid these memories but a way of turning them into happier memories is to have old photos or videos available that can help broaden the conversation.
If holding a conversation is challenging, then use the many great things about Christmas related to music and singing. Most people with dementia enjoy singing their favourite Christmas carols and there is a lot of evidence the music can relax people who are a bit stressed and overwhelmed.
Don’t underestimate the power of familiar surroundings
While that lunch at the restaurant seemed like a good idea at the time, for a person with dementia, being in unfamiliar surroundings can be distressing. Plan to reduce the stress as much as possible.
This includes packing a bag with all the necessary medication and up-to-date information about their needs. This will reduce the stress for everyone if the person becomes unwell. Include a change of clothes in the event of any accidents (and to reduce embarrassment).
Also remember that the person with dementia won’t have as much energy as they used to have which, coupled with the stress of seeing new people and potentially being in a new place, means they will get tired easily. If you can, make a rest space available for them so they can rest if they need to. This space should be quieter and away from the noise but be close to a well-lit bathroom in case they need to use the toilet.
Fortunately, our climate here in Australia allows access to some lovely outdoor space. To a person with dementia, noise can be as limiting as stairs are to those in a wheelchair so being able to have a break in a quiet spot for a while can be a welcome respite.
Carers need a break too
Last and definitely not least, don’t forget primary caregivers at Christmas. Caring is a full-time job that is stressful and often unrelenting. Christmas can be a time when carers can have a break because there is often family around who can assist.
Make sure you spend time with the person with dementia and create memories for you and them but don’t forget their carer who might be quite isolated due to their caring responsibilities.
Finally though, don’t overthink Christmas. As a famous person once said, ‘don’t sweat the small stuff’. Remain open to the possibility that nothing will go to plan and in the end, that is OK. Provided everyone has fun and there is laughter and love, the outcomes will look after themselves.