Celebrations this time of year often include special events — sometimes with a lot of people in unfamiliar places — which can cause confusion and anxiety for a person with Alzheimer’s. However, maintaining or adapting family traditions can help someone with dementia feel a sense of belonging and connection with their loved ones around the holidays. It’s important to make them feel involved in the celebrations when and where possible, which can sometimes feel challenging for caregivers and family members.
Caregivers and experts on dementia and caregiving share their best advice to help you prepare for (and enjoy!) the holiday season with your loved one:
Yelena Sokolsky, RN, CEO, Director of Patient Services at Galaxy Home Care NY, offers advice to caregivers and family members for planning and navigating holidays, starting with how to prepare family for interactions with their loved one:
“Caregivers and family members should have an open and honest conversation in advance with relatives and close friends/guests. Explain the person’s condition and any recent changes in behavior, and suggest ways to engage with and support their loved one during gatherings. It’s important to emphasize empathy, patience, and the need for a calm environment. Sharing information about the person’s preferences, triggers, and communication strategies can help create a more understanding and supportive atmosphere during family gatherings.”
Sokolsky also offers some ideas for ways to involve a loved one in the celebrations:
“When deciding on holiday events and gatherings, consider the individual’s comfort level, sensory sensitivities, and fatigue. Small, intimate gatherings in a familiar setting may be preferable to large, noisy parties. Flexibility in scheduling and the ability to leave early if necessary can also help ensure that the events are safe and manageable for the person with dementia. Creating a sensory-rich experience, such as playing their favorite music or preparing their favorite meal, can also bring the holiday spirit to them.
“If a loved one can’t attend gatherings or events, caregivers and family members can make them feel included by scheduling voice or video calls, reading cards or letters together, and sharing pictures and stories from the event.”
She also advises caregivers to prioritize self-care during the holidays to prevent burnout:
“This can include seeking support from family and friends, utilizing respite care services, and managing their own stress levels through relaxation techniques and time management. It’s essential to set realistic expectations, delegate tasks, and remember that self-care is not selfish but necessary for providing effective care and enjoying the holiday season.”
Meagan is the founder and CEO of Chapter, which helps families prepare for the challenges of caregiving and end-of-life. She notes that holidays often come with many events and gatherings, offering this advice to caregivers and family members to help determine what is manageable for their loved ones:
“If you’re wondering what events to bring your loved one to, start with how you think they will feel about the gatherings. Are they in a state where attending a party will bring them joy, or will it just cause stress and confusion, taking them out of their routine?”
She offers these guidelines to help caregivers make these decisions:
Consider the environment: “Evaluate the settings of potential events or gatherings. Is it a familiar and comfortable environment for the person with dementia? Is it likely to be too noisy, crowded, or overwhelming? Choose locations that are more conducive to their needs.”
Limit the duration: “Shorter, more manageable gatherings are often better than long, all-day events. Consider the person’s attention span, energy levels, and signs of fatigue or agitation.”
Choose the right time: “Select a time of day when the person is typically at their best. Many individuals experience “sundowning,” a phenomenon where their symptoms worsen in the late afternoon or evening. Morning or early afternoon gatherings may be more suitable.”
Be mindful of routines: “Try to maintain regular routines and schedules as much as possible. Consistency can help reduce stress and confusion for the person with dementia. If an event disrupts their routine significantly, it may be best to reconsider attending.”
“Ultimately, the key is to be considerate of your loved one’s needs and comfort. While it’s natural to want to participate in holiday events and gatherings, their well-being should always take precedence, and it’s okay to decline invitations or modify plans because that’s best for them.”
If a loved one can’t attend gatherings or events, she suggests a few ways caregivers and family members can make them feel included in the celebrations:
Schedule individual visitors. “If family members are getting together, but a loved one can’t be there, try and schedule individual visits from a few family members to provide that social interaction.”
Share past family holiday stories. “Take the time to share stories and reminisce about past holiday celebrations. Discussing shared memories can be a source of comfort and connection.”
Print photos. “Print photos or create a photo book from holiday activities. It can often be easier for somebody with dementia to look at a physical picture than on a phone.”
Bake or cook together. “Involve your loved one in easy baking or cooking activities, like decorating cookies or mixing ingredients. This can engage their senses and create a holiday atmosphere.”
She reminds caregivers and family members that the key to making your loved one feel included is to focus on their comfort and well-being:
“Each person with dementia is unique, so adapt these suggestions to suit their individual needs and preferences and keep in mind that even though you miss them at an event, they might not have enjoyed being there in their current state. Instead, inclusion can be achieved through simple, meaningful, and personalized activities that bring joy and connection during the holiday season.”
Barbara Huelat, AAHID / FASID /EDAC, Human-Centric healthcare, home designer, and dementia caregiving expert. She shares ideas for ways to involve a loved one in safe, manageable holiday preparation activities:
“During the holidays, try to keep activities very short for those suffering from dementia and attach as much memory to activities as you can, like saying, ‘This is a decoration we made together when we were kids.’
“You can also have a festive environment to remind them of the holiday season, get all the senses involved. Play a lot of holiday music they grew up with; music is helpful to set a festive mood. Put on old Christmas movies; they may not remember all of the movie or watch the whole thing, but they may remember some aspects, certain actors, etc.
“The smell of baking and holiday decorations help those with dementia keep grounded. However, if any sharp objects need to be used, the caregiver should be responsible for that and handling the oven or anything hot.”
Dr. Macie Smith, a licensed gerontology social worker at SYNERGY HomeCare, focuses on helping families support their aging loved ones through long-term care. She suggests using “reminiscent practices” to get a loved one living with dementia involved in holiday planning and celebrations:
“[Allow] them to participate in activities that are nostalgic, meaningful, and routine for them, such as baking sweet potato pie. Certainly, they may not be able to complete all the tasks with excellence; however, there are parts of the process that they may be able to do quite well, such as washing the potatoes.
“First, figure out what they enjoy. Then, figure out what part of the process they can participate in with little to no disruption in the overall goal. Lastly, prepare a safe space where they can participate and be as independent as possible in completing said tasks. Once they are done, praise them for their efforts, whatever that might be.”
When deciding what is manageable for a loved one, Dr. Smith says always to consider the person with dementia:
“The smaller the event, the better, as it would be less stimulation. Allow the person to dictate how they feel about each event. If at any time they get irritated and/or agitated, it’s time to go. If they start to repeat themselves, display restless behavior, and appear to be in distress, it’s time to go. It’s not about the party; it’s about the person.”
She offers tips to prepare for family interactions:
“It might be nice to wear name tags and that person’s relationship to their loved one so that there will be no guessing games played. You want to stay away from the guessing game. Don’t say things like, ‘Do you know what I am?’ or, ‘Do you remember me?’ Chances are, if you have to ask those questions, they don’t.
“Also, wearing a picture from long ago on your clothing or carrying it around in your pocket to pull out ever so often might also relieve some anxiety and agitation for the person.”
Shanna Grayson is the vice president of care management at Homethrive, an Illinois health tech company “transforming the caregiving crisis.” Grayson, a licensed social worker and a caregiver herself, shares these tips:
“The key is to find activities that will resonate with their loved one, perhaps that may spark memories from past holiday traditions. Additionally, keeping the activities simple (i.e., not too many steps) and, of course, safe (i.e., activities that don’t involve cooking over a stove, climbing ladders, or using sharp objects). Examples would be helping to pick out ornaments for the tree, decorating holiday-themed cookies, or helping to set the dinner table. Help them to feel important and involved, no matter how simple the activity may be.”
She helps caregivers prepare family members and friends for interacting with a loved one who has dementia. She suggests initiating a phone or email message using a script similar to this:
“I want you to be aware of some changes in [mom/grandpa, etc.]. As you know, they have been diagnosed with dementia. This means that their cognitive functioning is changing. In some instances, they may seem like their old self, but in other instances, they may seem off or different. It may be hard for them to follow conversations or to have in-depth conversations with you. It is best to keep it simple, such as talking about things going on in the present moment.”
Grayson says that when deciding what events to include a loved one with dementia, it is important to consider a few things:
“First, the time of the event. If the event is taking place in the afternoon or evening and you know that is the time of day when your loved one gets tired or more confused, it is a good idea to keep them home. If having your loved one there is important to you, consider having the event earlier in the day in familiar surroundings.
“Second, the setting of the event. If the event is taking place somewhere loud and without a space for the loved one to sit and escape from the noise, it could be overwhelming for them, and best not to bring them.
“If possible, schedule a separate visit at their home or senior living community to have a special holiday gathering just for them. If they are comfortable with screens and , schedule a special call if in-person gatherings are not possible. Sending a special gift with cards from the family and having someone go there to open it and read the cards with them.”