However, for many people, Christmas is a stressful time, and this is certainly the case if there you are struggling with caring for a family member with dementia. Tensions and difficulties can be made worse if there are conflicts in the family and expectations of family gatherings that could turn into pressured and distressing situations.

An added dimension is the pandemic: last year, the Christmas holiday period was severely disrupted by Covid restrictions. This year looks different, although the fear that many older people are living with that the new variant is spreading and presenting added risk, means that people with dementia and carers are feeling isolated and alone.

Here we provide some advice about coping with the holiday period and keeping safe.

1. Creating a peaceful environment

Unfamiliar experiences and can disrupt a person with dementia’s feeling of safety and comfort. Bright lights can be over- stimulating for a person with dementia, and if family and friends visit, conversations might be confusing and a person with dementia can easily feel excluded. A busy environment with too much activity and noise might feel bewildering and cause distress and agitation.

It is important for people with dementia to remain socially connected. Visitors are helpful in validating a person’s identity and offering opportunities for connection. It’s helpful to provide guidance to friends and family on how to relate to the person you are caring for, offer information in advance about subjects that are likely to spark recognition and positive responses. Shared activities help to provide meaning for a person with dementia. Maybe some artwork is appropriate: painting, drawing, craftwork help a person to express themselves; or looking at picture books to prompt memories of travel and holidays. Listening to music is very soothing for many people, connecting them with past memories or simply lifting their mood.

2. Manage expectations

If you are used to big family celebrations, it’s worth considering what you can do to adapt the situation. Talk to family members to enable them to understand the difficulties you might face with your relative during Christmas period

3. Reassurance

People with dementia may struggle with conversation and communication in a group setting, so they will need some sort of reassurance. They may not be able to get involved in the conversation. Keep reassuring them and be aware that as they are getting tired, they will get more agitated and stressed. Monitor how they are feeling and give them time out in a quieter environment and be aware that things may become over-stimulating.

4. Give relatives the heads-up

If it’s been a while since certain family members have seen the person, let them know that the dementia has progressed. If you are going into a restaurant for a family meal, discreetly let the restaurant staff know that the person has dementia and that there are issues in relation to their ability to cope in a busy environment. Too much cutlery on the table may confuse them for example. Being honest and upfront and saying to people: “We have got to make some allowances today because my father has dementia and it’s progressed” makes it easier for them to appreciate the situation. You can say: “He’s much more impaired and consequently he may well struggle with communication, the amount of tableware and he may get confused.” If you are upfront about it, people can make allowances.

5. Be wary of taking the person out of their own home

You may want the person to come to you or another relative’s house for Christmas, but this change in routine and environment could cause distress, though it depends on the person. Question whether it’s going to be beneficial for them and the rest of the family. Try to determine how you feel the person can cope in social environments before making a decision. If they tend to struggle and this leads to frustration and stress, you have to question whether it actually works. It may be easier for you to have dinner at the person’s house or take them out for lunch, but again be wary of large crowds and noisy environments.

6. Give them a break if they are getting stressed

If the person with dementia is in a social environment and they seem to be getting stressed, take them away from it before their frustration or confusion escalates. Sit down with them somewhere quiet and hold their hand if they feel comfortable with that. Sometimes you have to sit back and allow the person time to calm down if they have become angry. Some fresh air and a walk if this is possible can help, especially if the environment they were in was causing them stress. Putting on their favourite music and letting them listen to it while you reassure them can help.

7. Don’t feel disheartened if they don’t remember Christmas

If Christmas Day goes well and the person has a good time, don’t feel disappointed if they don’t remember any of it the next day. The most important thing is that you made them feel safe, secure and good in that moment. And even if they don’t remember what they did the next day, they may well remember that they felt good.

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