Tips for the holidays

Introductions matter

It is sorely tempting to say Hi to Aunt Jean, then ask if she remembers you. Or to ask, “Grandma – which one am I?” But asking a person with memory issues questions they may not be able to answer can cause distress and feelings of failure. Instead:

• Greet the person with a cheerful hello and a smile (even if it is obscured behind a mask).
• By greeting with, ‘Hello Grandpa,’ or ‘Hey! It’s my good friend Marion!’ you’re immediately giving a clue about the relationship.
• Without skipping a beat, point to yourself, and say your name, adding additional context as seems suitable. Try to add context in a way that doesn’t convey the message, ‘You need me to tell you this because you don’t remember so well anymore.’ Notice the difference between:
  
  “Hiya Bob. I’m Jack. We used to work together at the bank,” versus,
  “Hiya Bob,” (points to self), “Jack. Boy, I sure miss the fun we used to have working together at the bank!”
• Name tags, even at an intimate family gathering, can be a big help.

Be patient

Yes, Uncle Frank has told you that story before. Six times this evening, to be exact. Responses like, ‘You already told me that, or ‘You just asked me that,’ and either of these punctuated with the LEAST appropriate thing to say to a person with memory loss -- ‘Don’t you remember?’ can cause a person to feel like less than. Stupid. Unappreciated. And these feelings can lead to a person becoming argumentative or defensive. It’s up to the person with the healthy brain to manage such conversations in a compassionate way. Patiently follow each retelling with, “Wow, Uncle Frank. That’s quite a story!” Or maybe, since you’ve already heard the story, you can ask him to share specific details.

Many people with memory loss or dementia have trouble finding words. Don’t assume they want you to fill in the blank. Give them plenty of time, or ask if they would like assistance. “Hey – I think I know the word you’re looking for. Would you like some help?”

Create a dementia-friendly environment

• Pickup throw rugs and other tripping hazards.
• Consider whether the space should be walker/wheelchair friendly.
• Use signage to avoid confusion. A sign that says BATHROOM on the bathroom door, for instance, could be helpful.
• Avoid dim lighting, which can make it harder for a person with dementia.
• Check the noise level. Loud music. Lots of conversations. A TV playing in the background. These competing noises can create discomfort and confusion.
• If space allows, consider setting up a quiet, soothing place where the person with dementia could sit for one-on-one or small group conversations.

Stay out of judgement

Yes, Aunt Millie is picking her nose. And Grandpa is saying things that are inappropriate. And your cousin Emily has just eaten her fourth slice of pie—with her fingers. And your old golfing buddy, Tim, is wearing shoes that don’t match. They are all doing the best they can. There is nothing willful about these behaviors, they are simply the reality for a person whose brain doesn’t work so well anymore. Remember that dementia causes one to lose filters and can result in socially inappropriate behaviors.

This is an opportunity for us to get into the holiday spirit and be generous and genuine. Get Aunt Millie a tissue. Change the subject and invite Grandpa to go for a walk, or sing a song with you. You’d probably be doing Emily a favor by removing the pie, and offering her a warm cloth for her fingers. As for Tim’s shoes—they’re not hurting anyone, are they? Then let it go.

Don’t reality check

It’s painful that your sister thinks you’re the lady who works at the library. And it’s really hard to hear Dad complain bitterly about Mom for not showing up at the party when the reality is that she passed away 12 years ago. Trying to convince a person with dementia that their beliefs are incorrect will not get you very far. Instead, allow yourself to be sad about what is, while remaining grateful for what was.

And meet the person where they are. Regardless who your sister thinks you are, you can have a warm conversation and help her feel connected and appreciated. As for Dad, you can agree that it would be really nice if Mom was there, and then steer the conversation towards all the things that you both love about her. Who knows, maybe she is not at the party because she’s out buying him a gift?

Supporting a loved one with dementia comes with challenges. But it also comes with moments of joy. Especially if we are able to look for ways to create an environment that is warm and welcoming, and that says I love you for who you were, as well as for who you are.