Holidays and Alzheimer's

Hi neighbors. From the ghosts and goblins to the babies in top hats, this time of year is full of holidays. Holidays are traditionally a time for families to gather and celebrate their love. But if you are a caregiver to a person with Alzheimer's or other dementias, the thoughts of a houseful of guests -- even beloved guests -- can seem overwhelming.

The Alzheimer's Association has some tips on this particular aspect of caregiver stress and how to make the holidays enjoyable for everyone in the family. For more information go to Alz.org or call Barone Alzheimer's Care Center in Nevada (417-448-3999) for free information and tips.

The holidays are full of emotions, so it can help to let guests know what to expect before they arrive.

If the person is in the early stages of Alzheimer's, relatives and friends might not notice any changes. But the person with dementia may have trouble following conversation or tend to repeat him- or herself. Family can help with communication by being patient, not interrupting or correcting, and giving the person time to finish his or her thoughts.

If the person is in the middle or late stages of Alzheimer's, there may be significant changes in cognitive abilities since the last time an out-of-town friend or relative has visited. These changes can be hard to accept. Make sure visitors understand that changes in behavior and memory are caused by the disease and not the person.

You may find this easier to share changes in a letter or email that can be sent to multiple recipients. Here are some examples:

"I'm writing to let you know how things are going at our house. While we're looking forward to your visit, we thought it might be helpful if you understood our current situation before you arrive. You may notice that has changed since you last saw him/her. Among the changes you may notice are . Because ___ sometimes has problems remembering and thinking clearly, his/her behavior is a little unpredictable.

Please understand that ___ may not remember who you are and may confuse you with someone else. Please don't feel offended by this."

The stress of caregiving responsibilities layered with holiday traditions can take a toll. Invite family and friends to a face-to-face meeting, or if geography is an obstacle, set up a telephone conference call. Make sure everyone understands your caregiving situation and has realistic expectations about what you can do. Be honest about any limitations or needs, such as keeping a daily routine.

Give yourself permission to do only what you can reasonably manage. If you've always invited 15 to 20 people to your home, consider paring it down to a few guests for a simple meal. Let others contribute. Have a potluck dinner or ask them to host at their home. You also may want to consider breaking large gatherings up into smaller visits of two or three people at a time to keep the person with Alzheimer's and yourself from getting overtired.

If evening confusion and agitation are a problem, consider changing a holiday dinner into a holiday lunch or brunch. If you do keep the celebration at night, keep the room well-lit and try to avoid any known triggers.

Focus on activities that are meaningful to the person with dementia. Your family member may find comfort in singing old holiday songs or looking through old photo albums.

As the person's abilities allow, invite him or her to help you prepare food, wrap packages, help decorate or set the table. This could be as simple as having the person measure an ingredient or hand decorations to you as you put them up. (Be careful with decoration choices. Blinking lights may confuse or scare a person with dementia, and decorations that look like food could be mistaken as edible.)

Sticking to the person's normal routine will help keep the holidays from becoming disruptive or confusing. Plan time for breaks and rest.

Arrange for respite care so you can enjoy a movie or lunch with a friend.

Diminishing capacity may make some gifts unusable or even dangerous to a person with dementia. If someone asks for gift ideas, suggest items the person with dementia needs or can easily enjoy. Ideas include: an identification bracelet (available through MedicAlert® + Alzheimer's Association Safe Return®), comfortable clothing, audio tapes of favorite music, videos and photo albums.

If friends or family ask what you want for a gift, suggest a gift certificate or something that will help you take care of yourself as you care for your loved one. This could be a cleaning or household chore service, an offer to provide respite care, or something that provides you with a bit of rest and relaxation.