It is getting to be that time again and holidays are around the corner. Do your parents live in another city than you? For many the holiday period is a time when families are spending extended periods of togetherness, which can be both wonderful and challenging. If this is the case, this provides a wonderful opportunity to see how they are managing.

It is hard for many of us as adult children to watch our parent’s health deteriorate. It is hard to see that their current health no longer allows them to remember the names of their grandchildren, or family recipes that they can no longer follow. Be aware of the small things and things that are different. For example, is Mom now finishing Dad’s sentences because she always has or is he now not able to complete the sentence himself?

Here are a few suggestions.

• Don’t interrogate, use your observation and gentle questioning to determine how they are managing,
  • Take a drive with them,
  • Offer to make a meal with them or take them out for a meal, social awareness or lack thereof may be an indication of a change,
  • Start a conversation about the ‘what if’s’-
  • Find out what plans they have made should their health suddenly change,
  • Do they have a power of attorney in place,
  • Is there a list of emergency contact names and numbers on an easy to find location, should there be a need? (I personally like to place the emergency contact list on the refrigerator),
  • Take a look in the fridge to check expiry dates on the food or if there are blackened pots in the cupboard,
  • Pay attention whether they appear more frail or less stable on their feet,
  • Does the house seem unusually unkempt?
  • Is Mom, who was always a meticulous dresser now wearing stained clothes?

Part of this journey is acknowledging that your parents may need your assistance but are reluctant to show you or tell you that they need help. Pride and embarrassment can sometimes get in the way. To be sensitive to a parent’s needs, we have to get past our own denial about their health changes and perhaps their own denial as well. Assistance can be offered in many non threatening ways; such as, arranging for snow cleaning service or a house cleaning service or arranging to have a prepared meal delivered.

If you are traveling together, we have found that a little preparation can go along way:

1) Make sure to plan your itinerary with enough time in between events to allow everyone time to relax and re-energize in a quiet space. Try to plan events early in the day for shorter visiting periods to minimize the amount of time spent in large groups and loud places.

2) Always ensure the person carries identification with them should they become lost or disoriented. It may also be beneficial to consider registration in the Safely Home program through the Alzheimer’s Society wandering registry.

3) Whether you are driving, flying or taking a train this holiday season, make sure you have given yourself ample time to arrive at your destination.   If taking public transportation, ensure the person with dementia is sitting in the window seat and that you are sitting on the outside to avoid random wandering.

4) If staying in a hotel or an unfamiliar area, bring your own door alarm or child proof knob to help protect against wandering.

5) Try to follow and maintain the person’s regular routine as this will help reduce everyone’s stress levels and it will provide a sense of stability for the person with dementia. Do they have a particular item that is soothing?

6) If you are concerned about who/how/when someone will provide personal care services during your travels, you can always contact the personal support agency you are currently using if they have a location in the area you will be visiting, or you can contact another agency to arrange for someone local to provide personal support during your stay. This will allow the daily routine to remain as normal as possible and it will also decrease the amount of stress for the caregivers.

For caregivers, it is important to recognize your limits and take time for yourself. Try to change the expectations you place on yourself and others. Keep other family members and friends informed of your loved ones’ medical and cognitive status and seek help from them when you need a break. For the caregiver, providing some respite time can be a wonderful gift and one that is priceless. Stress and the holidays may seem to be inextricably linked but by planning outside the usual box, these tips will hopefully reduce stress for both you and your family member with dementia.

MAREP, an Alzheimer’s research organization has provided some great suggestions:

• Take your time – synchronize your pace to that of your family member with dementia. The holiday season is about enjoying quality time with family and excessive entertaining activities can be overwhelming
• Plan one activity at a time – multitasking can lead to frustration for everyone
• Understand if your family member doesn’t seem to appreciate the efforts of an elaborate dinner – they may be happy to be in your company and get anxious with all of the activity and fuss involved in meal preparation. Alternately, they may enjoy being included in the preparations for the holiday meal
• Consider the noise level and multiple distractions that cause a person with dementia a great deal of stress when with large groups of family or friends Do not be offended if they want to go home immediately after eating dinner
• Be considerate of the words “do you remember” as this often places pressure a person to reminisce and remember specifics if they have memory difficulty
• Sharing photo albums of previous holiday celebrations can assist with a relaxing form of reminiscence
• Provide a quiet place for a family member with dementia to relax – they may need some time to relax to continue with the activities of the season

• Set priorities and a routine for the holidays in advance.   Decide what is most important and focus on those priorities

Gift ideas can include:
• Talking and sharing stories
• Looking at photo albums together
• Listening to music and watching old movies together
• Hand lotion and a hand massage can be very well received- gentle touching can be appreciated
• For those in the later stages, picture books of animals and babies are often well received.

Our American colleagues at Aging with Grace have provided this list of suggestions for great senior gifts this holiday season: Senior Fast Food Holiday Basket which contains food items which are quick and easy for the senior and also fast and nutritious. Health and Beauty Basket: an assortment of the vitamins that they may take on a regular basis, Tylenol, soaps, hand creams, shampoo, etc. Pre-pay telephone and or cable bill for a few months. The payment will go as a credit on their bill.

Large face clocks or telephone with oversized keypads and adjustable volume (pre-programmed of course by a family member with all the most frequently called numbers.) Gift certificates for the barber or hairdresser’s, neighborhood grocery store. Memory Box filled with pictures and mementos of significant events in the senior’s life. Home Safety Box with Batteries for smoke and carbon monoxide detectors, night lights with built in sensors and don’t forget to include a supply of replacement bulbs. Video tapes of old TV shows such as I Love Lucy, Carol Burnett, Golden Girls, Milton Berle or tapes of old movies. Lawrence Welk is always a big hit!

Dinner for One (or Two) Club: prepare several dinners complete with dessert, freeze and place in their freezer for their future use. Be sure to mark what is in each container. Make a “Family Memory” video. This is a wonderful gift that reminds the receiver how much they mean to the family and a chance to thank them for all they have contributed over the years. Of course the best gift we can give our loved ones (and ourselves) is meaningful time spent together. It only takes a moment to create a lasting memory.

Originally published CARP Winter 2009