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Published on: December 8, 2014
As much as Christmas is a favourite time of year, it can also be busy, hurried and even chaotic – sometimes resulting in tension and pressure for the whole family.
For the person with dementia, stressful and unpredictable situations are even more unwelcome and can put strain on their strategies for managing their symptoms.
The good news is that with some planning ahead, the creation of ‘excess disabilities’ can be avoided for the person with dementia.Associate Professor Colm Cunningham, Director of HammondCare’s Dementia Centre, believes that people need not miss out on the happiness of Christmas because they have dementia.
To support families, carers and people living with dementia, Colm recommends five ‘considerations’ this Christmas covering food, mealtimes, conversations, unfamiliar surroundings and respite for carers.
1. Food – Nibbles and natter: Food is a feature at Christmas time and its prevalence can be a benefit to the person with dementia. Colm said that if the person with dementia was distracted from eating, there was likely to be a range of other snacksalready placed throughout the living area which they could enjoy. And this allowed for walking around, digesting food and engaging with others in the process.
Preparing finger foods in advance means that if the person forgets or has difficulty with cutlery they can still enjoy their food with dignity. This may also encourage more eating – for people with dementia under-nourishment is often an issue. Some people with dementia may have swallowing or chewing difficulties and so smaller portions and softer food are important. It is wise to check if there have been any changes in diet since the last time the family where together, and ensure any specialist advice is planned for in the menu.
2. Mealtimes – aiding recognition:Colm suggests starting mealtimes by saying grace or giving a toast. This brings focus to the start of the meal and is another social cue to eat. “Sherry is often shared at Christmas time as a traditional appetiser and this, or something else familiar before mealtime, gives the cue that food is coming.
“Depending on the progression of the person’s dementia, they may not recognise generic dining table items, such as cutlery. “Putting the knife and fork in their hands may prompt the memory of cutlery. Having a tactile cue will help trigger what to do with the utensils. ”It is also important to consider lighting, as a person with dementia may have trouble seeing what is on their plate. Colm’s suggestions are to position their place-setting in the best lit area, and use plates with contrasting colour to the meal.
3. Conversations – encourage confidence:People may find conversation challenging to navigate when talking to someone with dementia whose short-term memory is impaired.“Don’t highlight that they are on the back foot,” Colm said. “The primary goal in this instance is to avoid making them feel unsure or uneasy around guests. “It’s important to use short sentences, avoid complicated words, and try not to repeat things multiple times, but give the person with dementia time to process what has been said initially.
“Christmas actually provides many natural aids to conversation, as we remember people, places and things from the past. A person with dementia can often be in a stronger position in the conversation if they are drawing on long-term memories.
”Some sad memories may be more present at Christmas. While these shouldn’t be avoided, Colm suggests that having old photographs or home videos on hand can help to broaden the conversation. “And if holding conversation is challenging, then make the most of the musical aspect of Christmas – singing and listening together.
4. Unknown surroundings – plan ahead: Visiting family and friends for celebrations can take place in a variety of locations often not familiar to the person with dementia. To eliminate undue stress, it’s important to plan ahead as much as possible. “Having a bag packedwith appropriate medication (consult your doctor) and up-to-date information about their needs will ensure the right decisions will be made if the person becomes unwell,” Colm said.
“A change of clothes may also be sensible – avoiding embarrassment if the person has not easily found the toilet and an accident has occurred.”As family gatherings can be tiring and overwhelming, Colm suggests having a rest-place in mind. This could be a bedroom that is away from noise and crowds, but close to a well-lit bathroom.Noise can be to a person with dementia what stairs are to a person in a wheelchair, so being able to get away from the noise and bustle for a while may be a welcome respite.”
And a designated driver is another practical idea. “In the event the person with dementia has an unexpected turn, or becomes anxious in the unfamiliar environment and needs to be taken home, there will be a family member ready to see to their wellbeing.”
5. Respite – carers need a break too:Colm urged families not to forget primary caregivers at Christmas as it is a great opportunity to offer them support. “Ensure you spend timewith the family member who has dementia, but also with the carer who might otherwise be isolated due to their caring responsibilities. “It’s a perfect opportunity to provide respite to carers – perhaps offering to see to the needs of the person with dementia – so they can relax and enjoy the festivities or just have a break.”
These tips are generalised guidance and do not reflect the overall importance of knowing and engaging with the individual.
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