It’s that time of year; Christmas and the holiday season is right around the corner. The following strategies may help to ensure your holiday celebration is dementia friendly and supportive for all. Without any further ado, let’s get straight into it:

Establish a plan ahead of time

Thinking ahead and establishing a plan can help ensure everyone has the best possible chance of enjoying the day. Here are a few things I recommend worth considering in advance:

• Firstly, decide whether it would be best for the person with dementia to have a shorter visit rather than expecting them to attend a whole of day event. Can you organise arrival and departure times to take place during a quieter/calmer part of the day? Is there a particular time of day where you tend to find your family member or friend is feeling freshest (or, just as importantly, most agitated)? It may be worth taking this into account.

• If the person with dementia is attending a longer event, if possible, it is worthwhile to have a designated quiet, calm room/area the person can retreat to if the noise and stimulation gets too much. If the space has a well-lit bathroom next to it, that would be ideal. 

• Pack a bag with medications and a change of clothes in case they are required.

• Consider having a designated driver who can drive the person home if it gets too much and they need to leave.

 Turn off the Christmas tree lights

Be aware that while they’re a magical part of Christmas, flashing lights can be aggravating and confusing for some people with dementia. A simple yet effective solution is to turn Christmas lights off while they visit.

Try to keep to routine as much as possible and use social cues

People with dementia generally do well with routine. If possible, try to stick to their usual meal times and structure.

If the festive meal is a sit-down type event, support your family or friend by using social cues for when things are about to happen. They may recall traditions from the past and this will support a positive dining experience. For instance, they may recall saying a toast with “Merry Christmas!” at the table at the beginning of the meal. This can function as a  social cue that it is time to eat.

A Christmas dinner scenario

I have created the following scenario to help you consider what Christmas dinner could be like from the perspective of a person living with dementia:

You’re seated at a long table with a large group of people. The festive colour home decoration theme is white on white this year. Everyone says it looks beautiful and festive however you have some vision problems: you find it hard to tell colours apart when there’s not a great deal of colour contrast.

Because of the colour scheme you’re seated at the table and can’t really see the end of your chair so you worry you might fall. You look at the table and find it’s really hard for you to see where your plate ends and the table begins. Your glass is clear. Since you can’t see it, you don’t realise it’s there.

Some of the people sitting at the table are familiar, the rest are strangers. You can’t recall all their names, yet they can remember yours. You feel uneasy as you’re not used to being around this many people and it’s really noisy.

Everyone around the table is speaking a different language from you. You studied this particular language at high school, so you know a few words, but the rest have no meaning. A person suddenly says a word to you that sounds familiar. At last!

You pay extra attention now and focus on translating that word so you can respond. Unfortunately, you took too long: someone else has now said a new word. You’re now trying to work that out too. Do the two words relate to each other? Or are they different topics? After just a minute or two you realise it’s impossible to keep up. You start to feel isolated even though you are sitting in a group.

The food is unfamiliar, not like what you usually eat at lunch (you have a few favourite meals that you like to eat). The food is hard to see as it is white (food – turkey and potatoes) on white (plate) on a white (tablecloth).

You’re hungry but you struggle to use knives and forks as you find the food falls off them before you get the cutlery to your mouth. Worse, the food might fall onto your clothes and that would be awfully embarrassing in front of all these people.

After five minutes you’ve had enough. You stand up and walk away, going to find somewhere else where it is calmer and feels more familiar.

This scenario was not written to scare you or make you feel sad. Rather, it was written to include as many of the most common issues that people with dementia may be living with as possible. It’s important to note that every person’s experience with dementia is unique to them. Perhaps only one, or some, or perhaps all of situations explained in the scenario may apply to your family or friend.

By taking a moment to consider the experience from the perspective of the person with dementia you now have the ability to have greater understanding, awareness and compassion for what the experience may be like. A few simple adjustments may help to reduce some of the challenges people with dementia may face ensuring that they enjoy the festivities as much as possible.

Strategies for a dementia friendly festive dinner

I suggest a first step is becoming an honorary detective; make some observations and try to work out which of the issues I highlighted above are a particular problem that may need to be addressed for your family or friend. Does your family or friend have vision difficulties? Do they have trouble handling food or swallowing? Are they sensitive to noise? Are they really tired or agitated at certain times of the day? By working out what are their likely issues, you can then tailor your own strategy to best achieve an enjoyable experience for all.

After you’ve completed your detective work, there are some additional suggestions that you may like to use to help support you. Remember, not all of these will necessarily apply to your family or friend. Please use the ones that apply to your specific circumstances:

Consider whether a large “sit around the table” event is going to be a positive or stressful experience for everyone.

• Perhaps having a smaller gathering (3 – 4 people) may be a nicer experience for all.

• I realise that this may potentially be a bigger adjustment than may be possible for your situation. If you can’t do this and it’s to be a large gathering, there is no guilt! There are still practical things you can do to support even when there are larger volumes of people.

Consider whether softer or finger type food would be a better alternative for the person with dementia.

• If your family or friend resides in a residential care facility, it could be worth asking what types of food would be suitable.

• Finger foods are easier to pick up and eat without cutlery.

• Alternatively, soft foods that “stick” to a spoon/fork may be another option.

Use high colour contrast plates to table.

Remember, some people may struggle to see the food on the plate if there isn’t high colour contrast. Consider a red plate on a white tablecloth or a white plate on a red tablecloth. If you have a specific colour scheme such as white on white, you could place a single, bright coloured placemat underneath the plate for your family/friend to assist with increasing colour contrast if required.

Turn on the room lights/open the curtains.

Increasing the lighting in the room will make easier for the person to see what others are saying and to be able to eat.

If your family or friend wanders…

If your family or friend is unable to sit down or they wander off, please don’t take it personally or think of it as rejection. After reading the above scenario hopefully it is easier to empathise with why they may feel the need to leave.

• One idea could be to have suitable food placed in a few obvious/strategic places in rooms where they like to linger to help encourage them to eat.

Tips to help your family or friend stay hydrated

In Australia it is often hot in the summer and dehydration can be an issue, particularly for people with dementia. An all day Christmas event can be a long day for a person with dementia and it’s important to keep an eye on their hydration levels. (If they become dehydrated this can exacerbate confusion.)

If the person no longer understands “have a drink” and you are concerned about their hydration, one tip could be to pour a drink and then proactively gently place the cup into their hand. Their conditioning over their lifetime will often make them then automatically take the glass and then lift the glass to their mouth and take a sip. (You may find otherwise if you pour a drink and place it next to them that they will not actually take a sip.) 

Enjoy little moments

Rather than having a set expectation of how things “should” be or used to be, my wish for you is instead to focus instead on little moments. Don’t be concerned if things don’t go to plan. Rejoice in a shared moment of connection.

Look for a momentary smile, a twinkle in the eye, relaxed body language. If your family or friend falls asleep - please take it as a massive compliment. Your family member or friend felt calm enough to be able to relax and rest in your company.

I sincerely hope you‘ve found some of the strategies contained within this article to be useful. My wish for you is an enjoyable Christmas with all your family and friends. Please let me know if there are other topics you’d like me to address. I’m here to help.

About Kirstie Page

Kirstie Page is an Australian mixed media artist, classically trained musician and former dementia trainer with experience working on the front line in aged care. Kirstie creates beautifully uplifting artworks that incorporate her understanding of science and dementia to provide comfort and joy to people, including those living with dementia.

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