Making the holidays easier for a loved one with dementia, and yourself

The holiday season can be a joyous time filled with traditions, celebrations and opportunities to reconnect with friends and family. It can also be a time of stress and overwhelm—especially for those caring for loved ones with dementia.

Joey Nesler, LCSW, a clinical social worker with the Richard H. Pickup Center for Brain Health at Hoag, offers family caregivers thoughtful advice for balancing the needs of loved ones with holiday expectations.

“The goal isn't a perfect holiday,” Joey says. “It’s a holiday that works for the person you’re caring for, and for the person doing the caring.”

Nearly 13 million Americans provide unpaid care for someone with Alzheimer’s disease or another form of dementia, according to the Alzheimer’s Association.

“Care partners are aware that people with dementia often rely on routine to feel secure,” Joey says. “Changes in those routines can increase confusion and agitation.”

Joey suggests:

Keep it steady. Hold meals, medications, naps and bedtime close to usual times.

Keep it early. Many people with dementia do best earlier in the day. A holiday brunch may go better than a late dinner.

Keep it simple. Blinking lights and rearranged furniture can be disorienting, so keep decorations to a minimum.

Keep it small. A few visitors at a time, or a two-hour visit, is often easier than an all-day crowd.

Keep it familiar. Favorite songs have been found to reach people even when conversation can't.

It also helps to prepare guests. Let relatives know what to expect, and encourage them to introduce themselves, speak calmly and skip “Do you remember…?” questions.

“Another important factor in lowering stress is care partners need to remember to take care of themselves,” Joey emphasizes. “Care partners often minimize their own limits, and holiday hosting, shopping and expectations can push stress past the breaking point.”

Warning signs include:

• Constant exhaustion, even after rest

• Irritability or resentment

• Trouble sleeping or changes in appetite

• Withdrawing from friends or activities you enjoy

• Feeling anxious, sad or hopeless much of the time

“These feelings don't mean you're failing,” Joey says. “They mean you need support, and it’s a coping strength to ask for help.”

Be specific. Many caregivers wait for relatives to offer help, while relatives wait to be asked. Instead:

• Make concrete requests. "Can you sit with Dad tomorrow afternoon so I can shop?" is easier to say yes to than "Let me know if you can help."

• Hand off holiday tasks like hosting, cooking or travel logistics.

• Talk as a family about how care is going and how to share it in the year ahead.

• Scale back traditions without guilt. Keep the ones that matter most.

The Memory & Cognitive Disorders Program, part of Hoag’s Pickup Family Neurosciences Institute, provides evaluation, diagnosis and treatment for memory loss and dementia, including access to clinical trials. Its team works with patients and their loved ones to build care plans tailored to each family, recognizing that dementia affects everyone in the household.

This season, remember to care for yourself, too. It’s one of the best gifts you can give the person who depends on you.

Learn more or schedule an appointment.