Helping elders celebrate the season when in assisted living or a nursing home
by Carol Bradley Bursack, Editor-in-Chief
No matter what reason lies behind the move to a facility, when people move from the family home to an assisted living center or a nursing home, they still need to feel they are at home. This feeling of "home" is often highlighted during the holidays, when tradition commonly comes into play. Help your loved ones celebrate, even if they are not cognitively able to take part in festivities. In your heart, you'll know you did the right thing.
Hopefully, you or your loved ones saved a few special ornaments or decorations during the necessary downsizing before the move to a facility. The holiday season gives you a unique chance to reminisce as you display ornaments or decorations that have been a part of their lives, and likely yours, for decades. This show and tell session will help you share some tangible holiday memories with your loved ones. If you have old holiday photos, this is prime time to get them out, so you and your elder re-live holiday's past through pictures of long ago.
Why Bother Celebrating If They Aren't Aware of the Season?
Holiday celebration can be exhausting. At one time I juggled five different "Christmas homes," since I had growing children who needed me, my mother in one apartment, in-laws in another, and my dad and uncle in their own nursing home rooms. I went from place to place, feeling like a very tired Christmas elf, trying to decorate each home to suit the resident.
There were times when I wondered how I'd get through it all. My parents' wedding anniversary was the day after Christmas, so that added to the pressure. My mom needed me to write out her Christmas cards, buy gifts for those she wanted to give to (nearly everyone), give small thank you gifts to nursing home staff - the list was endless. Besides that, I still had to tend to my family's needs at our own home.
My dad's dementia was a peculiar type, rendering him nearly comatose on some days. Dad's dementia was the result of a surgery that backfired, but even with Alzheimer's or other dementia, people will, depending on their stage in the disease process, have times when they aren't aware of their surroundings. They will have times when they can't comprehend why people are wearing odd clothes or changing decorations in their room. They will have times when they are very confused.
So, why bother celebrating, especially with someone like my dad, who often was unaware of the reason for all of the fuss? We "bother" because including our elders- no matter what physical or mental state they are in - as we celebrate days and seasons of our year, reaffirms their humanity.
Sensitivity Is Essential When We Change Their Environment
If your elder has Alzheimer's or other dementia, he or she may be easily confused. Changes in surroundings can cause agitation. The plus side of digging out old decorations and other memorabilia is that with Alzheimer's, and some other dementias, it's the short-term memory that is affected. Many people can remember all kinds of things from the past. Therefore, if you decorate your loved one's room with items from years past, you could find that the objects are familiar and comforting to him. In fact, you may find you need to leave the familiar objects in place, even after the holidays, because the comfort factor remains.
Remember, however, that if you try to decorate with new items, or things from recent years, your loved one may find the change in his room disconcerting. You know your elder best. Try one approach, then another, until you feel you've done what you can. Just understand that you won't always be right.
Assisted Living Centers and Nursing Homes Generally Go All Out for Holidays
In any good facility, you'll probably find that you have a lot of help getting into the holiday spirit. The home where my folks spent their last years received many visits from groups of school children who performed their special programs. Other adult groups, sensitive to the loneliness of holidays for many elders, also visited the home. Some church groups and charities make it a point of stopping by each room to cheer the people and maybe leave a trinket of some kind.
All of this festive commotion may seem to get lost on many people in the later stages of Alzheimer's, just as your gestures and hard work may, at times, seem meaningless. However, unless the person becomes agitated or unduly upset by the socialization or the cheerful decorating, I'd suggest you help them carry on. We don't know for sure what people with dementia are picking up on. Also, they can have moments of clarity that seem to come out of nowhere. You and your loved one joining in the fun may make a new - if short- memory for your loved one. You just never know. Help that person enjoy the present moment. That is what counts at this stage.
Many Elders Actively Enjoy Holiday Festivities
Obviously, if you have an elder who is cognitively able to get into the spirit of the holiday and enjoy decorations, music and other activities, then you can just dive right in.
My mother was like that. Each year, I brought her beloved nativity scene to her room in the nursing home, plus many other decorations. She kept a bowl of candy on her table for the aides and visitors, we played Christmas music, and made sure she had festive clothing to wear.
We "did up" Christmas to the hilt - at least as much as one can in a nursing home. Mom enjoyed Christmas less and less each year, as her health failed, but she never got to the stage where she didn't know what was going on.
Taking Care of the Caregiver
I kept up the Christmas elf routine, year after year, even though it got ever more wearing for me as the years passed. Even though I thought I'd simplified celebrating for everyone as much as I could, it was hard.
I try to think back and to envision what I could have done differently to lighten my load as the primary caregiver to so many, while preserving my elders' feeling of being part of the season. What comes to mind is this:
- I should have been easier on myself. I didn't expect perfection from myself, but I did take each comment that indicated the slightest loneliness an elder (or a child at home) felt, right to my heart. Now, I think I'd try harder to help them understand that I could only do so much. I think I'd be better at setting some limits and sticking with them.
- I would have been more open with the wonderful staff at the nursing home about my limitations. I would have prepped them better with answers to my mother's complains about my "not being available," simply because she couldn't remember that I'd just been there that morning. They were wonderful caregivers and did their best, but I could let them help me more.
- I would have looked into more help from my parents' church to see if they could do a bit more visiting. I know these people are stretched, too, but I didn't even ask. I would have asked for and/or accepted more help from my siblings and friends of my parents.
- I would have looked into some in-home care agency hours to keep an elder in assisted living company, while I ran marathons for everyone else - not to say that I would have ignored that person, either. I would have just gotten more help.
- I would have taken an evening for myself, now and then, rather than baking every nostalgic Christmas cookie my elders remembered. I could have used the local bakery rather than my precious time and energy.
In the end, if I were to start over again with multiple elders and young children all expecting a happy holiday season, I would have pared back on the symbolic holiday trappings a little, cut more corners in recognition of the true essence of my Christmas, as well as theirs. I would rather please them primarily with the giving my time, with the genuine love of just being with them. This was truly the holiday gift they wanted the most. Still, looking back, I did indeed spend loving time each of them, the best that I then knew how, and have no real regrets.