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Dementia and celebrations: ways to prepare

by Kathryn Kilpatrick

Special occasions happen all the time in our lives. Sharing them with loved ones who are older, and experiencing some changes in their capabilities, requires some increased awareness on the part of families and caregivers. Often it means making necessary modifications so that everyone can better enjoy the memories of the time spent together.

When a person has Alzheimer's disease, or a related dementia, there are many reasons why situations that were a significant part of their life can become a concern. Often when the impairments are mild, the need may not seem as obvious until something happens that triggers a challenge, a difficult behavior or an unsafe situation. For those with more serious difficulties, everyone involved needs to put their heads together to make a plan appropriate for the person's current level of functioning.

Here are just a few of the circumstances that might warrant some additional planning or assistance. When you review them, think about how this might resemble your current situation, whether you are planning just a small local event, something taking place involving a trip out-of-town, or a special occasion over a period of several days.

Difficulty planning ahead for the company, shopping, and preparations: When someone was always the one counted on to carry on the traditions, that person may feel obligated, but then it appears to others like they are dragging their feet or not interested. Maybe all you will notice at first is increased frustration or some underlying agitation when the scope of the tasks are actually just overwhelming.

Trouble sequencing the steps for the items on the "to do " list: With celebrations come a multitude of tasks and jumping from one task to another can be difficult for any of us, under the best of circumstances. Special events can be overload for the older adult facing a variety of changes in their capabilities.

Unaware of the safety risks in some of the activities done infrequently: Perhaps a person is trying to do what they always did. Cleaning in places hard to get to, cooking new recipes, getting things on higher shelves, or using a variety of appliances may be more of a challenge now. When a person has problems with balance, or is forgetting or making a choice not to use a cane or walker, the risk of falls often increases.

Gets lost when trying to find areas they are familiar with but go to less often: With holidays comes travel, even within the local area. The issue of driving safely frequently comes up with older adults, especially when there are hearing, vision and memory problems. Holidays and busy schedules can mean a person is pushing the limit on what if any driving is appropriate.

Mixes up days or time of day: Often schedules are busier with more events and people coming and going at different times. With memory problems, the changes in routine, coupled with a lot of activity, can present a problem. Sometimes confusion is noted more often, and that might lead to changes in personality.

Needs modifications in the environment: Be sensitive to the changes you may be creating in their environment. With children, pets, toys, gifts, luggage and other items, the environment may feel overwhelming and there can be hazards that could cause an older adult to trip and fall. Try to operate in an area that is generally less cluttered, especially when a person prefers to have everything in its place, or is not used to having a lot of people around. If the gathering is in their home, make sure you return things to the place where the older adult had them before. People will certainly want to be helpful, but in an unfamiliar home, things are likely to get put away in a new place, or moved, to make room for all the company or the overnight guests. For those with memory loss this can increase confusion or create some anxiety.

Needs changes when traveling by car: If you are taking the older adult with you in the car, your plans may need to be modified, especially if the person has dementia. Long trips may not be a great idea. Perhaps you will need to break up the trip and spend the night in a motel. That brings its own set of concerns and, for some older adults, it can add to the confusion. Bring along snacks and familiar items, since there may be diet restrictions or limited places to stop. Take regular bathroom breaks to eliminate some of the problems trying to find one with little notice. Pay attention to the music selection and try to minimize any arguing since that can upset them more easily now.

Needs changes when traveling by airplane: First of all, evaluate whether the older adult should travel unaccompanied. Make sure they have all the contact numbers for people at home and at their destination in case of an emergency. Airport busyness, overhead pages, security checkpoints, and unforeseen delays have made travel much more complicated than it used to be, especially for older adults. If endurance, hearing, vision, or memory difficulties are present, they are more at risk even if it is a direct flight.

When traveling with an older adult, consider traveling at less busy times. Be careful not to get caught up in the hurrying and rushing around. Allow plenty of time between flights, or prior to events at your destination. The pace you might be used to, and the one an older adult does best with, are not usually the same. Irritation, anxiety and confusion may be the result of being in a different environment, with constant changes and information overload.

Make sure the  person is carrying information regarding insurance, medications, and physician contact information in case of emergency. A sufficient supply of medications should be taken on the trip to cover the time they plan to be away, plus an extra supply in case there is a delay on the return trip.

The upcoming blogs on this topic will cover each of these areas in more detail along with suggestions to assist in your future planning for holidays, celebrations and travel.

"To many people holidays are not voyages of discovery, but a ritual of reassurance." Philip Andrew