Christmas can be a magical time, but for people with dementia and their loved ones, it can bring challenges and stress. From decorations and lights to visitors and unfamiliar foods, people with dementia may find Christmas an unfamiliar and worrying time. We have put together a handy guide to help you make Christmas as enjoyable as possible for your loved one with dementia.

The Concern: Bright lights and changes in decoration

Hands up who loves Christmas lights and decorations! While decorating can be a fun part of getting into the Christmas spirit, for people with dementia, decorations can feel confusing and overwhelming. Those with dementia often rely on objects like cushions, ornaments, and nic naks to remind them where they are. Familiar objects help them recognise which room they are in and reassures them they are in the right place. Bringing out Christmas cushions, decorations, trees, and wall hangings can create confusion for people with dementia, and they may have difficulty in recognising rooms. They may even believe they are in the wrong house. In addition, people with dementia may not understand why there are decorations. Certain things, like Christmas trees and flashing lights, are likely to cause cause confusion and alarm if a person with dementia does not recognise them as decorations.

What you can do: Keep things subtle

To minimise disorientation and confusion, keep Christmas decorations to a minimum. Avoid anything that may cause distress, like flashing lights or decorations that sing or make noise. Everyone with dementia is different, and you know your loved one best, so think about which decorations may be best left in the attic. Your loved one may enjoy decorating with tinsel, but might not appreciate their cushion being replaced with something more festive. It’s worth considering your Christmas tree too: some people with dementia recognise faux trees as decorations, but become confused when they find a real tree in the house, and vice versa.

If you really must have dramatic Christmas decorations, and your loved one is not keen, it is a good idea to leave out whichever room is most used by your loved one, so they still have somewhere familiar to relax. Of course, make sure any decorations you do use are safe. Trailing tinsel can be a tripping hazard for your loved one, and swapping real candles for LED faux candles is a smart choice. Keep a close eye on plants like poinsettia and mistletoe if your loved one may touch or consume them.

The Concern: Visitors coming and going

For many of us, Christmas means lots of visits from friends and family. For people with dementia, visits from loved ones may pose a challenge. Those with dementia may not remember or recognise visitors, and the constant stream of visitors can be overwhelming and confusing. Some people with dementia may also experience feelings of guilt or frustration if they know they should remember someone, but cannot. Visitors may also be noisy and high-spirited!

What you can do: Slow things down over Christmas

If your loved one struggles with visitors or seeing old family and friends, it is a good idea to allow plenty of times between visitors (or keep to just one visit a day). This will allow your loved one to rest and recharge between visits. You may want to consider limiting the number of younger visitors, too. Children can be very noisy and this may not go down well with your loved one. As always, make sure visitors understand your loved one has dementia, and that they shouldn’t feel upset if they are not remembered or the person with dementia doesn’t feel like talking to them much, although you should ensure the person with dementia does not feel left out of conversation.

Remember to explain who is visiting and when. It may help to write visits on a calendar so your loved one can see. Reminding your loved one that there will visitors arriving soon will often go a long way towards helping them feel less anxious when the doorbell rings.

The Concern: Changes to routines and schedules

The run-up to Christmas can mean a change in your loved one’s routine, especially if people in the house have taken time off work. Late nights, different mealtimes, and potentially more people at home can be confusing for someone with dementia. A regular routine provides a sense of comfort and familiarity, and a disruption in this routine may cause disorientation. Many people with dementia find the predictability of TV schedules to be comforting, and it’s not uncommon for someone with dementia to use TV programmes to understand what time of day it is. Changes to TV schedules around Christmas can have a huge impact on someone with dementia.

What You Can Do: Be mindful of disruption over Christmas

Although it may not be easy, sticking to established routines around Christmas will go a long way in helping your loved one feel comfortable. Try to keep bedtime routines and times the same, and ensure you have meals at the usual times. If your loved one has particular activities they do at certain times of day, such as a walk or word puzzle, stick to this. Try to schedule visits around your loved one’s schedule to minimise disruption. If changes cannot be avoided, let your loved one know things may be a little different that day. Avoiding surprise changes is always a good idea.

TV schedules change around Christmas. If your loved one watches TV and uses it to understand time of day and what is ‘coming up’ in their routine, see if you can record what they usually watch so they can watch as usual over Christmas. Chances are, you can find many of their programmes online for free (try BBC iPlayer) or on streaming services like Netflix. Many people with dementia will know when watching a certain programme that it is almost time for dinner, bed, a visit, or medication. Taking steps to maintain their TV schedule can help avoid confusion.

The Concern: Unfamiliar foods

Most of us don’t have mince pies all year round. Christmas brings festive food and party snacks, many of which we won’t have enjoyed since last Christmas. For people with dementia, eating and drinking can be difficult. They may not realise when they need to eat or drink, may not be able to use cutlery or recognise food, or might only like very few foods. In addition, a person with dementia may find chewing and swallowing difficult, which could lead to choking. Deviating from their usual diet can be stressful for those with dementia. Other people with dementia may have diabetes, and extra care should be taken to monitor their blood sugar levels if they are eating different meals to usual, as they may not recognise the signs of low or high blood sugar. The Alzheimer’s Society has useful information on helping someone with dementia to enjoy food safely.

What you can do: Stick to what they like

If your loved one enjoys food, sharing Christmas goodies can be enjoyable and may spark memories. Even better, safely involving your loved one in baking or cooking can be a wonderful way to create memories you will treasure, while ensuring they don’t feel left out of the festive fun. Some foods, like nuts and small chocolates or sweets, can be a choking hazard for those with an eating difficulty. You may want to chop these foods into smaller pieces or avoid them altogether.

Some people with dementia won’t recognise all foods, and may only recognise certain foods. They might not want to eat Christmas pudding or sprouts. Instead, offer their usual meals and don’t pressure your loved one to try something if they don’t want to.

The Concern: Believing certain relatives will visit

Some people dementia forget certain relatives have passed away. They may speak of waiting for a visit from a sibling, or awaiting a card from a friend. This can be distressing for both the person with dementia, and their loved ones. These beliefs can be triggered by memories of past Christmases, when people who have since passed away used to visit. Explaining the death to them can cause feelings of loss and bereavement to resurface. Alternatively, they may refuse to believe someone has died, becoming frustrated and distressed if you try to convince them.

What you can do: Either remind or distract your loved one

If you feel your loved one will understand and accept being told someone has passed away, you can gently remind them. Some people with dementia may only occasionally need to be reminded of a loved one’s passing. For example, if they ask if their sibling will be visiting for Christmas, you could say ‘I know you miss Bert, but he passed away five years ago. He is not here with us anymore’. Be aware that this can be upsetting for someone with dementia, and they may even go through the grieving process again. It is important to speak to your loved one in a compassionate manner, and avoid letting any feelings of frustration or upset influence your response. If your loved one does not accept your answer or becomes confused, try diverting their attention.

If you don’t think your loved one will accept being told someone is dead, or feel the news will upset them, you can redirect their attention to something else. For instance, if they ask you if their grandmother is going to join you for Christmas, you could try asking them about an interest, hobby, or other topic they enjoy talking about. Alternatively, you could say something like ‘we will have lots of guests on Christmas Day. Aunt Jean and Uncle Jim, my friend Sally and her husband…’ Your loved one won’t feel as though their question has been ignored, but you will have diverted their attention to other people.

If your loved one is distressed or often asks about someone who has passed away, you may need to discuss the situation with their healthcare provider. If their belief is causing them upset, their wellbeing may be compromised. It can also be upsetting for carers and relatives. Working with their healthcare team can enable you to navigate the difficult questions and beliefs your loved one with dementia may express.

Finally…

Christmas can be a very challenging time for people with dementia and their carers. Caring for a loved one with dementia is demanding, and facing special occasions together can be distressing and overwhelming. You may remember past Christmases with a sense of grief and longing. Feelings of frustration can quickly give way to guilt. It is important to not only consider your relative’s wellbeing, but also your own. Seeking support for yourself is an integral part of caring for someone with dementia. You can learn more about Guideposts’ services for carers here.

To support carers this Christmas, go to www.guideposts.org.uk/caring-at-christmas or call 01993 893560.

Click here to find out more about Guideposts’ services for carers.