Taking care of Gram is a blessing and a joy, but it does require some adjustments and some work, especially around the holidays. Gram’s dementia means that routine and stability are paramount to her happiness, and she is always less anxious when everything is the same. Holiday visits from families, extra activity in the house, and more outings are inevitable and wonderful parts of this season, but they do present some challenges when caring for a loved one with dementia. So with that in mind, since we are about to embark on holiday season number five with Gram, here are some of my elder care tips for the holidays.
Keep Your Emotional Bank Account Full
The holidays are stressful and busy, for you and even more so for the person you care for. I’ve found that I can mitigate the stress levels for Gram by keeping our emotional bank account full. This means that I put in extra efforts to make her feel loved and cared for and wanted (depositing in the account) so that when I have to withdrawl- when events come about that distress her, or when I have to fight her to get into a second shower for the week, I’ve got the emotional capital to work with.
Make A Visual Schedule
Gram is more forgetful lately, and a source of frustration for all of us is when she forgets who is coming over or where we’re going. She feels like we’re keeping things from her, and I get upset that she’s mad when I told her five times what was going on.
This is so easy to avoid by just keeping a calendar or schedule on hand. We use a whiteboard that sits on top of a bookcase in Gram’s room. Most of the time, things are pretty routine around here so it doesn’t get used all the time, but when we have a busy week coming up, I write out what is happening and when. That way, if she forgets, she can just take a quick peek without having to ask (which spares her pride), and if she doesn’t realize that she has forgotten something (which also happens a lot), she sees the whiteboard and remembers.
Schedule Around Tough Times of Day
When I’m scheduling events for our family, I try to keep in mind what Gram needs to feel secure and settled for the day. I know that for her personally, her morning routine is of utmost important. She does everything step by step, in the same order, in the same way, each and every morning. If it gets interrupted, her whole day can be thrown off.
So I try my best to make sure that her morning routine can stay intact, which means not getting out the door right away in the morning. Sometimes, depending on her mood, it even means not mentioning an outing until she has finished her breakfast and coffee (the final step of her routine). It really can make all the difference.
I also try to avoid having Gram out after sundown, because her confusion and other dementia symptoms shoot up at that time of day. Just by making sure we’re back a little before or after dinner can help us avoid having her feel upset.
And Lots of Scaffolding When You Can’t
There are absolutely times when this can’t be avoided. Mark’s family lives an hour away, and with the sun setting earlier and earlier, sometimes we are out after dark. And every once in a while we do have to get up and go first thing in the morning. When I know that those situations are coming up, I do extra prep on the front end. Scaffolding ahead of time helps Gram feel secure when the routine changes.
I make sure to mention the upcoming change in routine at least a couple of times a day. This increases the likelihood that it will stick in her head. I also make sure to give her as many details as possible about where we are going, what we are doing, and why the timing is the way it is. I write it all on the white board. And, that day, I make sure to intercept her as soon as she wakes up, relay the whole of the information again, and give her time to answer any questions she has.
Do Extra Check Ins When Out and Pay Attention to Behavioral Indicators of Stress
When we are out, whether at an event or family function, it’s not always possible for me to be by Gram’s side at every moment. I do always make sure that I’m checking in with her regularly- getting down at her level, looking eye to eye, making sure she knows where I’ll be if I’m not in her eyeline. These kind of check ins serve to keep our emotional bank account high, but also allow me to keep an eye on the behaviors that indicate distress.
When Gram is nervous or confused, she scratches the sides of her face. It’s a calming motion for her, and is my clearest indicator that she something is wrong. After more than four years together, I know what her facial expressions look like when she’s peaceful, and what they look like when she’s distressed. When we are in the middle of a busy week, she is more likely to not have as much time to bounce back from outings or visits, which means that she is more likely to show those signs sooner. Paying closer attention to her body language helps me to help her to feel okay, even if we’re somewhere new.
Peacefulness Rubs Off
More and more these days I’m aware of the fact that I’m Gram’s person. I’m her touch point when she’s confused or worried or upset. I’m the person she remembers, the trusted caregiver. And just like my kids do, in new environments she looks to me to see how I’m reacting. If I’m stressed or anxious or upset, she is more likely to be so as well. But if I’m peaceful, if I’m joyful, if I’m contented, it can rub off on her.
This is the one I struggle with the most. The holidays can be stressful, and my introverted self can find it all a little much sometimes. But I’m working on it, and hoping that I can use all of these elder care tips for the holidays to my advantage this year.
I love how you approach your grandmother’s care. You allow her to maintain her dignity while making sure she is safe and comfortable. We did some of the same things with my father – a calendar with upcoming visits, a white board with the day’s events/visitors written out – so surprises were minimized. Routine was so comforting. And if he was confused we’d just keep explaining things and answering his questions. I hope you and your grandmother have a lovely holiday season.
Thank you so much! Maintaining her dignity is so important to us. And you’re right- routine is so very comforting and helpful in that! Our Thanksgiving went smoothly, with only minor bouts of anxiety and confusion. I hope you had a lovely celebration yourself!