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Tuesday, December 15, 2015

5 Tips for a Joyful, Inclusive Holiday

In my practice, I see many patients with dementia associated with different neurologic conditions: Parkinson’s disease, Lewy body dementia, Alzheimer’s disease, and stroke. For these patients and their families, the holidays can be challenging.


Adult children may be shocked when they return home for the holidays to find a parent who repeats thoughts frequently, has trouble conversing, or becomes easily confused. The children and grandchildren may feel frustrated or uncertain about how to interact.


Over the years, I’ve discovered activities that bring joy and meaning to holiday celebrations, some from my own family and some from the families with whom I’ve worked. Perhaps one of these ideas will make the holidays special for your family this year. 


1. Sing holiday carols or hymns. When I was a child, my family had a tradition of singing “Silent Night” before opening presents—an activity that allowed everyone to participate, even people with memory problems. People with Alzheimer’s disease can remember and sing songs even in advanced stages of the disease. Consider having an indoor caroling party or start a new tradition singing favorite holiday songs. (I recommend avoiding “Silent Night,” though. Those high notes can be brutal!)


2. Peruse old photo albums. Looking at old albums and photos from 20, 30, even 50 years ago allows your parent or grandparent to share long-term memories that are still strong and participate fully in the conversation. It also gives children and grandchildren an opportunity to ask questions and learn more about “the way things used to be.” You can also ask if there’s a story behind treasured old Christmas tree ornaments.


3. Put on a talent show. Children love to share their accomplishments. If you have children (or even adults) who play instruments, dance, write poetry, or create art, consider having a living room talent show. I have fond childhood memories of Christmas recitals where each cousin played instruments ranging from French horns to violins. Annual performances also allow family to appreciate improvements year to year.


4. Reimagine family traditions. Consider ways to adjust traditions, if needed. If, for example, you have an annual cookie-decorating party, prepare a plate of pre-baked cookies for your relative with dementia and set him at the table with his own icing and a few bowls of sprinkles.


5. Schedule breaks. If it looks as though your relative is feeling overwhelmed (for instance, she appears tired or confused), guide her to a quiet place in the house and encourage her to take a break or a nap, or plan to involve her only in certain parts of the day or gathering. The family of one of my patients with dementia from Parkinson’s disease started having family stay at a nearby hotel rather than hosting everyone at home. This made the holidays merrier for everyone. The grandfather with Parkinson’s disease was less confused and the extended family enjoyed special times with siblings and cousins at the hotel, in addition to planned activities at the house.


For more tips on managing the holidays with a neurologic condition, see “Holiday Gifts” in the December 2015/January 2016 issue.


Dr. Armstrong is a movement disorders specialist at the University of Florida in Gainesville and is involved in the American Academy of Neurology's evidence-based guideline program.