Preparing for festivities and celebrations
Decorations can be associated with a range of festivities such as Christmas, Thanksgiving, Diwali, Chinese New Year or Eid. Let’s explore why decorations might be unsettling or upsetting for people with dementia and some ideas about how you might deal with this.
If we think about the wintertime (November – February) we tend to want to hibernate, and then we are challenged to create a Happy Christmas, or a Hanukkah or Diwali which often involves seeing lots of people. Routines tend to go out of the window, services often stop for the holidays, and we might start eating rich food at strange times of the day. For example at Christmas, it can be perfectly acceptable to have a mince pie and mulled wine in the morning!
We know that dementia affects the brain, and it can change people’s vision and perception which means what a person may see and what they think they see might be two very different things. This means that decorations could be confusing and difficult to interpret and so we will look at this a bit more.
Understanding the brain
Let’s talk about the brain a bit more, in particular, the lobe at the back of the brain called the occipital lobe. This is the part that interprets what our eyes see, for example it helps us understand colour, shape, depth, how far away things are and so on.
Dementia can often affect the occipital lobe which means that people may find it difficult to fully understand what they are seeing as their brain is having difficulty processing the visual information. Some people with dementia may also experience visual hallucinations (seeing something that isn’t there) or visual misperceptions.
A misperception is when a person sees one object as another, for example, interprets a jumper folded on the bed as a cat on the bed. As you can imagine if someone’s occipital lobe is affected by dementia then decorations which often involve lots of small lights and flickering/shiny objects and are draped in unexpected places in or outside the home may start to cause lots of confusion.
Staying with the brain let’s look at the temporal lobe. This lobe plays an important part in being able to understand what is said to us and follow conversation. It also helps us retain new information. If the temporal lobe is affected by dementia, then explanations as to why these funny, twinkling lights are draped around the living room may not be understood and may not be remembered. This could mean the person with dementia feels anxious as the environment looks different and puzzling, but they can’t remember why, and you may find they need more reassurance and/or reminders to help them understand and therefore reduce their stress.
Our frontal lobes are very important as they help us cope with the unexpected, manage our emotions and override our impulses so we don’t offend others. If the frontal lobe is damaged, then the person with dementia may really struggle with adjusting to the decorative changes or they might sound quite direct and just say exactly what they think which could cause upset.
Our brain also plays a role in enabling us to move around safely ie. spatial awareness, which stops us bumping into furniture or doorways. We are also oriented and know where we are in time and place and how we relate to each other. The parietal lobe helps us with all of that, but you can imagine if that part of the brain is affected then it can become really challenging for someone if things aren’t where they are normally, or if there are new items such as decorations hanging in the house and there are new things to bump into.
However, it’s also important to acknowledge some of the positive benefits of festivals, decorations, and coming together as they encourage connection and can help bond us together. They are a time for reflection, a looking back, stimulating all of those happy memories. As a family, reminiscing about favourite music, favourite movies, singing well known songs, going through familiar rituals can all boost the positive feeling chemicals in the brain. These things can make us feel included and valued.
Here are some ideas and tips to think about when you are preparing for a festival or a celebration.
Try to introduce the festival and decorations and plans gradually. People with dementia often don’t deal well with sudden change as they use their routine to help them navigate the world and make sense of their world, so if you suddenly change something, then it could be confusing but also frightening, as well. Perhaps look through them together, reminisce about previous celebrations, discover the memories attached to different objects.
Involve the person with dementia in the choice of which decorations to use. What are they able to help with? Can they put decorations up or can they tell you if it’s straight? Are they able to hand you the decorations and garlands?
Think about who the decorations are for. This is when you may have to curb your desire to decorate the place head to toe and instead go with what the person is able cope with and what is meaningful to them as this will reduce their stress significantly.
Consider having a quiet room, a decoration free zone: a room where everything looks like it always does. Having a quiet room means, if needed, the person with dementia can retreat, or you can if you feel everything is getting a bit too much.
Avoid decorating hallways, stairs or kitchen as it’s important that people are safe when they are walking around, not feeling disoriented and confused by decorations and shiny, twinkly things.
Avoid everyday items becoming made into novelty items e.g. loo paper as if it doesn’t look like it usually does then the person with dementia might not use it.
Be aware of how decorations in gardens might be misperceived. At Diwali there may be lots of lights outside, at Christmas there may be Santa Claus heading for the chimney or reindeer on the lawn. It maybe your neighbours’ garden not yours so ensure curtains are closed as flashing Christmas lights and figures outside, can cause the person to become overstimulated and they might think what is outside is real which could make them feel anxious and distressed.
Think Safety: consider about battery operated candles instead of real candles if you are worried about safety.
Small groups: To help with people not becoming overwhelmed see if you can invite visitors, including family, in small groups rather than one large group.
Looking after yourself
There can often be a lot of pressure at times of festivals and celebrations to try and make everything perfect. Add that to your caring role and responsibilities and you may find yourself incredibly stressed. So what might help you cope?
- The benefit of being outdoors. Research shows that being outside can really help; going out for a walk, finding some outside space, getting some fresh air and daylight while you can, can be really beneficial, both for you and for the person that you care for.
- Seek support. We know that carers lose sight of their own needs and have to take on so much responsibility. At busy times of year when you may see family more, there are more people around who may be able to support you and allow you to have a break or a rest.
- Keep hydrated. Simple things like keeping hydrated by drinking plenty of water will make you feel more alert, and it is something that can easily be neglected.
- Mindfulness. Use of mindfulness has shown to be effective in managing and reducing stress. Are you able nip out for 5 mins and take a mindful walk where you pay attention to what is around you and focus on what you can see and what you can hear? Any mindful activity can help stop the swirling thoughts and help you reset.
- Deep breathing. We know that deep breathing can help reduce stress hormones and heart rate and can be done anywhere at any time.
- Quiet space. Try to ensure you have a quiet space in the home that you can retreat to if you need to.
- Music. For some people, listening to music can improve their mood and/or energy levels.
These are just some ideas, it will be different for everybody. But it’s important for you to know what will help so you can plan ahead and/or ask for help when needed.
We hope that the tips and information provided are of help whether it’s over the festive period or for any other religious or family celebration.
You can find more useful tips in this article by Dr Ruth Watson: Not feeling it in the festive season? 8 dementia carer tips
This article is based on a Seasonal Decorations live online session written and presented by Associate Practitioner, Helen Moores-Poole. Edits by Lissy Edwards