There are many proven techniques and suggestions for caring for a loved one with dementia, especially as it relates to talking and interacting with them. Over the holidays – often an emotional time – this communication can be even more important and can be challenging for long-distance family members who are visiting a loved one with dementia. 

Five Tips for Holiday Visits

Those visiting from out of town and don’t have regular contact with their loved one may be shocked at how the dementia has progressed or manifests itself when they encounter them in person. My mother was a master at masking her dementia on the phone; she often sounded absolutely fine and perfectly coherent. Since I lived three hours away, the phone was our primary mode of communication. When I did visit, I was often surprised that I couldn’t find the person who’d been on the phone with me! Here are a few strategies to make your holiday visit with a loved one with dementia more enjoyable for all involved:

1. Plan ahead...but don’t plan too much. Know what to expect, talk to caregivers in advance and ensure that everyone is in agreement on what the game plan will be for the holiday visit. Discuss holiday celebrations with relatives and close friends in advance as well; consider what may be expected of everyone, both socially and emotionally, and don’t plan too much. Those coping with dementia can get very overwhelmed with large crowds and too much noise or activity, so keep things calm. The holidays can involve large groups of people which may cause those with dementia to withdraw and be less comfortable socializing. Be sensitive to the fact they may have difficulty following conversations and may be embarrassed by this. Plan time for breaks and rest.
2. Maintain a normal routine and keep it calm. Understand that you are disrupting the usual routine by arriving from out of town for the holiday and that this could be stressful for someone suffering from dementia. They may be confused and disoriented by all the additional activities. Try to calibrate with and adhere to the person's normal routine as much as possible to keep the holidays from becoming disruptive.
3. Build on past traditions and memories. Your loved one who’s now living with dementia may have been the cornerstone of family holidays and traditions and now they aren’t. Be prepared for this. It may be as difficult for you to accept as it is for them. Cherish the times that you’ve had, but create new takes on old traditions. You may not be able to go to the Nutcracker ballet, but you can listen to the music from it in front of the fire while you page through old photo albums. Watch a favorite holiday movie together, sing Christmas carols. Make the time you do have together as special as possible.
4. Involve the person in holiday preparation. Keep your loved one as involved as possible, whether it’s decorating cookies or the tree. Make them feel they are still an integral part of the holiday and try to accept that the paradigm has shifted. As the person's abilities allow, invite them to help you prepare food, wrap packages, or set the table.
5. Focus on the positive. As you’re adjusting to how things are different this holiday season, don’t dwell on how things once were, but rather try to focus on the present. Hold onto and cherish those joyful, past, memories, but don’t let them depress you. Focusing on the positive, rather than becoming overwhelmed by the negative will not only help you cope and celebrate but also makes it easier for your loved one to relax and enjoy your time together.

How to Talk With a Person who has Dementia

One of the most difficult challenges with dementia is accepting and adapting to your loved one's new communication pattern. Whether it's a holiday visit or daily contact, there are ways to improve communication with someone who has dementia that will make it easier for you, as well as for them. The most important thing is to be patient. Don’t interrupt, let them complete their thoughts. Don’t correct them, even if what they are saying is incorrect. In most instances, it’s easier to agree. Their mind may not be tracking well. Likewise, if they repeat themselves, or tell the same story more than once, don’t tell them they did so. Let it go. Pointing out over and over that your loved one is wrong, or that their memory is flawed will not help them. Their brain has been altered in such a way that they are not likely to learn from their errors or correct them, so avoid arguing or attempting to reason. The following techniques are suggestions for how to cope and communicate with your loved one as positively and effectively as possible: 3

• Make eye contact when speaking.
• Speak slowly and clearly.
• Allow your loved ones time to respond, and repeat yourself as necessary. It may take a while for them to process the information you’ve provided and then formulate a response.
• Keep instructions and responses simple and concise. Avoid long explanations and complicated responses.
• Keep body language and facial expressions relaxed and friendly. As loved ones lose their ability to understand words, they will begin to watch your facial expressions and body language in order to understand.

How to Care for a Loved one with Dementia

Persons with dementia may experience changes in judgment which may lead to confusion, frustration, or wandering, thus caring for a parent with dementia requires love and patience. Make sure you’ve done everything possible to ensure they are in a safe environment to reduce the risk of injury and avoid situations that could be confusing for them. Much advice has been written on this, but here are some basics.

1. Keep walking areas clear. Arrange ample space for walking side-by-side, for wheelchairs, and walkers. Consider removing or relocating furniture (like low coffee tables) that may be a trip hazard. Limit or prevent access to places where injuries could occur, such as a stairwell, and make sure all areas are well-lit. During the holidays, avoid blinking lights and real candles.
2. Accept and understand communication limitations. As the disease progresses, your loved one may be unable to locate the words they want, or may not be able to process the words you’re using — potentially leaving both of you confused and frustrated. Be calm and supportive; speak slowly in a relaxed tone and avoid criticism.
3. Validate your loved one. The use of validation rather than “reality orientation” is advised. Your loved one’s reality is as real to them as yours is to you; don’t deny them their experience. Show empathy and use supportive statements; distract them with another topic. Go along with them when you’re able to, and use humor as appropriate.
4. Be inclusive. Help your loved one feel that they matter and that they are involved no matter what stage their dementia may be. Include them in conversations, encourage their reminiscing. You may be surprised at what they do remember and can articulate.

When dealing with dementia, we need to remember that the only predictable thing is the unpredictable. Be prepared. Don’t be surprised. And even if you are, don’t show it. Take deep breaths. And smile. Ultimately, it’s about redefining success – for them and for you.