Elderly relative with dementia - tips for Xmas

[Youngatheart00]

We will be spending Xmas as a large-ish group and part of that group is DH’s dear grandmother. She hasn’t been formally diagnosed (I don’t believe) but MIL believes she has dementia and has been worsening rapidly over the last year. She is well into her 90s now and physically frail but capable of sitting in an armchair etc, just gets very confused and agitated.

Any tips for helping her feel welcome but also putting myself (and others!) at ease? I’d like us all to enjoy Xmas and it feels like people are walking on eggshells in anticipation.

For eg - if she mistakes me for SIL (to be honest, we do look similar) - do I just go with it or correct her?

I hope no one feels this post is insensitive, I felt a bit clumsy writing it, but any help is appreciated.

It tends to be easier to go with confusion or to correct mildly. Reassurance. Talk and don't get irritated that you've now been told the same story six times.
She may want to go home fairly early on, might find all the chaos nd bustle a bit much.

Do you think a busy Christmas will be in her best interests? Will it all be a bit too much for her? Fine if she is happy to sit in a chair whilst everything else goes on around her, but not if she is going to get agitated.

Is her being in a large gathering which will most likely be noisy, the best thing for her? Changes in routine can be very distressing for dementia patients.

My mum has had dementia of increasing severity for the last 10 years, probably longer.

You are very wise to ask for tips. Christmas, and other big events, were the times that we noticed her dementia affecting her the most. Everything is different, more decorated, more people coming and going, and for someone who is struggling to make sense of life, that can throw them.

So yes, if she mistakes you for SIL go with it. Her brain will already be working overtime, trying to adjust to being in a new place, and to remember everyone.

Try and have someone who is happy to sit with her, just quietly, to be a reassuring presence, and to be able to answer any questions patiently for her.

Anticipate some of her needs. Don't ask her if she wants tea. Just bring her a cup now and then (and put a splash of cold water into it, so that it is not boiling). Check to see if she drinks it, or if she wants a glass of water - it's easy to forget fluids. Don't ask her what she wants to eat. Put a little on her plate, and then ask her if that looks nice, or if she needs anything else. Ask her if she wants to go to the loo, and walk with her, just in case she is not sure where it is and is embarrassed to ask.

People with early dementia are often very good at hiding it (and may also be afraid to admit there is a problem).

Hope that helps.

Thank you all, some very thoughtful advice here and all noted.

I haven’t had a say in organising Xmas this year, and we are not hosting - we are all at a relatives home for 3 days - and whilst it is familiar to DHGM i can see how that combined with the festive franticness might add to the stress of the situation.

Notverygrownup’s advice is spot on, but I just wanted to say that if she’s rapidly deteriorating it might be something other than dementia. My mother has deteriorated rapidly this year (her initial symptoms were confusion and loss of short term memory) and the GP initially thought it was a sodium/potassium imbalance, then we were given a tentative diagnosis of dementia, and finally they discovered it was normal pressure hydrocephalus which by that time was beyond treating (she is not expected to live much longer and is now bed bound). So it is worth going back to the GP if your MIL hasn’t already, as there might be something they can do.

If there are children there get the children to interact with her a little as well. I know with my DGM that towards the end she had more difficulty remembering the adults, but she never forgot her great-grandchildren and they would always make her smile and feel more relaxed.

My mum has found things like christmas extremely difficult and upsetting since she developed dementia. Things are different, and thats a massive trigger when you are clinging onto routine as a way of making sense of the world.
For mum, this would show as aggression, food flicking (unfamiliar food), spitting (if the food tasted different), and other things as well.
Not all people with dementia like children either - my ds was very distressed by mums behaviour towards him, and she got agitated more around children too. She's more non verbal now, and we don't see her on christmas day as it just doesn't work
So be really aware that childrens toys etc might agitate her (loud noises, children being naturally more active) and think about an exit plan for you and the kids if necessary.

There won’t be any children present this year (I wish there were...but that’s another story!) so even though we are late 30s we are the ‘young’ ones hence wanting to lighten the load for the others.

Thanks for the hint re diagnosis, she is very much resisting medical appts at the moment which is another battle.

I know it is nothing to do with Christmas but has your DH/MIL got a Power of Attorney in place with the grandmother? If not and she is rapidly deteriorating they need to sort that out before it is too late

Yes, MIL and FIL have which is a relief - thank you.

This post has lots of helpful info about how best to communicate
forum.alzheimers.org.uk/threads/compassionate-communication-with-the-memory-impaired.30801/

Definitely don’t correct her, as this will stress her. I think touch is very important, and if you can just sit with her and hold and stroke her hand she will find that comforting. Try to gently ask her questions about when she was young, but don’t overtax her. I would also take some photographs with you. When there was a lot of noise this helped to distract my Nan. Also try to make sure she has a drink regularly. They often forget and then get prone to UTI.

They often forget and then get prone to UTI. which in turn will make confusion worse.

They're struggling to make sense of their world, so once they've found a "story" that makes sense to them, let them stick with it and don't (by either contradiction or questioning) cause them to doubt it and hurl them back into the scary confusion. My dad is convinced that some of the care home staff are people on community service (including a lady who is doing community service having killed several people by driving the wrong way up the motorway) - this enables him to explain Agency staff and the odd carer who doesn't fully understand his needs.

Oh, and one final handy piece of advice. Try to train yourself not to use the word "No" to her. It can be very stressful for her.

ie she's just about to pour gravy, which had been left on the table, onto her Christmas pud. It's the easiest thing to say "Nooooooooo" but that is a negative which may well feel like criticism. Try to train yourself to say "Oops!"

"Oops Grandma, we left the gravy out. Can I get you some custard?"
"Oops Grandma, you forgot to put your skirt on. (One of my mum's favourites, quite early on!) Shall we go and get it?"
"Oops Grandma, you are going outside, instead of into the other room. It's cold out there. Shall we go and watch the TV?"

Thank you all so much. Some very kind and sensitive but very pragmatic advice, which is exactly what I was hoping for!

Get a comfortable chair, footstool and blanket and an endless supply of tea or coffee. Maybe even a pair of earplugs or ear defenders. If she shows signs of becoming very tired, you could take her somewhere to lie down. My mother has dementia and cannot tolerate long visits anywhere including to her own adult children. When I say 'long', I mean less than an hour before she becomes agitated and wants to go home. So you and the family who are bringing her, may have to keep that in mind. The noise and busy environment may be upsetting to her.