Managing Alzheimer’s at Holiday Gatherings

Dr. Jim Mittelberger, medical director at the Center for Elders Independence

There are times when dwelling on the past can be a good thing, and one of those times is when an older person with memory loss joins loved ones at a holiday gathering. That's according to Dr. Jim Mittelberger, medical director at the Center for Elders Independence (CEI), where many seniors with Alzheimer's disease and other forms of dementia are among the clients.

CEI provides daytime services and transportation to older people in several East Bay communities including San Leandro, with the aim of keeping them in their own homes while getting their needs met.

"I really like to look at what people can do, not what they can't do," Mittelberger said. 

With Alzheimer's, the most common form of dementia, the loved one's personality remains intact in the early stages of the disease. So does their thinking ability, he said.

"They're still there," the doctor said, "but they forget things." Their ability to plan effectively can also be affected, he added. 

It's things that happened relatively recently that a person with early Alzheimer's may forget, he said. Older memories are often quite intact.

"So, talk about old times, which they're likely to remember clearly, particularly when they had shared those with others present," Mittelberger said. 

Conflicts over recent or current events are best avoided, he added.

"Holidays are a great time to bring out old pictures and things from the past," Mittelberger said.

You can also bring out possessions they'll remember, along with playing or singing music. Music can bring great joy to a person with memory loss, especially if they remember enjoying it with some of the people present.

One can also talk about food, at Thanksgiving, in particular, he said. The older person may greatly enjoy helping prepare it, especially if they did so previously with family members or friends who are there. 

Another Thanksgiving tradition, everybody watching a football game, may present a bit of a problem. Music is much easier on the nerves of a person with Alzheimer's, he said.

For the same reason—too much going on at once—it's best to have one person at a time talk to your guest and to have people arrive one after another rather than in groups all at once. For that matter, big parties are not the best idea for someone with Alzheimer's, Dr. Mittelberger said. 

People with Alzheimer's can get weary at a gathering and providing a quiet place for them to rest or nap is a good idea, he added. 

Many people forget that any older person might suffer from hearing loss and fading eyesight, he said. So, it's best to look at the person and speak to them more clearly, a bit more slowly, and a little louder than you might with someone younger.

It's best to divert the conversation and not contradict a person with memory loss who gets some facts wrong. They may get wrong which city they're in or that a loved one has passed away. Be gentle with the latter, Dr. Mittelberger suggests.  

A person with memory loss can't just "try harder" to successfully remember things, the doctor cautioned. The memories are no longer physically there or never got made. If you correct a person with Alzheimer's on some fact, they might not remember and ask again in a few minutes.

People with memory loss can suffer stress from changes in the environment, so consider holding the gathering at their home in the first place rather than having them travel to yours, Dr. Mittelberger suggests.