How do you include, in family Christmas celebrations, a loved one who has entered a retirement home or nursing home during the past year? The following suggestions can make the holidays meaningful while keeping stress manageable for the whole family.
---Set realistic expectations and be prepared to modify traditions.
---Include your loved one in preparations to the best of his ability. Contributing in even small ways --- such as signing Christmas cards or helping to select gifts from a catalog --- will make him feel valued and create a feeling of partnership.
---Reminisce about past Christmases to help your relative get into the spirit of the season. Share special memories, bring in photo albums or favorite music, read aloud a favorite holiday story or Bible passage, or watch home movies or a classic holiday film.
---Plan ahead and space out activities as much as possible, scheduling quiet days in between eventful ones.
At nursing and retirement homes:
---Give staff at least a day's notice when you'd like to ensure your loved one is up and ready for a special visit or other event.
---Visit when you are not rushed for time. Be sensitive, though, to signs your relative is tiring or becoming restless, in which case cut the visit short.
---Bring children or grandchildren with you. (Ensure adult supervision at all times for youngsters.)
---Decorate your relative's room using window clings, children's artwork, garland, a small nativity scene or a miniature Christmas tree.
---Bring in greeting cards received to share with your loved one, and leave some with him.
---Bring homemade treats and take-out coffee or a thermal carafe of tea, and enjoy a holiday snack together. Consider supplying enough holiday sweets for your relative to share with roommates or staff if he wishes. Do check with nursing staff regarding dietary restrictions before you bring in food or beverages.
---Review the activities calendar to learn about scheduled holiday events --- such as bazaars, sing-alongs and visiting choirs --- and attend some of them with your loved one.
---If Christmas Mass is offered onsite, accompany your relative. Otherwise, if feasible, bring him to Mass at your church.
---Offer to accompany family members planning a first-time visit, to ease their anxiety.
---Join your loved one for Christmas dinner. Most facilities offer a midday meal with all the traditional holiday trimmings, and sell tickets to relatives and friends who would like to join residents. Another option is to hold a celebration in the family dining room or other private space that's available for booking; inquire about catering service.
On outings:
---Before deciding to bring your relative home for the day or overnight, determine his environmental needs --- addressing accessibility and safety issues --- as well as his care needs for the time period you have in mind. Run ideas by staff to see if they have concerns or suggestions. Even overnight visits may be feasible with assistance from family, friends or a privately contracted personal support worker.
---If you or staff is concerned that a large or lengthy gathering might be overwhelming for your loved one, arrange for him to attend only part of the event --- for example, joining the family for dinner rather than for the whole afternoon or evening. Keep in mind that people with Alzheimer's disease and related memory impairment function best in a familiar environment. Specifically, the ideal way to interact with them is through short, one-to-one visits at the care facility.
---If feasible, take your relative home for an afternoon so he can participate in (or simply observe, depending on his functioning) holiday preparations such as baking, decorating or gift wrapping. This can serve as a trial visit if you are considering bringing him home for Christmas.
---If your home isn't accessible, take your loved one out to the mall for gift shopping and lunch. Book accessible transportation if necessary. If he can get in and out of a car, take him out one evening for a holiday light tour.
---Ensure any destination is accessible, including its washroom facilities. If family members' homes aren't accessible, choose a restaurant or banquet hall that meets everyone's needs.
---Book accessible transportation well in advance, since use peaks during the holidays. Consider celebrating with your relative on a day other than December 25 to increase the likelihood that the service will be able to accommodate him.
---Give staff plenty of notice of the date and pickup and estimated return times for your loved one. This allows them sufficient time to make adjustments with food services and preparations with the pharmacy, as well as obtain a temporary leave of absence (TLA) order from the doctor if there isn't one in place.
---Prepare relatives and friends who haven't seen your relative in a while for any changes in his appearance, abilities or behavior.
---Ensure your loved one has appropriate clothing on hand, as well as warm outerwear. Let staff know what you would like him to wear for an event if he's unable to communicate this. Clothing should be comfortable and practical.
---Take along any necessary medical equipment, supplies and medications.
---Stick to your relative's routines as much as possible.
---Ensure there's a quiet place your loved one can retreat to if he becomes over-stimulated or fatigued.
---Videotape or photograph events your relative is unable to attend.
Lisa M. Petsche is a clinical social worker and freelance writer specializing in family life and adult care issues.
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