Christmas with Dementia
Written by Fiona Southgate, Psychologist
Is the perfect Christmas possible when a love one has dementia?
At Christmas time, perhaps more than any other time of the year, we look to family and tradition, passed down the generations in experiences we share at this time of year as ‘family-traditions’. The Christmas’ of years-past flood our thoughts, whether they are fond memories or those of trauma. They are encouraged none-the-less by the signs that Christmas is coming, the shops full of goodies, radio airplay dispersed with the Christmas’ hits of the last 70 years. How we spend this time of year and the amount of stress felt by it can largely be dictated by these thoughts and are laid down and imprinted into our memories from our first Christmas’ experienced as a young child. Over the years, we accumulate further experiences which shape the Christmas we share currently with our family. Whether visiting others, or hosting yourself, we keep the generational ball rolling by creating new memories for the youngest in the family, whilst continuing to traditions with the eldest.
For many of us, then, Christmas can be a time of heightened emotion and stress. For the middle-aged in the family, our lives are often busy and fast-paced, stretch even further to accommodate the planning of Christmas. A part of which may include spending time with an elderly relative. Inviting them to lunch may become overwhelming, as it can be that during this time, the early signs and symptoms of dementia may seem more apparent to you or others in the family. Your relative may seem more confused by the day, forget family names or connections, or obscure the generations. You might find that the attention and focus cause them to become repetitive, recounting the same story repeatedly. They may become distressed and verbally disinhibited, swearing or speaking in a manner that might have horrified them only years earlier. They may not sit or eat, playing with their food as though its purpose is lost to them, or they may refuse to sit down at all and demand to be taken home. All these situations can feel frustrating and upsetting. They can increase the stress felt by you and your family. Because of this, you find that you try to manage the situation in a number of ways which may only increase the stress already experienced and cause frictions between other members of the family.
A son of a patient of mine recalled how his family had learnt to cope with his father’s increasing symptoms of dementia over Christmas. He had hosted and provided Christmas lunch for his parents since marrying and buying a house of his own. Over the years he recalls how Christmas had become more and more stressful. His father was eating and talking less, eventually spending the meal slumped at the table, face down on the edge of the plate. The visits they made had changed too, becoming shorter and shorter. Eventually, Christmas day become more focused on how to time his visit, than about relaxing and enjoying the day; with the cooking of the meal being times, so that collection and drop-off could be arranged to run equally as smoothly.
Once his son was born, he had begun to consider not inviting his father at all for Christmas, wanting now to be able to start to create new Christmas memories for his son spent at home. The thought of this filled him with guilt and stress, and he felt uncomfortable at the choice he had to make. His father’s dementia was progressing, and the first Christmas after his son was born, his father had slowly slumped from the chair to the floor during the meal, relaxed and contented but no longer able to sit on the chair at the table for Christmas lunch. The son had panicked and, abandoning the family meal, drove him home.
The next year, they had agreed it would be the last. It would be a short visit, and they were stressed about how it would go. Their son was two, and he was worried about the impact of his father’s behaviour and their enjoyment of Christmas. Before the meal had begun, his father was on the floor, content to be left, silent. Thinking about immediately returning him home, he stopped himself and watched as his father and his toddler son began to play together. The toddler fully accepting of his grandfather’s behaviour and an assumption that his being on the floor meant he had a playmate.
The son watched, in disbelief as his silent father seemed to take up the occupation of being a playmate to his grandson and began to talk to him and crawl about after him. Grandson and Grandfather smiling and laughing together in the new play-tent set up in the front room. The son recalled how he was in awe of his father at that moment as he had been a busy working man all his life and had never had the time or been able to ‘get down on the floor’ and play with him in the way he was now playing with his son. He was so grateful for this; he left them to play and had an enjoyable, relaxed and lengthy meal with the rest of the family. His stress evaporated, his Christmas restored.
Recalling this, he had said that he had to let go of the traditional Christmas he had held in his mind and memory. And to some extent, perhaps the ‘traditional father’ and instead relax enough to begin to embrace the new one. Letting go of stress and the cause of stress in terms of creating a ‘traditional’ or ‘perfect’ Christmas can be difficult. However, the impact of doing this, on your relative and yourself, may prolong the time you can spend with them over the Christmas period. You may find yourself becoming more tolerant of their repetition. Finding a way to work with other family members, so no one is left with them for long periods, or they are left sitting alone. It may be useful to not bring them to task for their language each time they say something unwelcoming, as you will recognise it will have little impact in reducing it. Letting go and attaching less to the day and our expectations of it may allow us and them to enjoy it all the more.