With all their potential for joyous reunions with beloved family members and friends, the holidays also can generate a great deal of angst at the prospect of visiting a loved one with Alzheimer's disease or another memory disorder. The upcoming visit might lead to several questions:
■ How should I respond when Aunt Mary tells the same story over and over, or when she forgets who I am?
■ How can I help dad deal with his anger and frustration over mom's behavior?
■ What can I suggest to my young children and teens to help them enjoy the visit with grandpa?
Spending time, even just a few hours, with someone who has Alzheimer's can be stressful without some preparation to manage expectations and develop a list of activities and conversation topics. The goal is to create conditions where everyone — the patient and the visitors — may experience the pleasure of just being together.
A pre-visit discussion (in person, by phone or on the Internet) can help set expectations and plan activities. Agree to keep in mind that the priority is to ensure the person with Alzheimer's has a good time — whether that means enjoying the entire visit or just a few, separate moments of joy while you're together — and that achieving this goal might require some adjustments to the family's traditional celebration activities. For example:
■ Stick to the loved one's current routine so the visit isn't disruptive or confusing.
■ Consider changing the traditional family Christmas dinner to a brunch or lunch, when Aunt Mary is less tired.
■ Reduce the number of people in the gathering and allow others to help by bringing food.
■ Focus on activities that are meaningful to the loved one, such as having a sing-along of familiar tunes, reading short, well-known holiday stories or looking through photo albums.
■ Plan time for breaks, rest and respite throughout the holiday preparations — for yourself, for the loved one and for the caretaker. For extended visits, slip away for a few minutes or a few hours when you can to regain your perspective.
■ Allow grandma or grandpa to help in a way they can be successful, whether it's setting the table, helping wrap gifts or decorating cookies or the tree. If your loved one lives in a care facility, think about joining already-planned activities. Even in the early stages of Alzheimer's, the loved one might repeat himself often or have trouble following conversations. If telling a story again and again makes Aunt Mary smile or even laugh out loud, or if the inaccurate facts she keeps repeating are not relevant to how she feels at that moment, the best reaction might be to enjoy the retelling and ignore the discrepancies.
It might help to remember that grandpa's behavior, mood and memory changes are due to the disease, and not something he can consciously correct. Once lost, the brain connections destroyed by Alzheimer's don't repair themselves. Over time, mom simply does not realize her missteps; correcting or berating her will not improve her memory.
Determining whether the memory loss is due to Alzheimer's or another condition can be difficult. The Alzheimer's Association posts numerous resources on its website, Alz.org, including the 10 signs and even stages of the disease.
The association also offers Alzheimer's Navigator (Alzheimersnavigator.org), a tool to help caregivers and people with dementia evaluate their needs, identify action steps and connect with local programs and services. A social networking community, ALZConnected (Alzconnected.org), enables caregivers and people with dementia to connect and communicate 24 hours a day with others who understand their challenges.
The Alzheimer's Association also operates a 24-hour help line at 1-800-272-3900.
Living with Alzheimer's peaceably often means enjoying the moment at hand. And when it comes to spending time with family and other loved ones, that might be the best advice of all.