HOLIDAY STRESS RELIEF -Tips and Strategies to help make your holiday less stressful for you and your AD spouse.

HOLIDAY TIP #1 – ASSESS YOUR SPOUSE’S LEVEL OF FUNCTIONING BEFORE YOU MAKE ANY PLANS:

Alzheimer’s Disease changes everything. Whether your spouse is in the beginning stages or in a nursing home, their ability to handle commotion, “tumult”, distractions, company, decorations, and change of routine is affected by the disease.

Remember your first holiday together before you had children? It did not matter how many candles were burning; how many decorations were up; how many lights were blinking; how many people were coming and going for Open House.

Remember the first holiday when your baby was a toddler crawling and running into everything? When you had to plan around mealtimes, naptimes, cranky times, when you had to put everything dangerous out of reach?

Since Alzheimer patients go through developmental stages backwards ( i.e. return to childlike behavior), planning a holiday celebration when an AD spouse is involved is similar to planning when you have a child. You are the best judge of which “stage of development” your spouse is in, so you are the best judge as to what amount and type of stimulation they can handle. Take today to think about this aspect, and tomorrow we will discuss: Once you have decided what your spouse can handle – PLANNING AHEAD FOR IT.

HOLIDAY TIP #2 - PLAN, PLAN, PLAN AHEAD FOR YOUR HOLIDAY CELEBRATIONS – AD REQUIRES IT.

Tip #1 was to assess your spouse’s stage of the disease and stage of development before you make any holiday plans.

Today’s Tip #2 is to PLAN AHEAD. Decide in advance how much and what type of company your spouse can handle. Remember – if your spouse has a miserable holiday, is agitated, upset, and out of control, YOU will also have a miserable holiday.

KEEP TO YOUR AD SPOUSE’S ROUTINE AS MUCH AS POSSIBLE - If having the kids and grandkids stay overnight is too much of a break in routine – too many people running around; too much noise; too confusing for your spouse -TELL THEM. They may not understand, but you can’t worry about it.

We have friends who have so many children and grandchildren, I can’t keep track of all of them, and some of them are coming to visit for Thanksgiving. My friend told them that they had to stay in a hotel – it was just impossible for Daddy to handle all the commotion in the house. If your kids can’t afford a hotel, and are you are able to help with the funds, it’s well worth it for your sanity.

If you are having company just for the day, you have to decide on the amount of people your spouse (and you) can handle, and for how much time. You have to be creative. If you have a big family, you may want to divide it up into two or three different days. Since there are 8 days in Chanukah and 7 days in Kwanzaa, those holidays lend themselves quite well to this approach.

You may decide it would be better to have a very small group for the holiday, and take your spouse to visit to someone else’s house for an hour or two on another day.

In my research, I found a suggestion that I definitely disagreed with, but it may work for you. It was suggested that you have an Open House, with various people coming and going at different times during the day. It seemed to me that would prolong the day beyond what either you or your spouse could handle, and it would severely interrupt his/her routine. But that is for you to decide.

Whatever you decide, you know what is best for both of you. Stick to your guns, and don’t let family complaining wear you down into hosting an event that will stress both you and your spouse to the breaking point.

-HOLIDAY TIP #3 - ALZHEIMER PROOF YOUR HOUSE

I realize that everyone is in a different stage of the disease, and these tips may not apply to you. I am being as general as possible. At a later date, I will address the holidays and spouses who are in nursing facilities.

I also understand that many of you have been through years of holidays with your AD spouses, but you may find, as the disease has progressed, that you have to adjust your plans and expectations.

The plan is to make our holiday pleasant for us and our spouses. Sure, you want your family and guests to enjoy themselves, but our main focus has to be on what is best for us and our AD spouse. People with AD are calmer, happier, and easier to deal with when routines are not interrupted. That does not just mean eating and sleeping routines. It also means what they have come to expect concerning their home. When furniture is moved and familiar items are put away to make room for holiday decorations, it can be very upsetting to someone with AD. If they go into the den to watch TV, and their favorite chair is moved to accommodate some decorations, or the lamp they are used to is no longer on the table, the resulting confusion could set off a tantrum or tears. – neither of which you want to deal with.

This means we have to pay attention to:

Decorations: Less is best. Too many decorations, especially blinking lights, can be distracting and disturbing to someone with AD. Extra electric cords all over the floors can be very dangerous – Even in earlier stages, many AD patients are distracted and unfocused, which would make them prone to tripping over cords they were not expecting.

Furniture placement: Imagine how you would feel if you woke up one morning in a different house, and you had no idea where it was or how you got there. If too much furniture is moved around, it could make the room unrecognizable to your spouse. That will surely cause agitation and distress.

Candles: Oh, this has always been a problem in my house. Huge dogs with big tails prompted me to never leave candles burning. Way too dangerous. With an AD spouse who may be off balance or distracted, I consider burning candles a NO –NO. It may not be traditional, but they do make electric Chanukah menorahs. I figure it this way – Do you want Tradition or a pile of ashes for a house? I love candles – I have decorative candles all over my house – I just don’t light them.

Bottom line: Keep decorations, blinking lights, burning candles, electrical cords, and furniture moving to a minimum. Not only will it be less disturbing for your AD spouse, it will be less work for you. Remember - We are aiming for less stress for BOTH of you. The holidays are about religion, love, and family. You don’t need a lot of blinking lights and candles – you just need to be together with your spouse in as much peace and tranquility as possible.

JOAN’S BLOG – THURSDAY, DECEMBER 4, 2008 – HOLIDAY TIP #4- WHAT IS AN APPROPRIATE GIFT?

You thought this Blog was going to be about appropriate gifts for your AD spouse, didn’t you? We’ll get to that next time. This is about YOU. You do it ALL– the laundry, cooking, home repairs, homework help (for those of you with children at home), driving, organizing, remembering and thinking for both of you, working, nursing duties. So what would be some appropriate gifts for you? I heartily agree with these recommendations by experts. Get out your pens and make your lists:

1. RESPITE – When family members ask – What can I get for you?, Be specific and ask for a date that they can come to your house and stay with your spouse for the day., so you can get out by yourself. Ask for a “gift certificate” for a few days at a respite care facility for your spouse.
2. HOME REPAIRS - Ask for a day of someone’s time to come by and do yard work; to change all the batteries in the smoke detectors (We have 11 foot ceilings – I surely can’t get up on a ladder to do that job!); to help clean out the garage; to change light bulbs; to pay for a season’s worth of snow plowing; to do whatever jobs you haven’t had the time or energy to do.

3.PAMPERING – My number one request every year is a gift certificate for a massage. Nothing de-stresses like an hour of soft music, light fragrances, dim lighting, and expert hands kneading the kinks out of your tight, stress laden muscles. Gift certificates for facials, manicures, and pedicures are also high on the list. You DO NOT HAVE TO BE A WOMAN to enjoy these gifts.

-HOLIDAY TIP #5 - APPROPRIATE GIFTS FOR ALL STAGES OF AD

You would not think that something like gift giving would have any controversy attached to it, but there is one in the AD world of “experts”. It is called “age appropriateness”. Many of you have spouses in the later stages of AD, to whom the holidays mean nothing, but you may feel the desire to give them “something” that will offer them pleasure, especially those of you with spouses in nursing homes. As we know, in the later stages of AD, the patient regresses to a child-like state in cognition and physical abilities, with little or no memory of their loved ones. They are often agitated. Stuffed animals; soft dolls; brightly colored picture books are a few of the items that can be calming and soothing to hold, stoke, or in the case of the books, look at and enjoy the pictures. Many doctors, nurses, and family members welcome any “gift” that will soothe an AD patient.

The other school of thought, adhered to by many social workers and family members, is that such “toys” demean the patient - that during moments of lucidity they would lose their dignity. They suggest music CD’s as a better alternative. I have nothing against music. As you will see from my list below, I think music is an appropriate gift throughout all of the AD stages. It is just my opinion that if a soft, stuffed animal can calm your spouse or put a smile on their face, there is no harm in it. As is always my intention, I present the information and let you choose what you feel is best for yourself and your spouse. I welcome your views, pro and con.

Below are some gift suggestions based upon stages of the disease:

Early – In the early stages, brain games to exercise their cognition are a good option – Crossword puzzles; online scrabble; hand/eye coordination hand held games (i.e. Tetris); building hobby kits (SIMPLE cars; airplanes; boats);Music CD’s. If you plan to buy your spouse an IPod, or any other piece of electronic equipment through which to play the music, make sure someone pre-programs it, so it’s all ready to go, and will cause no frustration for your AD spouse who may no longer be able to read manuals and follow directions. (I don’t suffer from AD; I consider myself somewhat intelligent and computer savvy, and I CAN’T GET ONE SONG INTO AN IPOD!)

Middle – Fruit basket; food goodie basket; elementary level vocabulary games- there are many such board games; family picture album; Music CD’s.

Later stages – At the risk of offending anyone, I think whatever brings comfort is appropriate – stuffed animals; dolls; soft blankets; a visit from a dog or cat; Music CD’s.

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HOLIDAY TIP #6- ACKNOWLEDGING THE HOLIDAY WITH A SPOUSE WHO IS IN A NURSING HOME

There is no doubt that trying to enjoy the holiday season when your spouse is in a nursing home can be extremely painful, especially for those of you who have just recently made the placement decision.

As is always the case with AD, it falls to you to figure out the best method of bringing some holiday joy to your spouse. Here we go with those pesky experts again. Some of their reasonable recommendations are:

• Most AD nursing home residents adjust quite well to their new surroundings. Even those who have recently been placed, as some of you have written to say, seem to adjust fairly quickly. The staff at these facilities has expertise in planning holiday activities that are calming and enjoyable for the patients. It would be less stressful for both you and your spouse if you joined them in that planned celebration, rather than tried to plan something on your own.

• Even AD patients who do not seem to be aware of their surroundings or know who you are, respond to human companionship – a touch, a hug, a smile. Allow children and/or grandchildren to visit for a short period of time, but make sure it is only one or two at a time. More than that can be confusing, which may cause agitation.
• Pay attention to the time of day. If you are not already aware of it, the staff can tell you when your spouse is “at their best”. Try to schedule visits for those times of the day. Again, less stress for both of you.
• Gifts – I dealt with this topic in the Holiday Tip #5 – I still feel that whatever puts a smile on your spouse’s face is an appropriate gift – a warm stuffed animal; music they love; a soft blanket; a picture album of treasured memories.

Memories of holidays past creep into our minds– a movie of images when our spouses were their vibrant selves –playing with the children, opening gifts, putting together toys -the person with whom you have been in love for a lifetime. I do not chase away those memories. I cherish them as a reminder of how blessed I was to have had such a love in my life.

©Copyright 2008 Joan Gershman

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