The holidays and Alzheimer’s during COVID-19

The holidays should be filled with sharing, laughter and memories. But in 2020, the COVID-19 pandemic adds a layer of stress, disappointment, sadness, and a heightened risk for spreading the virus, especially for older adults who tend to have underlying health conditions.

For the families of the 76,000 Coloradans living with Alzheimer’s disease, it’s important to realize that a person living with Alzheimer’s may feel a special sense of loss during the holidays because of the changes he or she has experienced.

And for the 256,000 volunteer family caregivers, there will be the added challenge of maintaining traditions while providing care and adhering to safety precautions.

To help ensure safe and enjoyable holiday gatherings, the Alzheimer’s Association offers the following tips for safely engaging with family and friends during the holidays.  

Celebrate while physical distancing

• Continue holiday traditions by dropping off favorite baked goods or a care package in a way that avoids close contact, such as leaving the special delivery at the person’s front door. 
• Schedule your own “holiday parade” and ask family members and friends to drive by the older adult’s home with homemade signs or other festive decorations.  
• Plan an outdoor visit with hot chocolate and blankets. 
• Go outside for a walk in the neighborhood to enjoy holiday lights and decorations.
• Create and send holiday cards.
• Maintain at least 6 feet of distance between yourself and anyone not from your household.

Take extra precautions for in-person gatherings
If you choose to include older adults in an in-person holiday gathering, weigh the risks to their health. Even when precautions are taken, close contact with anyone outside of your household increases the risk of spreading COVID-19. Consider the following if you choose to include older adults:
 

• If the person living with dementia lives in a care community, check the visiting policies during the pandemic.
• Do not attend or host a gathering if you have been (or may have been) exposed to COVID-19.
• Ask attendees to avoid or strictly limit contact with others for 14 days prior to your gathering.
• Host the event outside, if possible.
• Ask attendees to wash/sanitize their hands regularly, wear masks and keep 6 feet of distance.
• Shorten the duration of the event or limit the amount of time older adults will be in attendance.
• Avoid hugging, handshakes and close contact of any kind.
• Limit the number of people at the event.
• Encourage guests to bring food and drinks for themselves and members of their household only. If food will be served to all attendees, avoid buffet and family-style meals in which many people handle serving dishes and utensils. Instead, designate one person to plate dinner. Also, consider creative seating options that will help guests practice physical distancing. 
• Consider the levels of COVID-19 transmission in the community where the event is being held. Also, keep in mind that travel increases the likelihood of spreading or contracting COVID-19, so consider this when inviting guests who live far away or in areas with high rates of transmission.

Adjust expectations
The stress of caregiving responsibilities layered with holiday traditions can take a toll. The current COVID-19 crisis is creating challenges that can feel overwhelming for many families impacted by dementia. It’s more important than ever to take care of your physical, mental and emotional well-being.
 

• Arrange for a group discussion via telephone, video call or email for family and friends to discuss holiday celebrations in advance. Make sure that everyone understands your caregiving situation, the safety precautions you’re taking to help keep your loved one healthy and has realistic expectations about what you can and cannot do.
• A conversation in advance is also a great time to let others know about any changes they might see in the person living with dementia. Read more about how to familiarize others with the situation during the holidays.
• Give yourself permission to do only what you can reasonably and safely manage. This likely means much smaller and more casual gatherings, if at all. No one should expect you to maintain every holiday tradition or event, especially during a pandemic.
• Consider celebrating earlier in the day so you can work around the evening confusion (sundowning) if it sometimes affects the person living with Alzheimer’s.

Connect through technology

• Use video call software like Zoom or Skype to gather virtually. Since it can be difficult to have conversations with larger groups over video, adding some structure to the call can help. Play a trivia game, sing carols or share pictures from past gatherings.
• Use video to capture and digitally send special moments, such as children opening gifts.
• Plan a video call to cook or bake a special recipe together.
• Record and send a “video holiday card” that includes personalized messages.
• Schedule a time to watch a favorite holiday movie together from separate homes. Text or video chat while you watch.
• If your loved one struggles with technology, ask a primary caregiver — or staff in an assisted living community — if they can help facilitate a video call. If that’s not possible, connecting with a simple phone call goes a long way toward feeling together on the holidays. 
• Cross talk or simultaneous conversations can be challenging for people living with dementia, so consider this when planning.

Familiarize others with the situation
The holidays are full of emotions, so it can help to let friends and family members know what to expect. If the person is in the early stages of Alzheimer's, relatives and friends might not notice any changes. But the person living with dementia may have trouble following conversation or tend to repeat himself or herself.

Family can help with communication by being patient, not interrupting or correcting, and giving the person time to finish his or her thoughts. If the person is in the middle or late stages of Alzheimer's, there may be significant changes in cognitive abilities since the last conversation. These changes can be hard to accept. Make sure friends and family understand that changes in behavior and memory are caused by the disease and not the person.

For more ideas on how to let others know about changes in your loved one, join ALZConnected, our free online support community where caregivers like you share tips on what has worked for them.

Involve the person living with dementia
Involve the person in safe, manageable holiday preparation activities that he or she enjoys:
 

• Ask him or her to help you prepare food, wrap packages, help decorate or set the table. (Avoid using candies, artificial fruits and vegetables as decorations because a person living with dementia might confuse them with real food. Blinking lights may also confuse the person.)
• When making holiday plans, consider what will be most comfortable and enjoyable for the person living with dementia, while keeping safety in mind. Maintain the person’s normal routine as much as possible, so that holiday preparations don’t become disruptive or confusing. 
• Focus on the things that bring happiness and let go of activities that seem overwhelming, stressful or too risky. Taking on too many tasks can wear on both of you.
• Build on traditions and memories and experiment with new, physically distanced traditions that might be less stressful or a better fit with your caregiving responsibilities, such as watching seasonal movies.

Adapt gift giving

• Ask people to send gifts in the mail rather than delivering them in person. Opening gifts over a video call like Zoom or Skype or even over a phone call can still feel very personal.   
• Provide people with suggestions for useful and enjoyable gifts for the person, such as an identification bracelet or membership in a wandering response service. Or, suggest comfortable, easy-to-remove clothing, favorite music, photo albums of family and friends, or favorite treats.
• Advise people not to give gifts such as potentially dangerous tools or instruments, utensils, challenging board games, complicated electronic equipment or pets.
• Depending on his or her abilities and preferences, involve the person in gift giving. For example, someone who once enjoyed baking may enjoy helping to make cookies and pack them in tins or boxes. Or you may want to buy the gift so that the person can wrap it.
• If friends or family members ask you what you’d like for a gift, you may want to suggest a gift certificate or something that will help make things easier, like house cleaning; lawn, handyman or laundry services; or restaurant or food delivery gift cards.

Ask for support
No question is too big or too small for the free Alzheimer’s Association Helpline, which is staffed 24/7 by trained professionals. Call the Helpline at 800-272-3900 for around-the-clock help and the latest information.
 

Alzheimer's Association

The Alzheimer's Association leads the way to end Alzheimer's and all other dementia — by accelerating global research, driving risk reduction and early detection, and maximizing quality care and support. Our vision is a world without Alzheimer's and all other dementia.™ For more information, visit www.alz.org or call the 24/7 Helpline at 800.272.3900.