Halloween is my favorite holiday. I want to share ideas for making it special for our loved ones with dementia. As if caring for someone with dementia wasn’t challenging enough, the past 18 months have added some new layers. Here are some simple ideas and tips for Care Partners to have a safe and sane (ok, as sane as possible) holiday.
1. Play to Your Loved One’s Strengths
Only do what your loved one can handle. Sometimes, we want to maintain years of tradition. But as times change, we all have to adapt. The same is true for the person living with dementia. In the past, your loved one held out the candy bowl for the bands of Trick-or-Treaters. Today, that may not be doable. Instead of answering the door holding a bowl of candy, maybe you have decided to leave candy outside of the front door. You and your family member can put out a half-dozen candy bars at a time and replenish in-between the waves of Trick-or-Treaters.
What should you do if there is an issue with impulsiveness (especially with the frontal-temporal dementias)? Some people living with dementia may want to interact with the Trick-or-Treaters. They may want to hug or touch the children. Again, you want to avoid any battles or issues. It may be best to skip the trick and treating altogether.
2.Change Activities and Decorations
Some people with dementia have difficulty with understanding what they are seeing. They may see a pillow and think it is a cat. Some people with dementia have balance problems. These issues should be considered as you think about traditional activities.
Carving a pumpkin? Maybe not. Painting a pumpkin? Better idea. Also, some stores have pumpkin push decorating kits, where you stick heads and feet or other decorations into the pumpkin…think “Mr. Potato Head” but for pumpkins. Amazon has some cool products that produce neat pumpkin decorations but without a knife. This is also a good idea if Halloween tends to be on the warmer side this year, or if your area has wildlife that may munch on the pumpkins. We had a big problem with skunks feasting on our carved pumpkins when we lived in central Pennsylvania….and a bigger problem when the family dog interacted with said skunks!
Your choice around decorations may also need some tweaking. People tend to avoid decorations that may serve as an obvious trip/fall hazard. Sometimes caregivers do not realize that certain kinds of decorations will trigger a fear response. You may want to avoid the shrieking welcome mat. Or the gnarly skeletal hand-in-the-candy bowl. These items can create an anxiety attack that morphs into a full-blown behavioral situation.
Some decorations that seem harmless can become a problem when the light changes. People with dementia are prone to mistake innocent household items, like a coat rack or chair, for a person when the lighting changes. A creepy zombie decoration or witchy doll, no matter how cute, has the potential to be mis-perceived with changing light. Some families have argued with me, “But we’ve had that scarecrow decoration for 15 years!” True. But as the dementia gets worse, and the memories fade, the family member may not recognize the scarecrow as a beloved family Halloween heirloom.
3. Candy and Over-eating
Some individuals with dementia, especially frontal-temporal dementia, have difficulty with something called hyperorality: they cannot stop eating, especially sweets. This behavior happens because the “brakes” of the brain are no longer working. If you are tempted to purchase a large bag of Halloween candy from a big-box store, reconsider. Money saved is not worth the fallout when the person with dementia consumes the entire bag in one sitting. Every year at this time, I receive messages involving a person with dementia consuming 5 pounds of M&Ms in about an hour…pretty impressive, especially as the candies were in those little snack-size bags. If your loved one has that same focus on candy and sweets, perhaps give out non-food items to the Trick-or-Treaters (stickers, fake tattoos, pencil erasers, pens, pencils–stuff you can find at the local dollar store).
4. Attending Fall Festivals and Parties
To attend or not to attend? Depends on the person’s personality, extent of forgetfulness, and tolerance for the anticipated activity level. Some fall festivals are outside and spread out, so there is less noise and overload. Other festivals and parties can be high-volume affairs with groups of shrieking, sugar-fueled munchkins running around like mini Tasmanian devils. People with dementia who were more on the extroverted side pre-illness may find these activities very enjoyable and even be the life of the party themselves. Others may want to leave about 5 minutes after arriving.
If you are not sure about the reaction, go to the activity but have a plan in place. Be ready to turn around and go home if the situation is over-whelming. Let the hosts know in advance that you want to give your loved one the opportunity to participate, but if he or she becomes overwhelmed, you will make a speedy exit.
5. Making Fall Festivals and Parties Dementia-Friendly
For those of you having or sponsoring the festivals and parties, you can help make these events a little more dementia-friendly. If possible, have a table and some chairs away from the main hub of activity. Welcome the person with dementia and the care partner by introducing yourself. Many people who are aware of their “forgets” may avoid these situations because they don’t want to embarrass themselves by not knowing names. Help out the care partner by offering to get them some food and drink, or offer to sit with their family member while they mingle a bit. Many times, persons with dementia shadow the care partner because the care partner is their life line…they feel safe with that person. This can creates stress for the care partner who feels like he or she can never have a moment alone (because they can’t).
I hope this post is helpful. I’m also interested in other folks’ experiences and suggestions as well.
Dr. Rita Jablonski
Rita Jablonski, PhD, CRNP, FAAN, FGSA is a nurse practitioner, researcher, tenured professor, and former family caregiver. Her research and practice involve all aspects of dementia management; she is best known for non-drug strategies to address dementia-related behaviors.