Consider This Before Decorating for the Holidays If You Have a Loved One With Dementia

My mom always decorated our house for the holidays. At Christmas, we had a huge tree with more ornaments than should have been put on it. She hung green garlands with red berries around the doors and put electric candles in every window of the house. She had two life-sized wooden nutcracker cutouts and a beautiful Santa statue. And of course, we always switched out our daily dishes to the Christmas Spode, and made sure the tablecloth matched the plates.

When my mom got Lewy body dementia (LBD), for many years we were able to put up Christmas decorations. But after a while, the amount of decorations decreased. Not only because it was a lot of work, but also because people with dementia function best in a clutter-free, familiar environment. Noticing fewer decorations made my mom’s living space easier to function in helped me see the many issues that can come up when we think about decorating a house or care community for people with dementia. I wanted to share some of the issues that can happen with decorations in the hopes you can assess how many decorations might work for your loved one with dementia to help them have a pleasant holiday season.

Here are a few reasons why decorations and dementia may not mix:

1. Decorations can make a once familiar space very unfamiliar.

Knick-knacks, trees, holiday cards on the mantle, statues, etc. All add clutter to the environment. This makes the environment very distracting and confusing. The room also may look completely unfamiliar to them, which can increase agitation and bring about some negative behaviors.

2. Decorations can make it harder for a person with dementia to find the items they use every day, and can decrease their independence.

For example, a simple snowman-shaped soap dispenser may be so unfamiliar that your loved one stops washing their hands, or it makes the sink look so different they can no longer turn on the water.

3. There are many safety issues with decorations.

A cute holiday throw rug is perfect for ending with a fall and broken hip. Food-shaped decorations can lead to an attempt to eat the item and are a choking hazard. Lights on a Christmas tree cast shadows and can make it harder for a person with dementia to see and function in a room. Twinkling lights are highly distracting and jarring. This can not only lead to falls, but it can trigger or worsen the visual hallucinations often found in dementia. People also tend to use a lot of electrical decorations during the holidays, and the cords can increase the risk of falls.

4. Decorations can increase behavioral issues.

If the person with dementia feels the decorations should not be there, you may end up with negative behaviors, such as throwing the decorations in the trash, or your loved one rearranging all the decorations. It could even increase or trigger wandering outside of the house. If the house looks so different to them, they may think they are not in their own home and thus try to leave. Going after them and trying to convince them this is their home can lead to arguments, or physical behaviors such as pushing or hitting.

5. Be careful of changing items you use daily.

My mom loved the Spode Christmas pattern and we used to change out our daily plates for the Christmas Spode every year. However, a patterned plate is cluttered and can cause frustration and picking at the plate after the food is already eaten. The pattern can also make it hard for a person with dementia to see what is food and what is not. If they are unsure, they may just not eat, which is very common for people with dementia. Solid-colored plates that have high contrast to the food you will be eating is best. For instance, turkey and mashed potatoes are hard to see on a white plate, but you could eat those items on a green plate. Fancy utensils may not only be uncomfortable because your loved one is not used to them, but also because they may be harder to hold if the handles are carved and curved, or very delicate.

So how should we handle decorations around the holidays for people with dementia?

1. Know your loved one well.

When considering whether or not to decorate for the holidays, it is very important to know your loved one well. They may not be at a point where decorations make the house unfamiliar, and in fact, if you did not decorate, they may feel that is too much of a change. Assess whether or not you need to bring out all the decorations, or just some really important ones.

2. Decorate in the least cluttered way as possible.

For example, don’t tack holiday cards on the wall, or arrange them in the middle of your kitchen table. It may also be good not to decorate in places where the person with dementia takes care of activities of daily living.

3. Leave the decorations out of the main living and working areas.

Changes in the bathroom, to the kitchen table, in the bedroom and around their main sitting or working area may cause too much confusion. Keeping decorations to the sitting room or on the mantle may be better.

4. Think about the reason for your decorations and what you want to get out of decorating.

Many of us are attached to tradition and decorating. We do it because it is a way to express love and care for our family and friends. It is a way to make our time together more festive and beautiful. If decorating the house brings more confusion and discomfort to our loved one with dementia, we have defeated the purpose and the meaning of the decorations. Rather than increasing joy and interaction, we increase confusion, which then can drastically increase feelings of worthlessness in our loved one.

Any event is about the relationships we foster, and the quality of time we get to spend with each other. Assess if your decorations meet the needs of your family interactions at this time, taking into consideration the changes brought about by dementia.

To start, I would suggest picking a few of your most favorite and cherished decorations and see if putting those up do not change the environment too much for your loved one, and work from there. This way, you can still create the holiday atmosphere and keep your loved one comfortable and safe.

Versions of this post were originally published on Resource Coaching and Rev. Katie Norris