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Chanukah with Alzheimer's

Chanukah with Alzheimer's

How to celebrate holidays and other events with people with dementia

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Bubby’s crispy latkes, Grandpa’s melodious singing, and the image of multiple generations gazing at the Chanukah flames—these are among some of our most cherished memories of the holiday of Chanukah. But what are we to do when someone in our family is suffering from dementia and is no longer able to celebrate the Jewish holidays as he or she once did? How can we make sure that Chanukah remains meaningful and enjoyable, as well as safe, for all the family?

In search of answers, we’ve spoken to two experts in the field of eldercare and dementia.

Dr. Allen Power FACP, is a geriatrician who is a recognized leader in the field of dementia and other eldercare topics. He has written extensively about dementia care and has been interviewed by major media outlets such as BBC Television and The Wall Street Journal.

He was joined by Mr. Dan Fern, the owner of Homewatch CareGivers, a home care services company in Phoenix, AZ. On an individual level, Dan’s mother is an elderly Holocaust survivor who suffers from dementia, so he brings both professional and personal experience to the table.

As we plan our holiday celebrations with our aging parents and grandparents in mind, what can we do to make the experience as smooth as possible?

Dr. Power: Scheduling is important. Think about what time of day your parent or grandparent feels best, and schedule your celebration for that time. Some people feel better in the morning, and others do better in the evenings, so plan accordingly. Also, bear in mind that they may not be able to handle as long a party as they once did, so plan to have a shorter party, or at least a way for them to leave when you sense that they are beginning to tire.

Also, coach small children in advance. Help them understand the sensitivities involved, and let them know about communication issues or other limitations beforehand so that they can contribute to a positive experience.

Dan: I would add that it may be better to bring the party to them instead of bringing them to the party. That will reduce the level of stimulation and allow them to enjoy the celebration in a safe, familiar environment. Also, designate someone in advance whose job it will be to act as caregiver, making sure that the parent or grandparent can take a rest or go to the bathroom when they need to.

How can we deal with dietary restrictions? And what do you suggest for seniors who are no longer able to cook as they once did?

Dr. Power: I don’t have a lot of concerns about food. In many cases, you can probably work around whatever restrictions there are. Even though there are some caveats, it’s important to involve people with traditions. Flavors and smells can evoke powerful memories, even for people who forget so much, so they are important.

Dan: In my work, it is important that our staff help our clients participate to whatever degree possible. We may have women read recipes, stir a pot, cut veggies, or give them other roles they feel connected to. Of course, for men, we also try to help them take on at least part of the role they used to have, making sure they are not left out.

What do you suggest for Chanukah menorah lighting? What can we do for people who are no longer able to light the menorah on their own?

Dan: My mom is 91, and she has moderate dementia. We go to her apartment and light the candles, and she loves to watch them and sing the songs. Singing is a big part of the Jewish holidays and a form of reminiscence. It has also been shown to put you in a better mood and brings oxygen to your brain. Stimulation from light, sounds and large crowds of people can be overwhelming for her, so we come to her apartment, and she thoroughly enjoys the experience. We also make sure to take out the menorah a few days in advance and leave it out where she can see it and discuss it. Just seeing the unlit menorah brings her comfort.

Dr. Power: Also make sure that you do it in a safe way. If you are afraid the person may knock over the flames, tea lights placed on a tray are a good, safe alternative.

With Chanukah gift giving, and lots of things to give to lots of people, what can be done to ease the discomfort of a gift-giver who no longer knows who gets what?

Dr. Power: If people are forgetful, never put them on the spot. Coach family members to introduce themselves when they arrive, and to do so often throughout the visit. Set things up so that they cannot make mistakes that will embarrass them. If there is gift giving, keep a written record so that they can refer to a list.

Dan: And when they do make a mistake, don’t correct them; just go with it. My mom knows my name but she doesn’t know our relationship. Sometimes she calls me her nephew, and sometimes she calls me a relative. I don’t correct her. If they use the wrong name, just accept it. Of course, you can help things along by reminding your parent or grandparent beforehand what people’s names are and how they are related.

How many nights of Chanukah would you suggest celebrating?

Dan: It’s a unique experience every night. Even if you do exactly the same thing every night, people with dementia will not remember and will be happy to do it each time. So see them as much as you can. It’s well documented that, for people with dementia, a good mood lingers even they no longer know what caused them to feel good in the first place. Remember, you have a limited number of days to celebrate with your beloved parent or grandparent, so take advantage of all the time that is available.

Dr. Power: That’s right. One of the wonderful things about people with dementia is that they live fully in the present, so make the most of each present moment. If you want to make some visits briefer than others, that’s fine.

What tips can you suggest for taking grandchildren to see grandparents with dementia?

Dr. Power: In my writings, I spend a lot of time talking about how we can model though our speech and body language, showing others how to deal with our seniors. Treat their limitations matter-of-factly and normalize them. Tell the kids, “This is grandma, we love her and its okay.” Give the message that they don’t need to be fearful. You can also show respect by asking the senior for an opinion, demonstrating that this person is someone to be looked up to. Cast your parent or grandparent in the role of wise elder. Also, since people with dementia live in the moment, they tend to do well with little kids who also live in the moment.

Dan: When asking questions, make sure they can answer them. Say things, like, “We use this candle to light the menorah, right?” or “Remember when we had such a great time last year?” Even if they don’t remember, they are likely to say they do. You can also engage them by using open-ended comments that allow them to respond as they see fit. With a lot of people, showing affection is very appropriate. Sit next to them, hug them, kiss them and hold their hand. Do what you can to make them feel welcomed and part of what is going on around them.

With so many people living far away from parents and grandparents, what can be done to make Chanukah and other holidays special from a distance?

Dr. Power: It depends on the person. You can always call and Skype, even when it’s not Chanukah. For some people, seeing a face and voice may be very reassuring. But be aware that some people may not relate to it, and seeing a loved one on a screen may be unsettling. In those cases, a handwritten letter that someone can read to them may be better.

Dan: A major limitation for many older people is hearing impairment, which makes the phone and Skype difficult. Cards, drawings and pictures can often accomplish the same thing, and they can be looked at again and again.

Any more advice before we end our conversation?

Dr. Power: Most people with dementia are an open book. Look in their eyes and you can see how they are feeling and proceed appropriately.

Dan: Constantly monitor the situation. Be aware of the possibility that you may be pushing the limits. They may be tired and ready for a nap. Keep close tabs, and act before things become a problem.

It all comes back to the fact that we want them to have a good time, we want to make them feel comfortable and not put them on the spot. If we’re sensitive to their emotions, it can be a great Chanukah celebration. Chanukah is a time when we make and relive great memories.

Dr. Power: I hope this will help people not be fearful of bringing Chanukah to a relative with dementia. Isolation can be harmful, so I hope people take the plunge and do it well.

Rabbi Menachem Posner serves as staff editor for Chabad.org.
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Pamela Reiz Overland Park December 23, 2014

I am a nurse at an all memory care community, nursing home, I had a Chanukah party, one res lit the menorah, my grandson came and sang, one lady who normally has a flat affect, smiled and sang the dreidel song, we ate latkes, in the past l had soft lakes that could be mashed for pureed diet Reply

Anonymous Jerusalem December 17, 2014

You never know what gets through Many years ago I and the other Jewish clergy in the city visited the area nursing homes each Friday morning and led a brief Erev Shabbat service with the Jewish patients. One woman with snow white hair was brought in by attendants each week for the service. Her eyes, a powerful shade of blue, were always vacant. She didn't acknowledge anything. One morning when I sang the Shema she looked straight at me and demanded, "Where did you learn that?" Then she was immediately gone again. It was such a powerful experience and I will always remember how those words, learned perhaps as a young child, got through to her if only for a second. Years later when my father-in-law was suffering from Alzheimer's we made havdalah with him each week. He had never been observant but he always joined in with the brachot usually mixing up the havdalah tune with that of the Hanukah blessings. He is gone now but I can still hear his lovely voice. Keep connecting. Reply

suri katz brooklyn December 7, 2014

Thank you did this timely article. My family will benefit from this tremendously Reply

David Salford, UK via lchaim.org.uk December 5, 2014

What a wonderful and sensitive perspective! Thank you so much for this heartwarming and constructive article Reply

Joyce Oxfeld Philadelphia December 3, 2014

Chanukah is perhaps more important to me at my age then when I was growing up. My family was not observant, and more Christian traditions of our neighbors surrounded us. So chanukah tended to resemble a Jewish Christmas, which it isn't. I learned that later on my own, when I could finally join a synagogue. My Dad was unaffiliated, and I would have loved to help him get there, but he had a very difficult life , being orphaned in childhood, being a soldier in WWII , fighting for our country, then witnessing a concentration camp. When he got dementia, it wasn't long after my ill Mother passed,so he went downhill afterwards. I did my best to be by his side and take care of his bills, and comfort him.At best as an only child, i felt I could offer little.
He was my support for so many years. Another geriatric care prgram looked out for for my Aunt . While she had the means for this
, but I wanted to be there for her as well. Dad never had a real childhood, never really had a chanukah experience, except 2 help me hav1 Reply

chaya meira November 30, 2014

excellent article.

thank you Reply

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