After every festive season, social services departments across the country see a sharp spike in call numbers.
People call with concerns about the wellbeing of older loved ones having spent time with them at Christmas. We take a look at how to tackle the sense of rising concern.
As society changes, and families grow ever more dispersed, the time between visits to relatives can grow from weeks to months. Christmas tends to throw changes in health and behaviour into sharp focus because it may be the time of year when we spend a prolonged period with relatives we might otherwise only chat with on the phone for a few minutes a week.
Sometimes there is a danger of looking for changes in older relatives that aren’t significant. Some people worry that their relative isn’t responding quickly enough to questions and conversations. The problem is, for working-aged people, life is very fast. We are used to our senses operating at full pelt all the time; music, emails, phone calls, texts, and questions coming from all directions.
Older people, especially those living alone, are not always used to conversation, let alone the rapid-fire dialogue of a young family taking over their home for three days. Couples who have been married for 60 years barely need to talk to communicate, and so the whirlwind of visitors at Christmas may just be overwhelming and tiring, not the first traces of Alzheimer’s disease.
Memory lapses alone are rarely signs of dementia. Who hasn’t stood at the top of the stairs, or in front of the fridge, being utterly unable to remember why we are there? Remember all this and don’t panic.
Forgetting the name of your neighbour they met at your barbecue in the summer is not an issue. However, when they have to be reminded of a close relative’s name every day, or at every mention, it may be time to take notice. Problems in changing routine may also ring alarm bells. For example, if you’re not allowed to have a cup of tea “because 3pm is the time for tea and it isn’t 3pm”.
Often, when families visit a loved one when dementia has been diagnosed, they try to “put things right”. But that can sometimes make things worse. They may see that dad’s cardigans are looking a bit threadbare so they replace the lot. The problem is that when he goes to her drawer he will not recognise them as being hers. A very common cause of difficulties comes when the family, meaning well, spring-clean the house from top to bottom. This can be a problem as they put things back where they think they should go, rather than where they were before. However kindly meant, their rationalisation can mean that their loved one can no longer wash the floor as they can’t find the mop. A well intentioned act can inadvertently lead to a relative becoming de-skilled and more dependent.
Moving people out of their home environment at Christmas can quickly reveal potential issues. Their home is set up to make their lives easy. They know where everything is and so they look, at a surface level, as if they are coping. Take them out of that comfort zone and the memory triggers, such as knowing where to find a mug, mean they can’t make a cup of tea as the sequence is broken. They may become anxious or even incontinent because they cannot make the new memories necessary to remember where the toilet is. This is upsetting for them and the family as it becomes apparent there is an issue.
If you visit a relative and you believe that they were not safe before you arrived, and will be in danger when you leave, it is time to call social services and potentially their GP. This could be because they wander away from their house at odd times; they regularly leave the house unsecured and open to intruders; they seem at risk of falling over; or they are answering phone calls and volunteering information to anyone.
The important thing is not to panic as this will exacerbate the anxiety experienced by your loved one. The good news is there is much that can be done to support them. Social services will organise an assessment of your loved one’s needs and, if they are living with a spouse or other carer, their needs will also be assessed in order to best support them to keep providing the right level of care. Panic buttons and personal alarms can support those prone to falls, and home-delivered meals ensure they can continue to have nutritious, balanced diets.
The most important thing is to use any professional support for you and your loved one to decide what is the best way forward for them, whether that is supported living or residential care.
Hints and tips for helping relatives with dementia
- Find out how your loved one gets dressed. If they start with their socks and you pass them their pants they may not be able to start dressing themselves, because the mental process to dress themselves has begun in the wrong place.
- Don’t throw old things out all in one go. If you bought a beautiful new cardigan for them for Christmas, don’t throw out all the old threadbare ones. Your loved one may think the cardigan belongs to someone else and may leave it on the hanger. They may also be confused at the apparent loss and even go cold as they think they have no cardigan. Instead, put it in the wardrobe with one of the old cardigans and encourage them to try the new one on; eventually they will see it as their own, and then you can start to remove the old ones.
- Standards in housekeeping may change as people age, mainly because they can no longer see the dirt and because they don’t have the energy or balance to tackle some tasks. If you clean your loved one’s home, think how you would go about tackling the same job in a teenager’s room, who doesn’t want anyone there. Make sure you put everything back exactly as you found it, whether it makes sense to you or not.
- Pace your activities and conversation to fit their speed and energy levels.
- Check for trip hazards such as torn carpets, uneven steps and curled-up rugs. Shoes and slippers should also be checked and replaced if necessary.
- If your loved one decides to move into residential care, visit a number of homes in your area. Care UK provides advice on what to look for in a care home on its website.