With Christmas fast approaching, we are all busy with last minute details and errands that need to be done. Having elderly family members in your family might mean it's time to modify the holiday schedule that you have become accustomed to. If you are a family caregiver for an ill or cognitively impaired individual, you may not be looking forward to the holidays; more work, more company (including those who may not realize how their presence and demands impacts on your schedule and work load), and additional stress on you and the person you care for. First and foremost, the comfort of our impaired loved one should be taken in to consideration, even if that means reluctantly modifying past holiday traditions that may add more confusion or stress to your loved one.

Holiday gatherings easily show off an individual’s deficits. Imagine how confusing it is to be impaired and surrounded by people who know you, but you have no recall. Think about the constant noise (music, bells, etc.), bright lights and decorations that distort your sense of who and where you are. Imagine going to a family party with foods that no longer may be recognizable to you or that you are unsure how to eat.

So some good advice is to learn to set realistic expectations—for you and your family member.

For your loved one:

Attempt to maintain a regular schedule whenever possible.
Simplify: shorten visits and events. You do not have to accept all invitations. Determine which ones might be the most important or provide the most joy to your loved one.
Watch your family member’s reactions. Pay attention to their stress levels and make adjustments as necessary.
Attempt to limit visitors to smaller, sporadic groups. This might be a perfect time to let other family members “visit” while you (caregiver) take a nap, Christmas shop or quietly read a book. If you must attend a large gathering, locate a quiet spot to leave the crowd for a “time out.”
Make introductions with explanations. Act like you are introducing the visitor to your Mom or Dad.
Maintain the familiar. Old traditions, familiar music, reading/signing holiday cards or other simple customs can be enjoyable and feel comfortable to the impaired individual.
Pay attention: unthinking guests may offer your 90 pound mom on heavy medication the “spiked” eggnog, or mom might forget she is lactose intolerant and make herself a cheese plate.
Keep physical conditions in mind. A person in pain or with special medical needs should be asked how much and when they want to participate. Don’t insist that they do. Give them an “out” if it becomes too exhausting. Needless to say, ask family who are sick to visit at another time.
Where possible, solicit your loved one’s involvement in simple preparations—cooking, cleaning, sorting, etc. Most importantly, thank them for their help. Everyone likes to be appreciated.
Get involved and do something (anything): a short walk to look at Christmas decorations, an animated holiday musical that encourages simulated dancing or swaying, decorating a tree - these are all possible activities.
Reminisce about past gatherings, traditions or people. It’s time to bring out those old photo albums!
Be prepared! Make sure you have a supply of medication, incontinence products, quick snacks, some baby wipes and an extra sweater when going out.

As a caregiver:

Set reasonable expectations for yourself. You cannot do everything, and, most importantly, you don’t have to. Do you really need to make 5 kinds of cookies when you can go to Costco?
Maintaining the same schedule and simplifying the season will go a long way in easing your stress.
Ask for assistance! Ask family members to come sit with mom and dad while you do errands. Better yet, ask them to bake the holiday cookies or come help you clean the day before Thanksgiving. Learning to ask for help will make for better caregiving. After dinner coffee when mom is taking her nap is a great time to bring up whatever ongoing help you need.
Self preservation: remember to take care of yourself first. Airlines advise you to put on your oxygen mask before your child’s so you can clearly and safely care for another. Self care helps you maintain your health, your patience and your sanity.
Forget about perfection! A lopsided tree, gift cards instead of an actual boxed presents or a bakery pie will not detract from what’s important about the season. Spending time with family, keeping mom or dad comfortable with the gathering, and sharing the love will create a much longer lasting memory.