Christmas is traditionally a time for getting together with family and friends. But if one of your guests, or someone you live with, is in the advanced stages of dementia, the change of routine that comes with getting together with other people can be fraught with difficulties, leaving you tense and anxious.
Dementia alters people's perceptions which is likely to make it difficult to do things and celebrate in the way you have in the past. This does not mean you have to scrap your plans for Christmas altogether though.
Maizie Mears-Owen, Head of Dementia Services at Care UK, suggests some simple ideas that can make a big difference and help the whole family enjoy the Christmas festivities.
"Begin to prepare them in advance by talking about who will be there, and who those people are to them - niece, grandson, friend. Photographs are very useful for this as it will help them to recognise faces."
Photographs can also be useful because people with dementia may be living in a different decade. It is common for people to believe they are at a younger point in their lives. If this is the case, use older photos to explain who people are - and don't get upset if your relative gets names wrong.
Muddling might happen
"If your mother calls you 'mum', do not get embarrassed and do not correct her - she is just at the point in her mind where you are her mother's age, or she sees something in you that reminds her of her mum," says Mears-Owen.
"Embrace it. Be 'Mum'. Help her with her food and with opening her presents - she will find it reassuring and calming. Contradicting her will make her feel agitated and confused."
Young children seem to take it all in their stride. However, teenagers can find it upsetting. "Not being recognised or seeing out-of-character behaviour can sometimes be confusing, embarrassing and hurtful," adds Mears-Owen.
She suggests talking the issue over together as a family before Christmas, and also recommends Matthew Snyman's book The Dementia Diaries (available from Amazon), which follows four young people dealing with their grandparents' dementias.
Christmas Eve is the time to start tapping into family traditions. Mears-Owen says: "If you prepare your vegetables on Christmas Eve night, encourage your loved one to take part. They will feel useful and it can start conversations about Christmases past. Reminiscence is vital to increasing wellbeing and something we do across our 114 care homes. Get them talking about their childhood Christmases as well as yours."
Dementia can take a toll on verbal communication skills. "Music is a great way to connect with someone, as well as being fun," says Mears-Owen. "Even if they cannot sing, they can enjoy tapping out a rhythm and joining in, so why not try a carol service or sing along with a CD?"
Make room for calm
Christmas mornings can be frenetic, especially if there are young children in the house. Set aside a quiet and comfortable place for your relative. "The hurly-burly of present opening, noisy toys and over-excited youngsters can prove too much for someone whose senses have changed," Mears-Owen explains.
"To avoid confusion and anxiety, offer your relative a cup of tea away from the chaos and, if they want it, sit with them and chat."
The festive feast
The centrepiece of Christmas is the family lunch. Ann Saunders, a Care UK operational director with a personal interest in nutrition in older people, says: "Dementia can take away depth perception and narrow the field of vision, so keep things fairly clear.
Hand out crackers when you are going to pull them, limit the amount of crockery and cutlery on the table and use a tablecloth that contrasts with the plates. White-on-white blends in and the person will not know where the plate ends and the cloth begins.
"I find a blue or bright yellow plate works best: the meal stands out as there is very little food in those colours. Do not use plates with patterns as these can cause optical illusions and confusion.
"Try not crowding the plate," she adds. "Appetites are small and lots of food adds to confusion. Keep the meat in one section of the plate, the carbs in another and the vegetables separate. It is attractive and clear.
"Taste buds age and older people often develop a sweet, sour or savoury tooth to compensate. Try adding lemon or lime for that extra zing, use plenty of fresh herbs and try adding a teaspoon of honey to the water you cook the carrots in. The most important thing is that everyone indulges in their favourite foodie treats throughout the day."