My caregiving clients have been asking, What should I give my loved one as a holiday gift? You might be wondering the same thing. Here are some guidelines, some idea sparks, and some examples to help you make informed choices for a loved one with dementia as you make your gift list this year.
GUIDELINE #1: Reflect on the activities, events, and objects that shaped your loved one’s identity at his or her peak, cognitively. Gifts that draw on this identity may stimulate hours of meaningful engagement over the coming weeks and months.
For others on your gift list, you may be seeking the newest, the latest, the coolest. But for a person with dementia, such gifts will seem unfamiliar, and may invite more irritation than intrigue.
A person with dementia has impaired visual, auditory, and problem solving processes. This makes it difficult to interpret and respond to the world effectively. Therefore unfamiliar objects, places, activities, and people can be a source of discomfort. For a person with dementia, what seems most familiar – and is therefore most comforting – is that which reinforces his or her identity at cognitive peak, when he or she had the power, control, and ability to succeed independently.
IDEA SPARK: What hobbies did your loved one enjoy in their peak? What events stand out on the timeline of his or her life? In what activities did he or she excel? Which celebrities or politicians or sports teams were most inspirational?
GUIDELINE #2: Items and activities that help family members and caregivers engage with your loved one will boost well-being. Gifts that offer an opportunity to “do it together” create positive experiences for everyone.
People with dementia benefit from social engagement – emotionally, spiritually, and even physically. Social engagement has a powerful impact on your loved one’s needs to feel he or she belongs, contributes to the family, and is valued.
Dementia caregivers often find themselves at a loss to create satisfying activities that will hold their loved one’s attention for any length of time. Often, for a person with dementia, just the social aspect of shared activities is enough to fulfill these needs. When these needs are met, the sense of comfort and contentment created will tend to extend the length of time that activities are enjoyable.
IDEA SPARK: What activities or interests do you and your loved one both enjoy? What interests does your loved one share with each of the other family members?
GUIDELINE #3: Consider where your loved one is in dementia’s progression, and more specifically, his or her present ability level. Select gifts accordingly.
Activities, tools, and equipment that your loved one used to master will gradually become more difficult due to increasing impairment. Rather than a sense of reward, tasks that are now too complicated create a sense of frustration. Other negative emotions often ensue, escalating situations.
Gifts that have a bit of skill “elasticity” may extend their useful life as promoters of positive emotions and well-being. The goal is to keep the person engaged at a comfortable level, promoting a sense of mastery rather than frustration.
IDEA SPARK: What items and activities can be successfully experienced, with modifications, in a range of skill levels?
Now, how might we apply these guidelines using the sparks provided to come up with some great gift ideas?
EXAMPLE #1
Let’s say your father was an avid tennis player in his prime. He can no longer get around the court, but you can still engage his tennis identity.
In the earlier stages of dementia, hand-eye coordination is still intact. Perhaps a miniature table tennis/ping pong set up, for social engagement and some physical activity? A ping pong ball and paddle might engage your loved one with simple bouncing and ball balancing drills.
In the middle stages, physical coordination may not be as reliable. Perhaps a coffee table picture book about the history of tennis could be something to look through together. Books of this kind can provide enjoyment over and over, since short term memory is challenged by this stage. A new can of tennis balls can provide some physical therapy. Your loved one can practice squeezing the balls to maintain hand/arm strength. While applying pressure, roll them back and forth over muscles in arms and legs to loosen fascia in an easy massage.
In the late stages, a photo album of tennis greats (printed from the internet), or of you loved one in action from “back in the day”, can offer an enjoyable way to pass the time. A tennis sweater might provide comfort physically, and even emotionally.
EXAMPLE #2
Your mother always loved game night. She was a ruthless competitor in Risk®, Monopoly®, and canasta when you were growing up, but these games have been in the attic since you graduated high school. Although the sequencing in complicated board games or computing of card scores may be too much now, you can still engage her competitive and gaming identity. Take your cues from the types of games she was playing in her cognitive peak.
Whether board or card based, all games involve some combination of strategy/skill and luck. As dementia progresses, modify favorite games (or choose similar ones) to rely more on luck than strategy or skill. This will usually simplify the rules as well.
In the early stages cards and board games that are shorter or less complex than the old favorites make great gift choices. Canasta is built on matching systems, so Crazy Eights, Rummy, or some forms of poker may still be enjoyable to play. Risk is based on geographic acquisition, so Battleship® may be a familiar, yet easier, alternative to enjoy today. As a journey game, Parcheesi may have too many rules and the board may seem daunting, but Trouble® may be a great gift choice, with rules and a board design that are simpler.
In the middle stages, Go Fish may replace Crazy Eights. Dice-driven backgammon may involve too much strategy, while Yahtzee®, which relies more on luck and less on strategy, could be a fun gift choice. Chess is too involved but checkers might become very lively in this stage. Caregivers should assume all scoring responsibilities in the middles stages of dementia.
In the beginnings of late stage dementia, simple sorting games may provide some comfort. Your loved one may enjoy grouping poker chips by color, or making uniform stacks with them, or just the tactile experience of fingering them like coins in a pocket or change purse. Mom may enjoy separating black from red cards, or face cards from the others
If you fear insulting your loved one with the gift of a simpler game like checkers, you can preserve dignity by making them special in a personal way – choose an antique or commemorative set, such as one that has been branded with your loved one’s favorite sports team.
EXAMPLE 3:
Your brother loved working with his hands, and was a great woodworker. Although he can no longer operate the tools or sequence the multi-step process necessary to build a rocking chair, he still has the ability to enjoy the tactile processes that fed his identity as a craftsman.
In the early stages of dementia, your brother may enjoy building models that replicate buildings, boats, airplanes, and other objects in miniature, requiring simple tools that are safe to use in this stage. Models are offered in different skill levels, making this an “elastic skill” activity and a great holiday gift choice. Modelling clay also offers a tactile experience in three dimensional work. Small powered and manual wheels may be a good gift option too, allowing your brother to create thrown clay pieces such as simple cups, bowls, plates and more. (These can be fired at a local studio in your area.)
In the middle stages of dementia, pottery is an activity that can be modified; when the potter’s wheel is too difficult, hand-built pieces can still provide a lot of tactile satisfaction. Modelling clay is a great holiday gift for a person with middle stage dementia.
In the late stages of dementia, your brother may enjoy exploring the visual and tactile qualities of an artist’s hand-carved work. Commission a wood carving of your brother’s favorite sports mascot for a gift. Or give a simple wooden puzzle with large pieces.
GUARANTEED SUCCESS:
If none of these ideas and examples helps, you can’t go wrong with music. Whether from a CD player or streaming speaker, music changes human biorhythms in a way that is advantages for dementia caregivers and those with dementia.
What era? What genre? What artist? Chances are, your loved one’s favorite music is that which was popular during the major life events that shaped his or her identity. The soundtrack we all make of our lives can be a powerful source of familiarity and comfort during dementia, often evoking the happy emotions that accompanied those life events. If your loved one’s musical preferences aren’t clear to you, search the internet for top hit lists during the years of your loved one’s major life achievements. The music hits from those eras will make great holiday gift choices for a person living with dementia.
Try to devise the simplest way for your loved one to access this music. Provide operating instructions for all caregivers and possible the tried-and-true tunes that de-escalate difficult situations created by dementia’s symptoms.
CONCLUSION
As a caution, dementia is a fluid disease. The progression is a regression of sorts, but the rate of decline is unpredictable and inconsistent, and symptoms vary from person to person. If your gift is not appropriate at this moment, there is a good chance that it will be a better fit at some point in the coming months. So don’t get discouraged if your gift doesn’t seem to be a hit the moment it is unwrapped.
The most important thing is that your loved one has something to unwrap this holiday season. While skills may fade, emotions are strong throughout dementia. Keep the guidelines and examples in mind as you brainstorm gift ideas for your loved one with dementia and you will find a meaningful gift choice.
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