For many, the holiday season is a joyful one spent together with loved ones—including families affected by dementia. Being adaptable and building an inclusive environment are key to creating dementia-friendly holidays and celebrations. With the holiday season right around the corner, the Alzheimer’s Foundation of America (AFA) is providing tips on how families affected by dementia can adapt holiday gatherings to make them safe and dementia-friendly during this festive time.

“The best way to support someone with dementia during the holiday season is to create an inclusive environment to enjoy holidays and celebrations, while understanding and adapting to changes and being aware of the many emotions the holidays can bring,” said Jennifer Reeder, LMSW, AFA’s Director of Educational and Social Services.

Families caring for someone with dementia should consider the following steps:

Build on old traditions where you can, such as enjoying favorite music or movies. Start new ones around things the persons can, and likes to do, such as touring neighborhood holiday lights, and do it together. Whenever possible, involve the person by asking what traditions are important to them (this will help you prioritize and plan). For example, if the person used to do all the holiday cooking, make it a new tradition to cook together as a family. If they oversaw hanging holiday lights, make it a group effort.

Excess stimuli may be challenging for someone with dementia. Too many flickering lights or an abundance of decorations can be overstimulating and disorienting. Also, be aware of the person’s sensitivity to factors such as loud noises.

Avoid fragile decorations (which can shatter and create sharp fragments) and ones that could be mistaken for edible treats (which can create a choking hazard or broken teeth). Reduce clutter to avoid potential tripping hazards. Securely hook Christmas trees to the wall to avoid falls and utilize menorahs or kinaras with electric candles to reduce fire hazards.

Like with traditions, adapting celebrations is key for a dementia-friendly holiday. Try to focus on what they enjoy while keeping in mind their safety and comfort.

Before the celebration

Prepare the person.

Help build familiarity and comfort by showing them photos of the guests or arrange a phone call/Facetime chat with the visitors beforehand.

Consider sharing beneficial information with guests beforehand, such as ways they can communicate with the person, what they respond well to, and what may upset them—especially visitors who don’t regularly interact with the individual. This will guide them on how they can be helpful and supportive.

During the celebration

Preserve normal routine.

Changes in daily routine can be challenging for someone living with dementia. If the person usually takes an afternoon walk, build in time for that. If they go to bed early, hold the celebration earlier in the day so that everyone can participate.

Take a Strengths-Based and Person-Centered Approach.

Focus on what the person is still able to do and what they choose to do now, rather than dwelling on what they used to do.

The AFA Helpline is available seven days a week to help provide additional information about creating dementia-friendly holidays or any other caregiving questions. Connect with a licensed social worker by calling 866-232-8484, web chatting at www.alzfdn.org or sending a text message to 646-586-5283. The web chat and text message features can serve individuals in more than 90 different languages.

Fraud occurs when someone tricks an elder into handing over assets such as money or investments. Watch out for many different schemes and scams. Remember, fraudsters vary their scams to catch their victims off guard. Financial elder abuse is most often perpetrated by someone an elder knows such as a caregiver, friend,or sadly, a relative. It involves taking assets by directly taking control of an elder’s finances or becoming close with an elder and convincing them to hand over their assets. Things to watch for include: making unauthorized (or fraudulently obtained) withdrawals or purchases using the elder’s ATM or credit card, or making unauthorized (or fraudulently obtained) changes to an elder’s will or power of attorney.

The need for senior fraud awareness and prevention has become greater than ever. Seniors are often easy targets for fraud, whether it’s for fraudulent sweepstakes prizes or too-good-to-be-true investment returns. Fraud can happen by phone, mail, online, and in person. Fraud can happen to wealthy seniors, and to those of limited means and on fixed incomes. Although anyone can commit senior fraud, the Los Angeles branch of Adult Protective Services reports that about 90% of their cases involve allegations that a family member has financially abused an elder. Education and awareness are the first steps to help protect seniors from becoming a victim of crime and fraud.

According to the Federal Trade Commission (FTC), con artists are more likely to target seniors than other age groups. Seniors are more susceptible to such scams because they are polite and trusting and often have good credit and own their own home and/or have other financial assets. The FTC reports that fraudulent telemarketers direct up to 80 percent of their calls at senior citizens. Seniors citizens continue to be a rapidly increasing segment of the population, and that makes them a prime target for con artists and thieves. Education and awareness are the first steps to help protect seniors from becoming a victim of crime and fraud.

The FTC is getting reports about people pretending to be from the Social Security Administration (SSA) who are trying to get your Social Security number and even your money. In one version of the scam, the caller says your Social Security number has been linked to a crime (often, he says it happened in Texas) involving drugs or sending money out of the country illegally. He then says your Social is blocked – but he might ask you for a fee to reactivate it, or to get a new number. And he will ask you to confirm your Social Security number.

Many people make assumptions about aging, what it is like to grow “old”, and how older age will affect them. But as we are getting older, it is important to understand the positive aspects of aging. Research has shown that you can help preserve your health and mobility as you age by adopting or continuing healthy habits and lifestyle choices.

1. If a family member has Alzheimer’s disease, I will have it, too.

A person’s chance of having Alzheimer’s disease may be higher if he or she has a family history of dementia because there are some genes that we know increase risk. However, having a parent with Alzheimer’s does not necessarily mean that someone will develop the disease.

Environmental and lifestyle factors, such as exercise, diet, exposure to pollutants, and smoking also may affect a person’s risk for Alzheimer’s. While you cannot control the genes you inherited, you can take steps to stay healthy as you age, such as getting regular exercise, controlling high blood pressure, and not smoking.

2. Now that I am older, I will have to give up driving.

As the U.S. population ages, the number of licensed older adults on the road will continue to increase. The Federal Highway Administration (FHWA) recorded a record-high 221.7 million licensed drivers in the U.S. in 2016, including 41.7 million — or almost one in five — who are 65 years or older. The question of when it is time to limit or stop driving should not be about age, rather, it should be about one’s ability to drive safely.

3. Only women need to worry about osteoporosis.

Although osteoporosis is more common in women, this disease still affects many men and could be underdiagnosed. While men may not be as likely to have osteoporosis because they start with more bone density than women, one in five men over the age of 50 will have an osteoporosis-related fracture. By age 65 or 70, men and women lose bone mass at the same rate.

Many of the things that put men at risk are the same as those for women, including family history, not enough calcium or vitamin D, and too little exercise. Low levels of testosterone, too much alcohol, taking certain drugs, and smoking are other risk factors.

4. I’m “too old” to quit smoking.

It doesn’t matter how old you are or how long you have been smoking, quitting at any time improves your health. Smokers who quit have fewer illnesses such as colds and the flu, lower rates of bronchitis and pneumonia, and an overall better feeling of well-being.

The benefits of quitting are almost immediate. Within a few hours, the carbon monoxide level in your blood begins to decline and, in a few weeks, your circulation improves, and your lung function increases.

5. My blood pressure has lowered or returned to normal, so I can stop taking my medication.

High blood pressure is a very common problem for older adults — especially those in their 80s and 90s — and can lead to serious health problems if not treated properly. If you take high blood pressure medicine and your blood pressure goes down, it means the medicine and any lifestyle changes you have made are working. However, it is very important to continue your treatment and activities long-term. If you stop taking your medicine, your blood pressure could rise again, increasing your risk for health problems like stroke and kidney disease.

More in next issue.

Engaging in high or medium levels of physical activity was associated with slower rates of cognitive decline in people with high or low levels of tau, compared to those with little physical activity. Led by researchers from the Rush University Medical Center, the findings were published in JAMA Network Open on Aug. 11. The researchers noted that measuring levels of tau, a protein that is a hallmark of Alzheimer’s disease, in the blood could help identify people who might benefit from early intervention to slow cognitive decline.

In people living with Alzheimer’s, abnormal accumulation of tau builds up into tangles in the brain. Higher levels of tau are associated with cognitive decline and an increase in memory and thinking problems. Research has shown that physical activity may help slow cognitive decline, but it was unknown if physical activity rates were associated with slow cognitive decline in people who have high levels of tau.

A team of researchers used data from 1,159 older adults who took part in a large study called the Chicago Health and Aging Project (CHAP) between 1993 and 2012. CHAP researchers assessed cognitive function using various tests, asked participants about their physical activity, and collected blood samples from the participants, who did not have Alzheimer’s at the start of the study. In 2019, researchers measured tau concentrations in the blood samples, which had been frozen, and compared rates of cognitive decline among people with high and low tau concentrations and high, medium, and low physical activity levels.

The researchers found that, among participants with high tau concentrations, those who had reported medium levels of physical activity had a 58% slower rate of cognitive decline than participants with low physical activity levels. Those who reported high physical activity levels had a 41% slower rate of cognitive decline than those with low self-reported physical activity levels. For participants with low tau concentrations, those with high physical activity levels had significantly slower cognitive decline than those with medium or low physical activity levels.

The study had some limitations. It included only white and African American participants, and it measured the duration but not the intensity of physical activity. The researchers also note that the rate of cognitive decline was sometimes lower among participants with medium physical activity levels than among those with high physical activity levels; the reasons for this variation warrant further study.

The findings suggest that measuring proteins — such as tau — in the blood could help identify people who would benefit from increased physical activity or other behavior changes that could help slow cognitive decline. Measuring such proteins could also help future studies measure the benefits of behavior changes in people who are at higher risk of Alzheimer’s.

This research was supported by NIA grants R01AG03154, R01AG051635, RF1AG057532, and R01AG058679.