Research to Practice

Anyone who works with older adults who have memory impairment or behavioral problems uses the fruits of clinical research every day. For example, studies of these elders and their reactions have shown a number of ways that overstimulation -- and the problems that come with it -- can be prevented or controlled. Just in time for the holidays, Daniel Sewell, a physician who serves as director of the Senior Behavioral Health Unit at the University of California, San Diego, draws on this research to offer readers of ASA CONNECTION suggestions on how caregivers can help elders with such difficulties get the most enjoyment out of family gatherings:

• If the elder is vulnerable to overstimulation, limit the activities or length of time in which the elder is included. For example, don't let holiday dinners drag on for hours.
• Establish a quiet room in the home so that the elder can step out of the hustle and bustle for a calm moment.
• Budget in nap time, especially if the older adult is accustomed to daily naps.
• Assign a family member to be that day's companion to monitor how the elder is doing and to make sure the elder feels comfortable.
• If the get-together is in the home of the person with memory impairment or behavioral problems, don't rearrange the furniture. This could be a source of confusion and anxiety. If the get-together is in a new place, remove slippery throw rugs.
• Don't put out a lot of finger foods, like sweets, especially if the individual has a problem with impulse control. Too many sweets can result in sugar-induced hyperactivity or an upset stomach.
• Limit or eliminate the elder's alcohol consumption. Drinking alcoholic beverages can provoke problem behavior or interfere with medications.
• Involve the elder in a simple, helpful preparation task, such as greasing one of the cooking pans or peeling potatoes. This aids self-esteem and helps the older adult feel a sense of contribution to the day's celebrations.
• Engage everyone, including the memory-impaired elder, in reminiscing. Often, individuals with memory problems can recall the past even though they can't remember recent events. By getting these elders to talk about the past, families can help younger members discover their roots, and the memory-impaired elder will feel validated for their perspective on family history.
• Avoid criticism that can embarrass or shame the older person. For example, when an elder forgets a recent conversation, refrain from asking, "Don't you remember?"
• Be sure to maintain the elder's regular schedule of medications.
• If you're traveling by air with the older adult, plan on how much time you'll need -- then double it. Rushing is very stressful for everyone. Airport services, such as wheelchair accommodations, might be in short supply with the heavy load of travelers during the holiday season.

"All of these suggestions need to be individualized for each person and their special needs," Sewell adds. "These folks can get lost in the shuffle and chaos of happy family gatherings. So just be sensitive and loving -- and plan ahead."

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