FOXcast SLP: Tips For A Great Holiday Season For Patients With Dementia

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Jimmy McKay, PT, DPT: Hello and welcome to a special holiday edition of FOXcast. I’ll be your host physical therapist Dr. Jimmy McKay. Now the biblical magi also known as The three wise men or three kings. Were a group of distinguished foreigners who visited Jesus after his birth bearing gifts of gold frankincense and myrrh. They were regular figures in traditional nativity scenes around Christmas for millennia. So we give you the three wise FOX clinicians and they say hello. Coming to you live from all American assisted living in Londonderry New Hampshire. Laura Cond, Brittney Skrabak and Christopher Carrozza guys hello. Welcome to the program. Excited to have you guys here we’re going to be doing our version of the three wise FOX clinician’s. Tips for clinicians and caregivers to help a loved one with dementia enjoy the holiday season. Let’s get started. First off. Love that we’re coming at this from three very different directions. Laura an SLP. Britney an OT. Chris a PT. So we’re bringing in all the strengths that FOX rehabilitation really brings to the table right?

Laura Conte, MS, CCC-SLP: Right. Absolutely.

Jimmy: I like how you agree with me perfect. We want to give the tips and we’ll do it we’ll do it specific by profession. But first question for the three wise clinicians who didn’t know it was going to be a pop quiz. Let’s start off for a hundred points each can any of you tell me what the heck frankincense and myrrh are?

Brittney Skrabak, MS, OTRL: Oh that’s a tough one I’m thinking an old old wooden ship? Am I correct?

I believe that’s San Diego. 50 points for the creativity. I had to google it so I can’t act like I actually knew this myrrh was commonly used as an anointing oil and frankincense as a perfume back in biblical days. And gold is well that is still used used today.

Laura: Well we know that one.

Jimmy: Yeah. All right. So we’re going to zoom in. We’re going to go to Laura first and Laura being our resident SLP. Hello hello. Got the tips for individuals, clients, caregivers, clinicians on working with individuals with dementia around the holiday season. What do you want to go first?

Laura: One of the biggest thing that happens during the holidays is we talk about memories of holidays past. A lot of things get brought up. Maybe previous travels. Memories of time spent together whether it was holiday times or not. And this ties directly into one of my tips about using reminicence to help incorporate your loved one with dementia into the holiday festivities. A lot of times someone with dementia may not remember someone’s name. If they are presented in front of them but we can help trying to bring up a good memory associated with that loved one. So it could be either introducing them with a little bit extra information. So for example, grandma look this is cousin Jimmy remember? This is who came over on Thanksgiving and we did a dance or whatever kind of identifying information. You don’t want to put pressure on your loved one with dementia depending on what stage of course they are, but you don’t put that pressure on them bringing up her name remember recalling something specific like a name or event. You want to take that pressure off. We call that errorless leraning frequently in therapy. Trying to guide the thoughts of the individual or the responses of the individual. That way we can kind of not shame them or not remembering. So if someone says oh you know and uses the wrong name. Say oh no no again that’s so and so. Guide them and encorperate them into the conversation take off that pressure of recall.

Jimmy: Yeah love that. Using reminiscence and that’s a perfect bit of advice remember that really is what we wind up doing around the holidays. Unfortunately as a young boy I wound up climbing a bookshelf at the McKay family Christmas tree. And wound up knocking the Christmas tree over so yea that gets to get brought up every single year.

Laura: And do you hear that every year?

Jimmy: Every single year. Because there’s always someone new right? There’s always like a new brother in law or someone to be reminded. So I’m sure I’ll be hearing that story well into my older adulthood. Thank goodness.

Laura: To incorporate your loveed one with dementia. Sometimes bringing pictures from previous Christmas celebrations, family photos bringing up favorite songs. If this person had a favorite hymn or Christmas carol from the season. Maybe they can’t particpate fully in a conversation. But songs and memories and kind of looking throug pictures together can again involved them in the conversation.

Jimmy: And we’ve talked earlier on episodes on the show which was giving time and making sure that sometimes older adults with dementia or other cognitive issues might need 60 to 90 seconds to actually respond and not to not to hurry or put them as you mentioned just seconds ago putting added pressure onto that. That’s some great advice from Laura our SLP one of our wise clinicians. Very very wise Laura. We’re going to shift. We’re going to shift the camera right now and we’re going to bring in Brittany who is our OT from Londonderry. Hey Brittney. Appreciate the dressing up love the antlers.

Brittney: Of course of course. Tis The Season.

Jimmy: Tis the season. And what are your tips? We do you want to impress upon clinicians, caregivers we’re working with older adults with dementia. What you got for us?

Brittney: So the biggest thing to keep the same for people with dementia is that routine is huge. So making sure that the day stays the same as much as possible especially in the morning and at night. The biggest thing I find especially in our community is making sure that they change their clothes daily and taking showers. So making sure that you facilitate and modify the environment use specific cues and strategies to get them to change their clothes give them only one option. Maybe even family can pack it ahead of time. Make sure when they take it off at night put it right in the hamper and get the next outfit ready for the next day. So limiting choices to make sure that they’re not too overwhelmed and that will make sure that their behaviors stay pleasant.

Jimmy: I’m sensing a theme there right? Routine, giving time, giving cues and making sure not to rush to the answer. Letting them participate in that even if it’s a little bit delayed. That’s that’s OK. And even knowing that knowing that it’s OK is probably a big one right?

Brittney: Exactly. Exactly. So if you especially limit their choices make sure that they’re not overwhelmed with multiple outfits or you know making sure that there’s only really just like one person asking them. Would you like to do this or this and kind of stick to that.

Jimmy: Like that and very very gutsy call. I like it. You are in New Hampshire right now. I’m sure a lot of our colleagues in Pennsylvania and the Home Office area appreciate the, Yes go birds go with the Philadelphia Eagles sweater. All right. Let’s shift the camera all the way over for our last wise clinician and there’s Chris. Chris how are we doing today?

Chris Carrozza, MPT: Good how are you. Hey. Just stand up just a little bit so we can get a full view. So we will say at the facility that you’re at which is all-American assisted living you guys are doing, I can’t even called it an ugly sweater that is gorgeous classy. You got stuff hanging down from the arms they’re going all over. I’m going to give you. You’re definitely the myrrh.

Chris: Everyone knows what I am then.

Jimmy: All right Chris coming at it from the angle of a PT giving tips for older adults clients, clinicians, caregivers. What would you give for helping an older adult with dementia enjoy the holidays?

Chris: I mean just like Britney said the routine but sometimes in her routine they do have like nap times or rest times. So sometimes if they always take a nap at 12 maybe have the festivities a little bit later or make sure that they get their rest in and if they’re at your house a little bit earlier within that time, let them rest at your house. So then they are not messing up their routine and they have enough energy to go through the day. And saying that you don’t want your festivities too late because sometimes sundowning happens and you don’t want that to happen at a party. So you just want to keep that routine as much as possible and doing what the routine is and trying to get them involved as much as possible.

Jimmy: That’s perfect. Let’s let’s bring all three of you back into the shot. Now we’re going to get a good eyeful there. Oh that is perfect. Appreciate you guys giving us your advice and your tips the very first live broadcast that we’ve done here at FOXcast. And you even coordinate the outfits. We appreciate the three wise clinicians from FOX rehabilitation. Staff from New Hampshire. Thank you guys. I feel like this might be a theme in the future even though not around the holidays. The Three Wise clinicians could make a return to the FOXcast.

Brittney: Thank you!

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