Suzie Dickson Moyer in Amherst, Massachusetts, usually hosts a cookie-decorating party at Christmas for 40 to 50 people. This year, she downsized to close family to accommodate her 92-year-old mother, who will be visiting from an assisted living facility.
While mom, Mary Campbell Dickson, is doing well, "I want to maintain infection control so she doesn't get sick," Moyer said.
She has made other plans to ensure the 10-day visit goes well. Her mother's facility pre-packaged medications and Moyer pulled the throw rugs from the guest room to avoid slipping accidents. Moyer also has grab bars in the bathroom her mother will use and has put two of her adult daughters who live nearby on notice that their assistance might be needed.
"I think it's really important," Moyer said, "to think about, 'Oh my God, what happens if I get sick and can't care for her?'"
When checking a senior out of assisted living to enjoy the holidays at home, logistics are key, but Moyer said other things are important, too. Keeping a frail loved one involved and socially engaged while also taking care to watch for signs of stress or fatigue are necessary steps.
Bridgette Sloan lost her mother, Emma, in 2012 at age 87, after dementia set in. She had been in assisted living in Ohio, where Sloan and her family lived. Emma would visit regularly but overnight stays at the old, two-story house in Columbus became too challenging as her mother's condition progressed, so Sloan decided on day visits at the holidays to make it easier.
"When she spent the night she would sleep in the recliner, which she preferred," Sloan said. "She was cooler at night, which affected her arthritis, so we had to make sure the heat was up higher than we were used to. She could get to the bathroom herself with her cane but we had to make sure the path to the bathroom was well lit and that she could manage some step-ups we had in the house."
Health
Her mother's recliner was in the family room off the dining room, at the centre of holiday hub-bub, which Emma enjoyed. There was a fireplace and she was near the Christmas tree. She took meals on a tray but was included in table talk with the rest of the family, Sloan recalled.
"She wanted to be around all the grandchildren, the dog. She loved that," Sloan said. "We also tried to keep family drama down. With her dementia, she would sometimes get confused when there was conflict and think it was her fault."
Also key for relatives is knowing when skilled help is needed - for lifting and bathing, or to administer injectable medications.
That's why nursing homes and other facilities often recommend the temporary use of home health aides, whether it's for the duration of a stay or for a few hours each day.
Jane Emmerth, an RN who works as a supervisor and clinical case manager for Partners in Care, a home care agency in New York, regularly dispatches nurses and aides to private homes. During the holidays, people often hire for two to four hours to help with visiting loved ones.
"The person going home might not feel comfortable with their daughter bathing them," she said. "They might not feel as secure. If the person has a wound, it has to be taken care of."
Bill Lowe, chief executive for Chicagoland Methodist Senior Services, a network of care providers, agreed that hiring temporary assistance can make a visit run more smoothly. Beyond care management, he said many families struggle to understand when they should include a visitor in activities.
"Don't assume that with memory loss, your family member can't participate in activities like food preparation or party games," he said. "In my own family, my grandmother, who had memory loss, always enjoyed playing a particularly complicated rummy game. Even at times when she seemed distant, we could often get her to leave her room for a game of cards, and we were always amazed that she could capably manage hands as large as 17 cards."
But sometimes, Emmerth said, a family needs to know when a home visit wouldn't work. Taking a patient with advanced dementia out of the routine and environment of a familiar assisted living facility, for example, may be more stressful for a senior than a home visit is worth, Emmerth said.
"It can really be disruptive to them. They wouldn't have a good visit," she said. "Sometimes it makes more sense for a facility to set up a private room for a little Christmas for the family there."
