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Anthea Rowan

This is the 52nd instalment in a series on dementia, including the research into its causes and treatment, advice for carers, and stories of hope.
Christmas after my mother’s dementia became apparent was a tricky affair.
When we gathered as we had in previous years – all her children, many of her grandchildren – it quickly became clear she wasn’t sure who we all were.
This caused her some distress. She wasn’t sure who was giving her presents and whom she was meant to thank.
Finding a gift for her was difficult. She could no longer read and her prized puzzles had become an exercise in frustration. An adult colouring book sent her into a fury of feeling patronised.
I made playing cards with family photographs on them to help jog her memory.

One Christmas Eve, as we all sat down to a laboriously prepared dinner, mum refused to leave her room. I took a plate to her, and remember feeling hurt.
Later I understood it was probably because – even if she hadn’t known the people sitting to her right and left – she might have found the noise too much, the light too low, the stories we recounted too strange: who were all these people we spoke of, including my father – her long deceased husband?
Christmas is an overcharged event; with dementia it can be a real challenge. So how do you cope as a carer?
Keep it simple, keep it calm, avoid surprises, say the experts. Anyone who joins your celebration needs to know how bad a person’s dementia is – and should reintroduce themselves to those with dementia, even if they’ve known them for years.
Let any guests, friends or relatives you are celebrating with know beforehand that your loved one has dementia and ask them to keep conversations clear and simple
Emily Ka-Hei Lui, dementia specialist Admiral Nurse
Chris Lynch, deputy chief executive at Alzheimer’s Disease International based in the UK, says striking the right balance and planning well are important at Christmas.
While social interactions and opportunities to meet with family and friends are fun for those who are well, and “can be both stimulating and enjoyable” for those struggling with dementia, “the change in routines, unfamiliar people, changes in environment and diet can be challenging”, he says.
If there is food on the holiday menu that the person with dementia does not enjoy or can no longer manage, make sure there is something they do like – and present it without fuss or fanfare.
My mum liked to think she was part of the group even if she did not know who the group was – being able to eat and enjoy with us helped mum to relax and feel included.
As Lynch says, Christmas tends to be louder than usual, so build in plenty of quiet time. “For carers, too, it is vital to factor in some respite or opportunities to relax and celebrate.”

Emily Ka-Hei Lui is a dementia specialist Admiral Nurse at Dementia UK with experience supporting families from the Chinese community in Hong Kong who are living with dementia. She now works together with the Chinese Welfare Trust to support families from London Chinese communities living with dementia.
Nothing captures the festive spirit quite like Christmas lights across Hong Kong, or other cities, she says.
“If you’re planning to explore Christmas displays and decorations in shopping centres, consider involving the person with dementia. Keep the visit short and allow for downtime to ensure they stay comfortable and enjoy the experience.”
Like Lynch, she urges carers to stick to routines.

“Family get-togethers can be stressful … Changes to routine can make a person with dementia feel uneasy, so try to stick to their normal routine where possible, even if this means they don’t eat a traditional Christmas dinner,” Lui says.
“It’s also helpful to plan ahead and let any guests, friends or relatives you are celebrating with know beforehand that your loved one has dementia and ask them to keep conversations clear and simple.
“Most of all, it’s important to be kind to yourself as a carer and not put pressure on yourself if things aren’t perfect.Enjoy the day for what it is, and accept any help others offer.”

6 tips for managing dementia over the holidays
The UK-based Alzheimer’s Society’s senior knowledge officer for well-being Angelo Makri offers these ways to make Christmas less stressful for a person with dementia – and their carers.
1. Put up – and take down – decorations gradually
A sudden change in environment can be confusing and distressing for someone living with dementia. Introduce Christmas decorations gradually so it does not come as a shock to the person with dementia.
2. Keep it simple and familiar
Christmas can be overwhelming for someone with dementia. Keep them relaxed by keeping activities low-key. For example, if your loved one usually goes to midnight mass every year but is unable to this Christmas, consider alternatives such as a televised or online service.
3. Get everyone involved
There’s a lot going on at Christmas but there are ways to get your loved one involved. This could be as simple as asking them to hang a decoration on a tree, or doing some shopping with your support, or encouraging them to choose their favourite music.
Music is known to play a vital role in the lives of people living with dementia. Make the most of Christmas music; much of it will be the same as when they were young.

4. Create a quiet area
Having lots of people about during the festive season can be frightening for people with dementia.
Designate a “quiet space” for the person with dementia to retreat to and relax or doze. This will help keep them from feeling overwhelmed, agitated or anxious.
5. Bring back old memories
It’s not just music that can bring back old memories; photos and traditions do too. These can be a great way to engage and help to start conversations. Take time out to sit and reminisce with a person with dementia, or make them feel part of the festivities.
6. Be flexible
It’s easy to get caught up in family traditions, but as dementia progresses, it’s good to be flexible. Be prepared to change plans if a particular element isn’t working. It’s best that everyone is comfortable and able to celebrate in whatever way suits.
Like what you read? Follow SCMP Lifestyle on Facebook, X and Instagram. You can also sign up for our eNewsletter here.


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Wellness

Exchanging gifts with a loved one with dementia can be challenging whether they are the giver or the recipient. Photo: Shutterstock


Christmas can be a bewildering time for people with dementia, but there are lots of things you can do, or avoid, to make it a happy occasion for them. Photo: Shutterstock

The writer made playing cards with family photographs on, so a game of patience became one of memory for her mother. Photo: Anthea Rowan

Try to involve the person with dementia in short trips to see Christmas lights or decorations in shopping centres, says Emily Ka-Hei Lui, a dementia specialist Admiral Nurse at Dementia UK. Photo: Dementia UK

Exchanging gifts with a loved one with dementia can be challenging whether they are the giver or the recipient. Photo: Shutterstock 

To get your loved one involved could be as simple as asking them to hang a decoration on a tree. Photo: Shutterstock

Having lots of people about during the festive season can be frightening for people with dementia, so designate a quiet place for them. Photo: Shutterstock 

Dementia and frailty are linked. How to stave off both, according to expert on ageing

To avoid or slow the progression of frailty, maintain social connections.
Photo: Shutterstock

Walking slowly is one of the signs of frailty, a condition that increases the risk of dementia. An expert on ageing explains how to head off both. Photo: Shutterstock



Feeling old can be a self-fulfilling prophecy; it leads people to do less and become frailer quicker as a result. Photo: Shutterstock

Dr David Ward, a research fellow in Ageing and Geriatric Medicine at the University of Queensland, in Australia, says greater frailty increases the risk of death irrespective of age. Photo: Dr David Ward

A dynamometer can test grip strength. A low grip strength is one of the five criteria for frailty, according to a 2001 study. Photo: Shutterstock

An elderly man runs with a young man in a park. Low amounts of energy are one of the signs of frailty. Ward says staying active as we get older is a great way to stay physically and mentally healthy. Photo: Shutterstock

Frailty increases the risk of death, irrespective of age. It is also a marker of dementia and a risk factor for its development. Photo: Shutterstock

Ward says exercise, especially strength-based exercise, is great for reducing frailty. Photo: Shutterstock

To avoid or slow the progression of frailty, follow a healthy diet rich in protein; older adults need more protein to maintain muscle mass. Photo: Shutterstock

Why men don’t express grief but feel physical pain instead, and how to get them to open up

What men struggle with most while grieving is the feeling of powerlessness that always follows the loss of a loved one. Photo: Shutterstock

Men grieve in secret, Thomas Achenbach says. They do not talk much about their feelings. Photo: Shutterstock 

Many men go into a kind of shock after the loss of a loved one that really paralyses them. Photo: Shutterstock

Unlike women, many men develop physical symptoms of grief. Photo: Getty Images

Hardly any men will show up for a self-help discussion group, but they will take part in a weekend hike or bicycle tour for the grieving. Photo: Shutterstock

Elderly couples often don’t talk. How to reconnect and have emotional communication

After decades together, some elderly couples run out of things to say, but following some expert tips can get them talking again. Photo: Shutterstock

Elderly couples may spend all their time together, even going into medical treatment rooms together. Photo: Shutterstock

Communication is a big part of any good relationship, but after decades in each other’s pockets, some couples may feel they have said everything. Photo: Shutterstock

Spending time apart from your partner can help keep you together, so try to cultivate outside interests. Photo: Shutterstock 

How fasting, as Chris Hemsworth did on his Disney+ series Limitless, may help us live longer by stopping ‘zombie cells’

Chris Hemsworth fasted to stave off ageing for his Disney+ Limitless series. Scientific studies show restricted eating patterns may stop “zombie cells” and extend our lives. Photo: Disney+

Chris Hemsworth in his documentary series Limitless, in which he explores different ways humans can live better for longer by taking on physical challenges. Photo: Disney+

Colin Selman, professor of biogerontology at the University of Glasgow. Photo: Twitter/@colinselman1

Studies in mice have found that reducing food intake or providing food only within a compressed amount of time provides significant health benefits. Photo: Shutterstock 

Ilaria Bellatuono, co-director of the Healthy Lifespan Institute at the University of Sheffield. Photo: University of Sheffield

Consuming only water for 48 hours could safeguard the immune system against ageing’s effects, one study suggests. Photo: Shutterstock

Lifestyle

Health & Wellness

Health

Family & Relationships

Lists

Decoding dementia

How caring for a parent with dementia taught me about symptoms, prevention and why seeking out the latest research is so important

Author Anthea Rowan (right) with her mother.

Author Anthea Rowan (right) with her mother, who has Alzheimer’s disease, the most common type of dementia. Photo: Anthea Rowan

Anthea with her mother. Photo: Anthea Rowan

Studies suggest that regular exercise lowers the risk of cognitive decline by 35 per cent. Photo: Getty Images

Staying active can help prevent or delay the onset of dementia, studies suggest. Photo: Shutterstock

Why should you have a brain scan to test for dementia when there’s no cure? Knowing can help you delay its onset, neurologist says

It can be daunting to get a brain scan to test for signs of dementia, but a neurologist behind new research reveals the advantages of knowing early. Photo: Shutterstock

New research has found that dementia can be detected as early as nine years before symptoms manifest, and this could have significant implications for treatment. Photo: Shutterstock

Timothy Rittman, the neurologist who led the dementia research at Cambridge University. Photo: Cambridge University

A brain scan showing signs of dementia. Photo: Getty Images

Lizzie Perry, founder of This is Dementia, with her father, who was diagnosed with the disease at 58. Photo: This is Dementia

The approval in the US of a new drug that slows the onset of Alzheimer’s makes Rittman hopeful about the future of dementia treatment. Photo: Cambridge University

Why women are more likely to have dementia than men as they age, and how exercise and engagement can help lower your risk

Women may be at a greater risk of developing Alzheimer’s than men for a number of reasons: biological, societal or cultural. Experts suggest exercise and social engagement can help offset the risk. Photo: Getty Images

The spread of tau – the protein that clumps into the telltale tangles of dementia – may contribute to Alzheimer’s disease. Photo: Shutterstock

Female twins with a male co-twin were less likely to be diagnosed with dementia than female twins with a female co-twin. Photo: Shutterstock

Prenatal care and monitoring pregnant women’s health is key, as it may impact cognition and dementia risk in later life. Photo: Shutterstock

Taking regular exercise is key for women – and men – to reduce the risk of dementia. Photo: Shutterstock

How high or low blood pressure increases the risk of dementia, and why it’s never too late, or early, to adopt a healthy lifestyle to manage it

Having blood pressure that is too high or too low has been linked to a higher risk of dementia, but it’s never too late to start living a healthy lifestyle that will help maintain optimal blood pressure. Photo: Shutterstock


An optimal blood pressure reading, easily measured with a home device, is around 120/80. Photo: Shutterstock

Dr Ruth Peters was lead author of a study looking at the links between blood pressure and dementia. Photo: Dr Ruth Peters

It’s never too late, or too early, to start thinking about brain health and living a healthy lifestyle. Photo: Shutterstock

Problems with reasoning, planning, judgment, memory and other thought processes may result from damage caused by impaired blood flow to the brain – which may be brought on by high blood pressure. Photo: Shutterstock

6 dementia fighting tips from Dr Sanjay Gupta and Marc Milstein, experts on brain health – walk, talk, read, learn, relax, and eat and drink properly

We can protect ourselves against the risk of dementia with some simple lifestyle practices. Exercising (above), eating a good diet, drinking less alcohol, socialising, reading more and trying new things all help keep the brain sharp, say brain experts including Dr Sanjay Gupta. Photo: Shutterstock 

The cover of one of Dr Sanjay Gupta’s book. Photo: Simon & Schuster

The cover of Marc Milstein’s book. Photo: Marc Milstein

Drink alcohol mindfully and ask yourself why you are having that drink. Photo: Shutterstock

Learning new things creates new brain cell connections and helps keep your mind sharp. Photo: Shutterstock

Reading is good for brain health. Try to read a wide range of book styles, and join a book club to discuss with others what you are reading. Photo: Shutterstock

During sleep, our brains are restored and repaired, so relaxing is important if we’re going to get those seven hours of quality sleep. Photo: Shutterstock

Relationships keep us engaged, interested and interesting, and may help prevent dementia. Photo: Shutterstock

‘Like a light switch’: how sundowning syndrome affects dementia sufferers – and their carers; what it is and tips for how to cope

A person with dementia may experience “sundowning” syndrome - towards the end of the day they become more agitated, confused, panicked, resistant to instruction and restless. This affects their carers, too. Photo: Shutterstock

A person in bed, unable to sleep. Conservative estimates suggest about 20 per cent of dementia patients experience sundowning at some point.

Trey Todd is a neuroscientist at the University of Wyoming. Photo: Trey Todd

Sundowning was coined in 1987 by Lois Evans of Penn Nursing at Pennsylvania University. Photo: University of Pennsylvania

The pineal gland in our brain produces melatonin, which is what helps prompt us to sleep and awaken. In a broken system it is disrupted. Melatonin supplements might help fight sundowning. Photo: Shutterstock

Taking a patient with sundowning syndrome for a walk at a consistent time each day, morning or evening, may alleviate symptoms. Photo: Shutterstock

Getting out into the daylight early in the day is good for our sleep patterns, whether we have dementia or not. Photo: Shutterstock

Healthy marriage, healthy mind? Dementia risk lower for people married a long time, studies show; expert suggests why

Research suggests that people who have stayed married for a long time have a lower risk for dementia because they feel less lonely, are more likely to eat well and exercise more, and are more cognitively engaged. Photo: Shutterstock

Vegard Skirbekk is a researcher at the Norwegian Institute of Public Health. Photo: Norwegian Institute of Public Health

Anthea Rowan’s parents on their wedding day. Photo: courtesy of Anthea Rowan

A long-time married partner represents a security that provides a buffer against stressors. Photo: Shutterstock

Anthea Rowan and her husband on their wedding day. Photo: courtesy of Anthea Rowan

If you live with a partner long term, you are more likely to develop healthy daily patterns, to eat well and exercise more. Photo: Shutterstock

‘Dementia village’ that’s the first of its kind helps residents live normal lives, has a restaurant, theatre and supermarket – and no one wears a white coat

Residents are free to live their lives as they like at the world’s first “dementia village”, The Hogeweyk in The Netherlands. Photo: The Hogeweyk

The Hogeweyk, a “dementia villlage” in the Netherlands, provides care and a familiar and safe environment in which people with dementia live while retaining their own identity and autonomy as much as possible. Photo: The Hogeweyk

Jannette Spiering is the senior managing adviser and co-founder at The Hogeweyk in the Netherlands, which offers “humanising care for people with dementia”. Photo: The Hogeweyk

Residents relax around the fountain in the theatre square at The Hogeweyk. Photo: The Hogeweyk 

Residents of The Hogeweyk respond positively to their increased autonomy. Photo: The Hogeweyk

Residents at the healthcare facility take part in a painting class. Photo: The Hogeweyk

Hearing loss dramatically raises the risk of dementia, so why are so many people in midlife doing nothing to prevent it? A test is easy to arrange

Hearing loss has been linked to a higher risk of dementia and cognitive decline,  say experts, who recommend testing for preventable hearing problems (above).  Photo: Getty Images

Alison Huang, a senior research associate at the Cochlear Centre at Johns Hopkins, in the US, says hearing loss makes the brain work harder to process sounds. Photo: Johns Hopkins

Jiang Fan from the School of Public Health at China’s Shandong University. Photo: Shandong University

Checking your hearing in midlife is crucial, and can help you stave off cognitive deterioration. Photo: Shutterstock

Can HRT reduce dementia risk? New hormone replacement therapy studies say yes, upending 2002 reports

HRT use has been linked to better cognition, blood flow and brain size and a reduction in all neurodegenerative disease in recent studies. Photo: Shutterstock

HRT (hormone replacement therapy) use has been linked to better cognition, blood flow and brain size and a reduction in dementia and other neurodegenerative disease in recent studies. Photo: Shutterstock

If HRT is started after the age of 65, brain cells will have already been deprived of oestrogen for many years. This could mean there is a decline in neuronal connections – the brain’s messaging system. Photo: Shutterstock

HRT was found to be most effective when introduced early in menopause, says Anne Marie Minihane, director of the UK’s Norwich Institute of Healthy Ageing at the University of East Anglia. Photo: University of East Anglia

Dr Andrea Kwakowsky from at the University of Galway in Ireland believes the “critical period” for starting HRT is within five years of menopause. Photo: University of Galway

How can you prevent dementia? Free brain health online tool teaches the risks and gives essential tips on avoiding it

The new free “Think Brain Health Check-in” online tool from Alzheimer’s Research UK doesn’t test your memory but checks how well you’re looking after your brain and gives tips to help prevent dementia. Photo: Shutterstock

Dr Susan Mitchell is head of policy at Alzheimer’s Research UK. Photo: Dr Susan Mitchell

The Think Brain Health Check-in asks how often you challenge your brain - and then highlights why challenging your brain is key to staving off dementia. Photo: Shutterstock

Getting a good night’s sleep every night is one way to lower the risk of developing dementia. Photo: Shutterstock

Up to 40 per cent of dementia cases could be prevented if people were mindful of the risk factors for the illness and made lifestyle changes to prevent them. Photo: Shutterstock

Can lack of sleep raise dementia risk? Yes, studies say – but with one exception

Having only five hours of sleep a night can increase dementia risk by 30 per cent for adults over 50, one study says. Photo: Shutterstock

One tip to overcome insomnia is to avoid clock-watching. Photo: Shutterstock

Taking a warm shower or bath in the hour or so before bed may help you fall asleep – and stay asleep. Photo: Shutterstock

Professor Roger Wong of the department of public health and preventive medicine at the State University of New York’s Upstate Medical University. Photo: Roger Wong

Sleep aids can heighten dementia risk, Wong says. Photo: Shutterstock

Can’t sleep? Try getting up and engaging in cognitively stimulating activities, like reading or making jam. Photo: Shutterstock

Dementia and ACB scores: how common prescription and over-the-counter drugs raise the risk of memory loss and cognitive decline

Certain common drugs, including antihistamines, antacids, antidepressants and anti-anxiety medicines, can disrupt the neurotransmitter acetylcholine, dubbed the “memory molecule” increasing the risk of dementia. Photo: Shutterstock

The writer, Anthea Rowan, with her mother. Photo: Anthea Rowan

Taking medications that block the action of acetylcholine can lead to memory loss, problems with spatial awareness, and cognitive decline. Photo: Shutterstock

Studies have found that anticholinergic drugs carried “significant’ dementia risk” for the over-65s. Photo: Shutterstock

Doctors need to be mindful of the risks posed by anticholinergic drugs, especially to an already at-risk population: the over 65s. Photo: Shutterstock

How to safeguard your ageing brain: build ‘cognitive reserve’ with mental and physical exercise, and stay active and socially engaged

The phrase ‘use it or lose it’ is not just a hypothesis, it’s a basic biological fact that holds as true for our brains as our muscles or bones. Photo:
Shutterstock

Our brains, like our muscles need regular use to stay healthy and flexible, say experts, and keeping our brains active builds our ‘cognitive reserve’, helping us to stave off dementia. Photo: Shutterstock

Geriatric psychiatrist Dr David Merrill recommends the active pursuit of activities that keep the brain sharp to stave off dementia. Photo: Dr David Merrill

Dorina Cadar says cultural and social engagement, reading, doing crossword puzzles, visiting art galleries, clubs and cinemas, and volunteering all increase our cognitive reserve. Photo: Dorina Cadar

How to help a loved one with dementia enjoy the holiday season

The festive season can be confusing and noisy for those with dementia, but these expert tips will help everyone enjoy the occasion