What are ways to include an individual with dementia in Halloween activities?

Halloween is one of the most celebrated days in the United States and the second-largest commercial holiday, with Americans spending more than $6 billion annually on costumes, candy, decorations and the like.

Scary costumes and frightening decor can create anxiety or stress for someone with Alzheimer's or dementia. For some, "Halloween activates that sense of someone being in danger and being surprised and caught unaware," says Dr. Lauren Cook, a therapist, speaker and author. Therefore, it is so important to organize and make Halloween stress-free and an occasion for fun and enjoyment for the individual with dementia.

Think about the decorations in the house. These should be kept to a minimum. Such things as creepy plastic, hanging spiders, skeleton or monster decor, an outdoor fake cemetery, scary and abrupt sounds, and even candles and flashlights lit all through the home should be avoided. An individual with Alzheimer's or dementia often experiences visual perception changes and these lights cast shadows and eerie glows that can lead to anxiety. A good rule of thumb is that if it scares a 6-year-old, it will scare the affected individual. Try decorating with traditional autumn colors and use non-threatening Halloween and/or fall decor to represent the holiday.

Crowded parties and/or elaborate celebrations may be too much external stimulation for the affected individual, so try to organize opportunities for smaller, more intimate gatherings so the individual can be included and feel more comfortable. Additionally, the constant ring of the doorbell or the knock on the door and children yelling, "Trick or treat!", can make the affected individual extremely nervous and anxious.

A good suggestion for the caregiver and loved one would be to sit outside near the front door, and if the individual with dementia is willing, have them distribute the candy to the kids. This provides opportunities for socialization and enjoyment in the community and chances to share in the excitement of little children. However, as mentioned, do be aware if the affected individual becomes anxious or agitated at seeing all the various costumes the trick-or-treaters are wearing. If behavioral expressions begin to spew, take the individual to a more comfortable, quiet place inside until they settle down.

There is really no Halloween without candy, with filled candy dishes around the house and kids sharing their trick-or-treat goodies with siblings and friends. It is difficult for the affected individual to avoid high-calorie and flavorful foods like sugary sweets. Try to keep the candy in a safe place and out of sight, as the affected individual oftentimes has no control when it comes to sweets. Allow him or her to enjoy the celebrations and monitor intake.

Aside from these precautions, Halloween can be adapted and personalized to make a meaningful and enjoyable celebration for the individual with Alzheimer's or dementia. Involve the affected individual as much as possible, like making decorations together, allowing for creative self-expression, carving jack-o'-lanterns, and building self-esteem. Keep in mind personal choices, cultural differences, and past experiences with Halloween celebrations in the life of the affected individual and honor them.