Halloween can be a fun time for young and old alike. For many, it’s their favorite time of the year. But, for the cognitively impaired, Halloween can present special challenges.
Caveat
Some of these tips are and have pros and cons.
There’s going to be a sense in which let’s say for example turning off the lights in order to dissuade trick-or-treaters might be an increased risk for tripping inside the home and it might be an invitation to vandalism or burglary. You may need to adapt some of these tips for your specific situation.
Two Main Concerns
Firstly, Halloween presents dangers for your Alzheimer’s-afflicted or dementia-stricken loved one. Secondly, people who are cognitively impaired may present challenges for others – not least, youthful trick or treaters.
Problems for Dementia Sufferers
Alzheimer’s Disease and other forms of cognitive impairment may result in anxiety, agitation, confusion, and numerous other emotional changes.
In general, these affective, cognitive, and physical difficulties are made worse during a holiday like Halloween.
One primary reason for this is that the normal trappings of Halloween can add to, magnify, or trigger negative states such as confusion and disorientation. It can exacerbate emotional problems like anxiety, agitation, and fear.
Additionally, Halloween can present certain physical dangers that go beyond what you would experience in the normal course of Alzheimer’s Disease.
Fire
There are burning hazards from candles, bonfires, jack-o-lanterns, and other things.
Choking
Depending on the stage of your loved one’s condition, you may have to contend with choking hazards from candy and other kinds of treats that are left out.
Falling and Tripping
Normal, age-related mobility issues are made worse by cognitive impairments. But the low-lighting conditions that often accompany Halloween can lead to increased risks of falls and trips.
Criminal Activity
In addition, and unfortunately, there are those people who are looking to take advantage of elderly people. People who are cognitively impaired (for example, who might be in early or middle stages), but who are still able to live alone part of the time, can be targeted and victimized in an array of ways.
On the severe end of the spectrum there are things like assaults and burglaries. On the less serious side, things like pranks, vandalism, and scams may escalate during holidays,
Cognitively impaired individuals may misperceive threats in a couple of different ways.
Number one, they may misperceive a person who is really an innocent trick-or-treater as a threat.
Number two, they might misperceive a person is actually a threat, as not being a threat.
Disorienting Factors
Doorbells and Knocking
Think about the amount of time the doorbell might ring during the evening. Or consider the effect that repeated knocks on the door might cause.
These can be startling at best. But they can actually be panic inducing at worst.
Of course, the actual effect will depend on the nature of your loved one’s affliction.
The geographical area and crime rate also play large roles, here.
Costumes and Masks
Another aspect of disorientation is the costumes and masks worn by party goers and revelers.
In the first place, some of these can be downright scary.
But, in the second place, they might make it even more difficult than usual for a cognitively impaired person to identify someone else – even if that person is (or should be) known or recognizable.
Alzheimer’s and other dementia-afflicted persons react poorly and even unpredictably to unfamiliar situations.
Masks and other kinds of costumes are going to obviously make it difficult to recognize a person. Predictably, this is going to increase the level of confusion that might be felt by some sufferers – or their caretakers.
Decorations
Halloween decorations can range from the grotesque and the off-putting to the downright terrifying. Be mindful of the effect these might have.
Horror Movies
Television, and other kinds of movies and “programming” can be horrifying and extremely scary, especially for young children and – again – those who are cognitively impaired.
Bear in mind that hallucinations and even paranoia are a couple of symptoms that typically go along with dementia. (For my article on this, see HERE.)
And these perceptual maladies are just a normal part of Alzheimer’s! Halloween just can make these kinds of things a little bit worse.
Cognitive and emotional difficulties are compounded by numerous factors.
Dim, Flickering, or Strobing Lights
There are often lighting changes.
So, for example, lights are often turned down low. This dim lighting might make it difficult for a dementia-affected person to perceive his or her surroundings or navigate the living environment.
This, in turn, can lead to falls and trips.
Some lighting might be flickering or strobing, which can also be disorienting. It might also cause seizures in individuals who are prone to epileptic-type fits.
Other changes might include candles and bonfires. These present numerous hazards.
Firstly, as previously mentioned, they may cause burns and house fires.
Secondly, they may give off smoke (and set off agitating smoke alarms) or even deadly carbon-monoxide gas. (For more on these dangers, and how to alleviate them, see HERE and HERE and HERE.)
Thirdly, they can also lead to an increased risk for tripping and falling inside the house. The flickering and uneven light can be just as disorienting as many novelty lamps or black lights.
Strange Sounds
Sounds might be loud.
Or they might be just plain eerie. And that can be unnerving.
Miscellaneous Dangers
Additionally, knives and other paraphernalia (for instance, those that may be used to carve pumpkins or set decorations) could be left lying around.
Dos and Don’ts
So, what can you do? (An abbreviated version of this list is online HERE.)
Don’ts
Hopefully it goes without saying, but don’t put your fun over your loved one’s well-being. Many people love Halloween and are ready to go all out. But remember, if you’re dealing with somebody who’s got a cognitive impairment. They may require special and a particular amount of love and care, especially during a time like this. You may have to sacrifice a few of your decorations and so on.
Don’t bring love ones to disorienting environments – out to malls (if there are any remaining!), to parties, or in general to places where there is bound to be lots of boisterousness or commotion.
Don’t leave Alzheimer’s suffers alone.
Don’t leave carving equipment lying about.
Don’t alter lighting beyond what would be safe.
This one is a bit tricky because, on the one hand, you’re going to want to leave lighting on inside the home for the purpose of helping your loved one to navigate the home environment. But, on the other hand, leaving the light on inside can signal to trick-or-treaters that you actually have a house that is worth visiting.
So, there can be some pressure to turn the lights down low in order to dissuade people from coming up to your door.
If you have good window treatments on the outside of the house or on the inside of the house, then you can turn the lights on inside without having to worry about that light penetrating to the outside.
If not, it might be better to retreat to an inner portion of the house where perhaps you can turn those lights on and leave the outermost lights off.
Don’t leave exterior or porch lights on, as it can signal the trick-or-treaters that yours is a house that you might that they might want to approach. (But, per my caveats, if you are in a burglary- or vandalism-prone area, then you may want to leave the lights on after all.)
Don’t over-decorate the house.
Don’t over stimulate your loved one. This can even include the opening and shutting of the doors.
If you are passing out candy, don’t overwhelm your afflicted relative with guests or parties inside the home (or outside of it, for that matter).
Dos
Do keep a careful watch over your loved one.
Do emphasize the lighthearted over the horrifying.
Do keep interiors well enough lit for safe passage.
Do remove the car from the driveway, if feasible. Placing it into the garage so that the house does not appear to be occupied.
HOWEVER… As I started off the video by saying, some of these tips have pros and cons. This is one such tip.
If you live in an area where you think that the house would be construed as vacant if it didn’t show signs of presence inside; or, relatedly, if you think that the lack of light or a vehicle might make the home more of a risk for a burglary attempt; then you obviously want to mitigate that risk by modifying or disregarding these sorts of tips.
So, again, you may have to adapt some of these tips for your own situation.
It’s also worth a discussion about whether your household should pass out candy or not. Obviously, if it’s going to disrupt the evening or if it’s going to disturb your Alzheimer’s-afflicted relative or loved one, then it’s probably not a good idea.
Some people advise placing candy outside, maybe in a bowl, and putting a sign on it that says, “Go ahead; take one; don’t ring the doorbell.”
Other people say, “No, you shouldn’t do that,” because candy left outside could be tainted or manipulated or stolen. Again, the sign could be interpreted as an indication that no one is home, which – depending on the area that you’re in – might be an invitation to criminals.
This is something you’ll have to figure out by yourself, given your situation.
Depending on your level of comfort, you might consider having someone else pass out candy for you. He or she could remain outside, provided that the weather is agreeable. If that person has whatever he or she needs, then this would reduce or eliminate the need to have to enter and exit the home very often. This would be a big help in terms of minimizing agitation. The question is: is it worth all that just to appease trick or treaters?
Do respond to signs of upset – whether this be due to overstimulation or agitation.
Some helpful tips are do set up some sort of a safe environment inside the house – a safe space, a room that’s especially quiet. You should have some quiet activities planned out and ready to go. These can be simple puzzles or photo albums. They could be familiar movies, music, and so on, or familiar books – something that you would be able to read to your afflicted relative.
Do reassure if necessary.
And do remove problematic decorations.
You might also consider just not being in the home (especially if you think you’re in a high traffic area). Different neighborhoods vary in this regard. Sometimes the neighborhood could be completely quiet and other times it might be extremely filled with activity.
Not to sound like a broken record but weigh the benefits of leaving against liabilities – for example if you think an unoccupied home would be a target. On the other hand, it might be a good idea to permanently relocate your loved one if they live in a high-crime area. Though, this is often easier said than done – especially if money is tight.
Disclaimers: First of all, there is no substitute for watchfulness any of the tips that I may provide are not supposed to be a substitution for diligently and vigilantly watching your loved one. Number two I am not a lawyer. I am not a doctor. I cannot give you specific advice I can give you specific Promises that any of the things that we will discuss will prevent injury and that is why watchfulness is so important.
Have a happy and safe Halloween!
Once again, for my quick-reference list, see: