Thanks to breakthroughs in medicine and nutrition in recent years, we are living longer than ever before. But this increase in life expectancy also brings an increase in the number of diseases, injuries and impairments that affect older adults. With this in mind, we at the Salem Visiting Angels office have created this series of articles to keep our older population and their families informed and to offer some practical advice for meeting the challenges faced by seniors and those who care for them.

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While a good scare is all part of the fun of the Halloween season, for older adults living with Alzheimer’s disease and other forms of dementia, Halloween can be confusing and even downright terrifying. Most people are able to recognize the spooky sights and scary sounds of the holiday for the decorations and sound effects that they are, but for people with moderate or late-stage dementia, those sights and sounds can be all too real.

Families caring for loved ones with dementia should be careful about the number and kinds of Halloween decorations they use. Too many decorations may overstimulate someone with dementia leading to anxiety and agitation, and decorations that are too frightening could also add to a senior’s confusion. Decorations with flashing lights, spooky sounds and screaming, and items that move or talk should not be used.

However, decorations which focus on fall themes, such as uncarved pumpkins and autumn leaves are less stressful than skeletons and ghosts. Also, playing relaxing music or songs that the person enjoys may help to ease anxiety.

People with dementia should not be left alone while trick-or-treating is going on in their community. It’s always best to have a trusted friend or relative stay with someone with dementia, preferably a person who can keep them from wandering and help them make sense of what’s going on around them. Small children in cute costumes may not be too disorienting, but older children or adults in gory costumes could be frightening. For some people living with dementia, it may be best to avoid gatherings with costumes and masks.

Sometimes, placing a bowl of candy outside with instructions to take a piece is preferable to answering the door and interacting with trick-or-treaters. Costumed characters should never be asked to come inside the home. Keeping the candy away from loved ones with dementia is also a good idea, since sugar can lead to increased agitation.

The evening hours during the Halloween season may be particularly difficult for those dealing with Sundown Syndrome. Sundown Syndrome, or Sundowning, is a condition in which older adults may become agitated, aggressive or confused as natural sunlight starts to fade at the end of the day. While it is primarily found in people with Alzheimer’s disease and other forms of dementia, it can occur in adults without dementia.

In addition to agitation, confusion and aggression, other common symptoms of Sundowning include restlessness, pacing and mood swings. The person may hallucinate or display signs of paranoia. They may seem disoriented and wander. Yelling and irritability are also common.

Environmental conditions, such as shadows, can play a part in causing the symptoms of Sundowning, which means homes should be kept well lit during trick-or-treat hours, and families caring for loved ones with Sundowning symptoms should avoid using candles and low lighting as part of their Halloween decorating. Flashlight and strobe lighting can also cause anxiety in dementia patients who do not experience Sundowning.

Some seniors in the early stages of dementia may still be able to recognize the costumes and decorations for what they are and can still enjoy the fun of the holiday, but the family members who care for them should watch for the signs that they are no longer able to understand what they are seeing and hearing around them. In these cases, it’s time to remove them from the situation that may be becoming overstimulating or stressful.

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Information provided by Visiting Angels, America’s choice in homecare. Visiting Angels’ non-medical home care services allow people to continue enjoying the independence of their daily routines and familiar surroundings. To set up an appointment for a free in-home consultation, call 330-332-1203.