Halloween is a holiday that’s all about harmless fun for many. The ghosts and goblins that run from home to home will go away if you give them candy (no toothbrushes!), and the closest any of us will get to an axe-wielding maniac is through a TV screen. For one group, though, Halloween can be a stressful, terrifying time that’s filled with confusion and anxiety.

Caregivers for patients with dementia and Alzheimer’s disease are all too familiar with the dangers that something as innocent as trick-or-treating can pose, though it’s not something most of us consider. It’s all fake, after all. For those with dementia and Alzheimer’s and their caregivers, though, the fear is all too real.

Why Halloween Can Be A Nightmare

Two of the most common symptoms of Alzheimer’s and dementia are memory loss and confusion. On a normal day, these can lead to anxiety and agitation. Now, imagine the exacerbation of symptoms when everyone is in costumes and disorienting lights, sounds and decorations are everywhere.

We may know that werewolf on the front lawn is really Taylor from down the street, but your loved one may not.

Since dementia and Alzheimer’s can inhibit cognition, Halloween’s scarier traditions could be interpreted very differently. We may know that werewolf on the front lawn is really Taylor from down the street, but your loved one may not. Even if they know the monsters are just costumes, masks and makeup can make it difficult to recognize even family members.

Additionally, decorating your home in a scary manner can be frightening and disorienting to seniors with dementia or Alzheimer’s. For many with Alzheimer’s and dementia, a calm, stable environment can be paramount. The amount of decorations, especially in the context of Halloween, can be disorienting. While this doesn’t mean you can’t decorate, you should keep your loved one in mind when getting into the Halloween spirit. If you do choose to decorate, remember to keep your home dementia-friendly and safe.

Signs to Watch For

Recognizing the signs of agitation and anxiety in sufferers of dementia and Alzheimer’s can be difficult, but that makes it even more important that you spot it early. A primary sign can be restlessness. “Regarding signs of possible agitation, an individual may become restless or worried or not able to settle down,” said Jeremy Bland, the Alzheimer’s Association Greater Pennsylvania Chapter’s director of marketing and communications. “This could cause pacing, or aggression and irritability, which could manifest as a person lashing out verbally or trying to hit or hurt someone.”

A primary sign of agitation is restlessness or an inability to settle down.

So, if your loved one suddenly begins pacing or is unable to sit still, it may be because of the environment. They may become fixated on a particular detail that is bothering them. You may notice them become confused or frustrated. In particularly bad instances, they may even become aggressive or angry.

How to Limit or Prevent Issues

Once you spot the signs of agitation, you should respond quickly. Remove them from the stressful environment or modify it. Take down the scary decorations or stop trick-or-treating for the night. It may help to have a “safe room” that’s not decorated and quiet that they can retreat to.

“By assisting the individual or distracting them, you can help calm them,” Bland told us. “Another opportunity to alleviate agitation is to engage in a quiet activity (like looking at photographs) as another means of distraction. You should also move them away from the upsetting environment right away and maintain a calm tone of voice. Speak softly and reassure your loved one that they are safe.”

Prevention is always preferable to treatment, so it’s important you take steps to prevent agitation and anxiety.

Preventing an issue is always preferable to treating it, though. When decorating the house, there are a few things you can do to lessen the chances of causing anxiety and confusion. If your home is already safety-proofed for your loved one, you’re one step ahead. But, Halloween presents risks and temptations that should be avoided. We’re not saying you can’t decorate, but you must be careful.

Avoid any decorations that are too scary, especially moving or motion-sensing items. A good rule of thumb is if the item would scare a kid, it’s probably too scary. This isn’t to say your loved one is a child, but it’s a safe level of scariness, since it’s better to be safe than sorry. Flashing lights or loud noises can also cause agitation. Finally, put candy outside for trick-or-treaters. You can trust the honor system with a “Take One” sign or someone can sit out with the bowl. Keeping the candy outside will prevent children from ringing the doorbell or causing a commotion that might agitate your loved one.

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Halloween is a fun holiday, when you can dress up as the things that scare you most and snack on candy or attend a party. While we can choose to be scared, people who struggle with dementia and Alzheimer’s may not be able to make that decision. If you’re a caregiver for a loved one suffering from either of these illnesses, it’s up to you to make Halloween as safe and fun as possible. By following these tips, you’re well on your way!

Further Reading

Medicareful Living — Why a Smart Home is a Safe Home: Dementia Caregiving