Should dad with dementia attend wedding?
My niece just got engaged and the wedding planning frenzy has started. Rather than feeling thrilled, I started worrying about whether dad, who has dementia, should attend the wedding. Signed, All Nerves
The idea of having an individual with dementia at a wedding is often anxiety provoking for caregivers. This dilemma comes up often in my practice around big celebrations. The first question to ask yourself is: what stage of the illness is your dad in? The fact that you are concerned implies that he may have some behaviours or issues that make having him at the event worrisome for you — or for him.
The concept of most “wedding days” implies many hours and many potential scheduling manoeuvres. Individuals who are well and cognitively intact are often challenged by the wedding day, so these challenges can be amplified for someone with cognitive vulnerabilities.
If dad recognizes his niece and is still involved in her life, he may want to partake in the festivities and could benefit from enjoying some parts of the celebration. The question is how to do so and what this would look like on a practical level. If he does not know his niece and can no longer understand the family structure, think twice. I often see families drag someone through the steps of a celebration only to cause themselves and their relatives undue stress and hardship. Consider: What is the purpose of having him attend? Does he have the capacity to enjoy it and to engage on a reasonable level? How does he do in other large family gatherings? If there are issues, then reconsider. Fearing the judgment of others who do not fully appreciate the difficulties of dementia is not reason enough to have him attend.
The varied components of a wedding that make it onerous for someone with dementia include the potentially large crowds, noisy space and the confusion of so many differ- ent (and maybe unrecognizable) people. The compressed timelines may be a stress as well; and many weddings have a long schedule including the ceremony, picturetaking and the reception.
Many people with dementia fatigue easily, which can lead to them manifesting difficult behaviour. Perhaps having him attend only the ceremony or the reception is an option? It is also important to have someone familiar — or private help hired — to assist dad one-on-one for the duration of the wedding. Setting up a buddy for dad is ideal, to help him negotiate the events and overcome any hurdles which could potentially trigger responsive behaviour if things are not going smooth- ly. Practical issues such as going to the washroom and eating may require assistance, especially in a new and chaotic environment.
Other useful considerations are whether there is a quiet room to allow him to spend some time to refuel and rest. A short nap or just some “down time” can help orient and relax someone with impairment. Many venues offer this or can arrange for it in advance.
You may need to be free to deal with the family and festivities, but having other reliable friends or family help to orient and engage dad is helpful. Rather than having him wander around, friends and loved ones should be encouraged to sit, visit and converse with him. Finding a quiet nook or a couch in the hall where people can congregate more intimately can help. Seating is also important. Ensure that dad is seated in a location with others who can make it as easy as possible for him.
When the dancing and celebratory parts of the wedding occur, these can be too loud and overwhelming for those with dementia. Being prepared to deal with negative or irritable behaviour is ideal. Some people with dementia enjoy all the dancing and festivities, and it can be a good non-verbal outlet for them. Be ready for either contingency.
Lastly, make sure that you have an exit plan. If things are going well, don’t stretch it to the last moment so he gets overwhelmed. Leave on a high note. Plan for a ride or taxi back home. Have the helper/buddy escort him to his home, since he may find it more difficult to get settled after being in an overstimulating environment such as a wedding.
Like any other event, having someone with dementia around is not always straightforward. Reassess participation and ensure that it is happening in the right way and for the right reasons! Nira Rittenberg is an occupational therapist who specializes in geriatrics and dementia care at Baycrest Health Sciences Centre and in private practice. She is co-author of Dementia: A Caregiver’s Guide available at baycrest.org/dacg. Email questions to caregivingwithnira@baycrest.org.