An important part of caring for a person with Alzheimer's disease is to help her to continue to engage in activities that have special personal or family meaning (this is not a big problem in the early stages.) With suitable support, she will be able to enjoy taking trips, participating in events that mark significant moments in family and community life, and going to events such as college reunions and revisiting places that are part of her own personal history quite far into the disease.

Joyous celebrations such as weddings, baptisms, and birthdays and distressing events such as funerals may all occur during the years the person is ill. Some of these events will be expected and you will have time to give thoughtful consideration to the decision about if and how to include the person with dementia. Other events will occur suddenly and you will need to decide quickly how to respond.

There is no "right answer" to the question about whether to include or exclude the person with dementia. Experts, friends, and family may not all agree on the best plan, but there are some questions you can ask yourself to help you decide. How will the abilities the person has lost and those that are retained affect his participation? Will it be meaningful to the person to be present at a given event? Will it be meaningful to others that the person with dementia is present regardless of his ability to understand what is happening?

Issues to Consider: The Stage of Dementia

In general a person in the early stage of Alzheimer's can handle interacting in a social situation. However, he will need support to be able to take part in and enjoy events outside his regular daily routine. The person in the early stage may need to be reminded of the names and his relationship to the people he is talking to. If word-finding is a problem, a supportive person nearby may be able to fill in the gaps. A trip to the bathroom may require a guide.

A person in the middle stage will need continuous support to attend an event that is not in a setting designed to meet his needs and to keep him safe. There is the danger that the person will be overwhelmed by the unfamiliar activity, misunderstand what is happening, or wander away. If incontinence is already a symptom it should be dealt with in such a way that it does not embarrass the person with dementia or interfere with the comfort of others.

In the late stage it is unlikely that a person with dementia will be attending events outside his place of residence.

Will the Person Enjoy Being Present?

If you think that the person will be able to enjoy being present because there is food and music, even if he does not understand exactly what is happening and does not recognize the other guests, the experience may be enjoyable. On the other hand, if the environment will be overwhelming or overstimulating, the person may become agitated.

• Will there be a place where the person can rest or take a break from the activity?
• Will the behavior of the person with dementia interfere with the experience of others?

Arrangements necessary to provide for the person's safety and comfort:

• If the event is not near the person's home, will the trip be too tiring and confusing?
• Do you need to bring an aide or other support person along? How expensive will the additional services be?
• Will it be necessary to stay at a hotel or the home of a friend or family member?
• Will adaptive devices such as a raised toilet seat or commode be available?
• Will the person with dementia wander around or wake up in the middle of the night and disturb others?
• Will the person with dementia feel uncomfortable in an unfamiliar setting?
• If the event is near the person's home, and getting the person to the event and back home again is not too difficult, you may feel more willing to "risk" bringing him.
• If the person cannot walk, is the bathroom wheelchair accessible?
• Is there a ramp or an elevator for people who cannot climb steps?

Will You Enjoy Having the Person Present?

Will you be so distracted by the arrangements for the person with dementia that you will not be able to enjoy the event yourself? It is entirely reasonable to consider your own
needs, the meaning of the event to you, and how the presence of the person with dementia will affect you. Will it be worth all the effort to include the person in
the particular activity?

As with all activities you plan for a person with dementia, don't try to do it on your own. Get help for all aspects of the arrangements and expect the unexpected.

And don't be disappointed if the person does not remember the event or having taken part in it. The good feelings created by being there may persist beyond the memory of the actual event. On the other hand, if things did not go well, they may soon be forgotten.

Can You Be Flexible?

Can you be flexible and change the arrangements at the last minute? Even the best of plans may need to be changed, or canceled entirely, if symptoms of the illness interfere. The person with dementia may become too agitated, behave inappropriately, or be unable to get ready in time to go, perhaps making you or someone else miss the event as well. If it turns out that it is not feasible to include the person with dementia, can you accept this as a result of the symptoms of the illness?