Before I knew anything about Alzheimer's, a kind of helpless anxiety used to throb when I visited my Gram, whose dementia was very progressed. What do I say? How should I act? I lived far away; she changed from visit to visit. I didn't interact with her day to day.

I bet many people whose holidays will involve a relative or friend with dementia are familiar with that apprehensive feeling. Even adult children have it. It's called being human.

What helps?

If the person has early dementia:

• Don't be afraid. Your mantra: The person hasn't morphed into a disease; the person is the same person. Be yourself; that's the best way to make the person feel comfortable and happy.
• Be inclusive. Take care not to talk about the person as if he weren't in the room. Ask direct questions instead of waiting for the person to join in.
• Skip simple "yes or no" questions in favor of open-ended ones. Just don't make the questions feel like tests: "How do you like these decorations?" not, "What did you think about the election?"
• Offer conversational crutches. It's okay to supply the right word if the person seems to be having trouble, so long as you aren't patronizing about it. Caring.com has more how-to-say it tips.

If the person has moderate dementia:

• Approach gently. To avoid startling the person, approach from the front. Touch her lightly. Work in an introduction even if you're very close: "Hi Grandma, it's your favorite granddaughter Mary!" "Hey Bob, your cousin Sam has come to see you."
• Go for the one-on-one. It's hard for the person with mid-dementia to track a group conversation. Sit close and chat, just the two of you. Use eye contact and smile. Good opener: "Tell me a story about when you were a kid." (Early memories last longest.) If the person can't, offer prompts: "I love dogs; I think you used to have a dog named Dandy."
• Be kind about repetitions. Don't point out that you just heard that story. Try offering a bridge to a different topic: "That reminds me…" "That sounds like my…"
• Speak sincerely. Claudia Strauss's handy book Talking to Alzheimer's offers nice "Do say" phrases: "Thanks for telling me!!" "I wish I could be as funny/caring/feisty as you."
• Offer to be the designated carer. Parties, with their noise and new faces, can quickly overwhelm. Tell the caregiver that you'll be the person who stays by the person's side throughout. Casually guide him to another room for conversation, cards, napkin-folding, or another quiet diversion when things get rowdy.

If the person has late dementia:

• Give the "ministry of presence." I've always loved this lovely phrase I learned from Kristi Marie Gott. Simply being there and offering a hand squeeze ministers to the person and says, "I'm here for you, I care."
• Try a serenade. Holidays are a natural excuse for music. After my post about the lasting power of music to soothe and connect, reader Amy G shared how her grandmother joined in hymns long after she couldn't speak coherently. Another inspirational example: In spite of having advanced Alzheimer's, the mother of one of Caring.com's founders continued to take piano lessons until the week before she passed away last Saturday. It's never too late to share this language of the soul.

For everybody:

• Hey, say thanks. Tell the person how you're grateful to him or her. Don't forget their daily caregivers. Blogger tenderlovingeldercare says it beautifully: "If you can’t find the words or feel awkward saying them, this video is absolutely right -- a hand gesture, a wink of the eye, or even a special smile can get your message of appreciation across."

Don't miss that video. Happy Thanksgiving travels.

Vintage Thanksgiving postcard by Flickr user riptheskull, used under the Creative Commons attribution license.