Not Home for the Holidays – Making the Best of Spending the Holidays in Long Term Care

The following is a guest blog post from Charles A. Lewis, the Administrator of Heritage Healthcare in Utica, New York.  He graciously agreed to share some valuable information on how to help make the most of the holidays in long term care facilities.

The holidays can be stressful, but they can be especially trying for residents in a long term care facility. After a lifetime of having family and tradition to define the holidays, residents find themselves in a nursing home instead. The stress can vary from person to person. It’s somewhat less traumatic if there has been enough time to build new relationships, and more so if the person is less social, or has barriers to entering into new relationships.

It can be very stressful for the families as well. Loved ones who may not regularly visit come to the facility at holiday time, and their unfamiliarity with the condition of their friend or relative is often unsettling. The reaction they have can affect the resident negatively, triggering behaviors and poor interactions with staff. Trying to include the resident in traditional family activities can prove difficult if not impossible, especially if the demands are more than the resident is capable of at the moment.

What’s more, the staff has their own families and holiday traditions placing demands on them, making it all but impossible to have extra staff on hand to meet the added needs of visitors during the holidays. Supporting the staff on hand is critical to having a successful day.

Resident mood changes can also be difficult to navigate. Many times, cognizant residents are overwhelmed with memories of past holidays and loved ones, and become sad when making a comparison with their current situation. Becoming withdrawn, unusually quiet, and refusing to take part in activities, or poor appetite are signs that there may be a problem. Listening to staff speak to each other about their plans, gift buying, or holiday dinner plans sounds innocent, but can trigger feelings of loss and loneliness.

Trying to combat the above is a challenge, and it takes a team to come up with solutions that are right for residents and their families. By listening to the residents and including them in the decision making process, the holidays can be fun and exciting for all those involved. Creating a variety of activities that include family members and focus on the new traditions can help the residents to cope. Here are some ideas that have been successful in the past:

The Holiday Photo

 After decorating the facility, our residents can get dressed up and have a photo taken of them in front of our main Christmas tree, wearing a Santa hat, or in a location of their choice. This allows the resident something to give their loved ones, or we mail it in a card to their family for the residents (participation requires permission for those who lack capacity, of course).

The Holiday Meal

Following resident preference, we invite families to join the residents in a meal either before or on the holiday itself. This requires extra space to accommodate seating residents with their families and full staff participation to help with seating and serving the extra guests. This gives residents a feeling of having their loved ones over for the Holidays and is a critical time to build good will and demonstrate customer service.

The Holiday Party

We have a combined resident/staff party for a whole day. A holiday movie marathon, bowls of eggnog, and the scent of hot mulled cider are available to accompany various hors d’oeuvres. Everyone enjoys a hearty buffet lunch, and we have specialty sweets for dessert. There are raffles and games and positive non ‘work’ interaction between staff and residents. Building the relationships here is the key to resident satisfaction and running a successful facility.

The Resident Family Party

This is a scaled down version where families of residents are invited to partake in cookies and sweets prepared by the residents’ cooking club. If families can’t make the dinner, it affords another opportunity to join with their loved ones to celebrate the holiday season.

The Holiday Breakfast 

We hold a special breakfast set up restaurant style where residents can order from a menu and get their meal prepared in front of them and served by staff. Residents vote on choice of breakfast items and date of the breakfast prior.

Photos of Christmas Past 

This requires family members to bring in a photo of the resident taken on a holiday and the year it was taken. Put up a collage of the photos and see who can guess the person and the year. This incorporates past holiday seasons and provides a sense of continuity for the residents.

Build Your Email Tree! 

Ask family members to add their email address to the list so they can be apprised of upcoming functions and facility news. Try to extend family participation to events year round.

These are only a few of the programs that have been successful; hopefully they will inspire you to make the most out of this holiday season. By supplying a variety of ways to participate, most residents will find something to enjoy and families can add new traditions to the holidays. This time of year has it’s stresses and joys for all of us. Please do what you can to make it a positive one for those who may not have many left to enjoy.

Charles A. Lewis is a Licensed Nursing Home Administrator in New York State and he has three decades of experience as a small business owner. For questions or comments he can be reached via LinkedIn or by sending an email to

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