Celebrating Birthdays When Someone is Living with Dementia

Posted by Rachael Wonderlin on September 25, 2019

Our Guest Blogger, Rachael Wonderlin, MS, is a dementia care consultant living in Pittsburgh, PA. She runs a blog, Dementia By Day, and wrote a book called, “When Someone You Know is Living in a Dementia Care Community,” published by Johns Hopkins University Press.

MaryAnn looked at the calendar on her wall. Her birthday was coming up! “I don’t feel 50,” she thought. “I feel as young as I ever did.” MaryAnn smiled to herself as she thought about her last few birthdays. She hoped that her family would show up with ice cream cake—her favorite.

When MaryAnn’s birthday finally arrived, her family showed up with her cake. As she opened the lid, MaryAnn revealed an ice cream cake with the numbers “9-0” written on it. More specifically, the cake read, “Happy 90th, Mom!”

“What is this?” MaryAnn asked. “This is the wrong cake!”

“Huh?” Her oldest son asked. “This is your favorite type of cake, Mom! And it’s your 90th birthday—remember?”

It’s not uncommon for me to hear a family lament about a relative living with dementia and their upcoming birthday. “What do we do if he doesn’t know he’s as old as he actually is? My brother thinks he’s turning 40—he’s actually turning 82!” Families are not sure how to handle a birthday when the person living with dementia is unclear about their numerical age.

Here’s my best advice.

  1. First, we need to find out how old this person believes that they are. Use context clues to find out where this individual’s reality is. For example, if they constantly talk about how they’re going to work, or how they were at work that week, they probably don’t believe that they’re 90 years old. When we know where someone’s reality is, it makes it much easier to go there.
  2. Accept that their reality may be different from ours. I call this, “Embracing Someone’s Reality.” When we embrace someone’s reality, we take a trip with them to their world: instead of arguing and trying to correct where they are, we let them take us to their space.
  3. Even if you can’t figure out where their reality is, err on the side of caution and don’t use numbers or assign an age to someone whose true age may not correspond with their reality’s age. For example, take MaryAnn’s situation. MaryAnn believed that she was turning 50 years old. Seeing an age on a cake—90—completely confused her.
  4. Wish your friend or relative a happy birthday, but without the age. You can still say, “Happy birthday!” Without the number. We never want to make someone living with dementia do any math. What I mean is this: don’t spend time trying to “convince” your mom that she’s 90. “Well, Mom, remember that it’s 2019...” is not an effective way to start a conversation. Mom is going to become defensive, upset and confused. Even if you do succeed in convincing her of her real age, you’ve accomplished very little. What’s the point in reminding her of her true numerical age?

Even if someone’s reality doesn’t line up with your reality, you can still celebrate their birthday. The key is to enjoy the time with them—whether they know it’s their birthday or not. Don’t force the issue: a person can still have a great time at their party even if they don’t recognize it’s a party for them.

Our goal should never be to “fix” a person’s reality or “make them understand.” You’re always going to have a better day with a loved one living with dementia if you choose to let them take the reins on what reality you’re both living in.