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As the miracle of modern medicine allows us to live longer, it is becoming more and more common to live with and care for loved ones who experience cognitive decline, including Alzheimer’s and other forms of dementia.

While every day brings its own struggles and victories, the difficulties may be especially acute during holidays, when we see such a stark difference from how our loved ones were able to celebrate in years past. If this describes you and your loved one, read on for some advice from people who have been there and done that.

Our first panelist is Eliezer Sobel, who lovingly cared for his mother and authored books designed to be read together with people with dementia, including one for the Jewish community, L’Chaim!: Pictures to Evoke Memories of Jewish Life , as well as The Silver Lining of Alzheimer’s.

He is joined by our second panelist, Rivky, who for 14 years balanced the care of her father, whose home was around the corner from hers, with her busy family and work life.

What are realistic expectations for Pesach for people with dementia?

ELIEZER: Every memory-impaired person is unique, and exists in an internal and highly personal world of experience that none of us on the outside can ever know. Furthermore, they are each at a different stage of their process. It is therefore not really possible to generalize about “people with dementia.”

In my mother’s case, whose Alzheimer’s lasted 20 years, as long as she was still able to walk and talk, we had no problem bringing her along to family events like a Seder.

RIVKY: There will come a time in a person’s dementia journey when they will no longer be capable of doing mitzvahs as they once did. This is different for everyone, and may express itself differently, as well. Consult with a competent rabbi to ensure that you strike the right balance.

Also, if you are not sure how things will go, perhaps limit the guest list to people you are comfortable with and who will be OK with an occasional hiccup in the program.

Is it better to have them at the Seder even if they will not act as they would have or should they be kept home to maintain their dignity?

ELIEZER: It’s not good for anyone to create a situation that will likely turn into an unhappy occasion for everyone present. It will be fairly obvious when it is time to keep your loved one away from group events, and fortunately, that moment is usually quite near the time when they will no longer be aware that they are missing anything or feel left out.

RIVKY: After a lifetime of leading Sedarim with dignity and grace, my father became unable to even know it was a Seder. He literally went from Seder plate to Seder plate, taking the hard-boiled eggs and eating them. At that point, my sister and I walked our father home and helped him go to bed. He was not enjoying the Seder anyway, and his dignity remained intact.

In later years, one or two of us would walk over and do a quick Seder with him—primarily the songs—and be back home with our families in time for the Four Questions.

How can we help kids interact with an elder with dementia at the Seder?

RIVKY: Kids follow our lead. They copy our actions and our attitudes. If they see us sitting right next to Grandpa, making eye contact, helping him enjoy his favorite foods, holding his hand and singing with him, they will do the same.

ELIEZER: Kids are easy. That’s why many memory units in nursing homes regularly “import” children from local schools to come visit, because they share a certain in-the-moment presence with dementia patients, who are often quite happy to finally have a companion to “play” with, one who makes no demands for logic or the ordinary adult rules for interaction or conversation.

What do you do if a loved one wants chametz on Passover?

RIVKY: We never had to face this painful situation with my father. If he didn’t see it, he wouldn’t ask for it, and there was no chametz around to see.

(Obviously, you cannot give chametz to your loved one on Pesach, when you may not benefit from it.)

An important skill to master when caring for a person with dementia is redirecting. Here is how you’d use it here: Suppose your father insists on checking the house with a candle for chametz, and insists that you scatter 10 pieces of bread so he can search … NOW! The problem is that a. he is not safe with a candle and b. it’s the fourth day of Passover and there is no chametz to scatter. Don’t bother reasoning with him or convincing him he’s got the days mixed up. Instead, say, “Let’s go to the store to buy the paper to wrap it in,” and then take the long way to the store and at the store get busy buying things he likes.

This takes practice and creativity but can relieve a lot of the stress associated with caring for people with dementia.

How can we help a person who insists on retaining certain duties or roles when they are no longer capable?

ELIEZER: If they are at an early enough stage to think they want to cook and host, then generally that means they are also at a stage where they will soon recognize their limitations and inabilities. While still at this stage, family members can gently help them as needed, trying to fill in for them and bypassing situations where they will need to recall things that may be difficult for them. And, as Rivky said, redirecting can be very useful here.

What parts of the Seder can they enjoy even as their memory and function decline?

ELIEZER: Music is a magical trigger for even some of the most “gone” people, and when they hear a beloved song from their past it can wake them up in astounding ways. The familiar melodies of my childhood Seders remained a joy to my mother long after she could no longer communicate with words.

Also, having never been even a social drinker, it seemed she definitely enjoyed the wine on Passover! (Not the fancy imported kosher wines from Israel, but the traditional sweet Manischewitz she must have grown up on.) Of course, it’s important to make sure the alcohol won’t negatively interact with any medications they may be taking.

How can you help them perhaps recall memories of Passovers past?

ELIEZER: There’s usually only a short window at the beginning of their decline when helping them recall any memories, Passover or not, is helpful.

For the most part, the last thing a loved one or caregiver should ever focus on is trying to help them recall anything. That simply provokes anxiety and communicates a message that there is something wrong that they should struggle to correct.

Being present and enjoying the moment, the way a six-month-old infant simply gazes at everything with awe and wonder, is truly what should be emphasized.

RIVKY: My sweet father had dementia for 14 long years. It wasn’t easy, not for him, not for his wife, and not for us. Early on, when we already knew where we were headed, I spent many hours with him, creating a book of his favorite songs. At that point, he was still healthy enough to check it and correct it and make sure it was exactly right.

As the years passed and he became unable to remember his own songs, the booklet was always there, one copy on the kitchen table and one on the piano. Whoever came to visit could use it to sing with my father, which is what he liked best. Long after people can speak, they can still sing. And long after they can no longer sing, they can enjoy your singing.

Keep singing and keep saying his favorite prayers aloud. Even when my father didn’t respond, I knew he heard it and I knew he loved it and needed it. Music is magic, both entertaining and soothing.

Any final advice for your readers?

ELIEZER: Try to reframe your mindset about what’s happening. Instead of dwelling on losing your loved one, begin to recognize that a brand new and mysterious being has arrived in your midst, someone still quite capable of feeling and loving and connecting. It can be a magical time in their and your lives.

RIVKY: Remember, that as lonely and painful as this experience may be for you, you are not alone. Millions of your peers are also going through the same thing. Connect with them, support each other, and you will both gain skills and encouragement.