Elderly Care During Diwali: What Actually to look for

When families think about keeping elderly parents safe during Diwali, firecrackers and burns are usually the first things that come to mind. These are genuine concerns, but there are other everyday risks that often go unnoticed.

A wet floor, a missed blood pressure tablet or a few nights without proper sleep can cause serious problems for an older person. With guests arriving, meals getting delayed and the house looking different from usual, even simple daily routines can get disrupted.

The good news is that many of these problems can be avoided with a little planning before the celebrations begin.

Falls Are a Major Concern for Older Adults During Diwali

A fall may seem like a minor accident, but it can have serious consequences for an older person. Recovery from a hip fracture, for example, can be difficult and may affect their ability to move around independently.

According to global estimates, around 842,000 people died from falls in 2023, with roughly seven in ten of these deaths occurring among people aged 60 and above.

Diwali celebrations can make homes less safe without families realising it. Think about everything that changes during the festive season:

• Floors are mopped more frequently and may remain wet.
• Rangoli is made near entrances and doorways, where people regularly walk.
• Diyas are placed on floors, balconies and stair edges.
• Extra footwear is left near the entrance.
• Decorative rugs and mats are brought out.
• Furniture is moved to make room for guests.
• Main lights are switched off, leaving rooms with dim decorative lighting.
• Older family members may stay awake later than usual and walk around when they are tired.

For someone who already has difficulty walking or maintaining balance, these changes can increase the chances of a fall.

Areas of the Home That Need Extra Attention

Two other things are easy to overlook:

• Footwear: Encourage older adults to wear comfortable, well-fitting indoor shoes instead of loose slippers or walking in socks on smooth floors.
• Walking aids: If a walking stick or walker has been moved out of sight to make the house look tidy, put it back where the person can easily reach it.

Some medicines can also cause dizziness or light-headedness, making falls more likely. A sudden drop in blood pressure when standing up is another common reason older adults lose their balance. Dehydration and spending time in a hot kitchen can make this worse.

Keep Their Medication Routine on Track During Diwali

Medication schedules can easily get disturbed during festivals, especially when the whole family is busy preparing for celebrations.

Older adults may have medicines linked to specific times of the day, such as a tablet after breakfast, insulin before dinner or medication before going to bed. These routines help ensure that medicines are taken correctly.

But during Diwali, the usual schedule can change:

• Dinner may get delayed because guests arrive late.
• Breakfast may be skipped after a late night.
• The family member who usually manages medicines may be busy with preparations.
• Someone may assume another family member has already given the medicines.

Missing medicines for even a couple of days can affect blood pressure, blood sugar and heart health.

Here are a few ways to avoid confusion:

• Keep a written medicine list: Include the name of each medicine, its dose, timing and purpose. Add vitamins, supplements and over-the-counter medicines as well.
• Use a weekly pill organiser: Fill it in advance so family members can easily check whether a dose has been taken.
• Set phone reminders: Don’t depend entirely on meal timings, as these often change during festivals.
• Assign one family member: Decide who will be responsible for giving medicines, with another person available as backup.
• Keep the area well-lit: Always check medicines properly before handing them over.
• Arrange medicines in advance: Keep at least two weeks of regular medicines at home to avoid last-minute problems when pharmacies have holiday closures.

Pay particular attention if your parent takes insulin, blood thinners, anti-epileptic medicines or medicines for heart failure. Missing doses or making changes without medical advice can cause complications.

Diwali Smoke Can Affect Older Adults More Than You Think

Smoke from firecrackers, incense sticks and other sources can irritate the airways. Older adults may find it harder to cope with poor air quality, particularly if they already have asthma, COPD or another heart or lung condition.

One concern is that they may not always complain about breathing difficulties. Instead, you might notice that they are unusually quiet, sitting down more often, eating less or appearing confused.

A few simple steps can help reduce their exposure to smoke:

• Keep windows closed: During smoky evenings and early mornings, keep windows shut. Open them in the early afternoon when outdoor air quality is better.
• Use an air purifier: Place it in the bedroom and keep the door closed while it is running.
• Avoid indoor smoke: Limit incense sticks, mosquito coils and candles, as these can add to indoor air pollution.
• Continue prescribed inhalers: If your parent uses an inhaler, make sure they take it as prescribed rather than waiting for breathing problems to appear.

Extra Precautions for Older Adults Using Home Oxygen

If your parent uses an oxygen concentrator or oxygen cylinders, take extra care around anything that can produce a flame.

Keep diyas, candles, incense sticks and other open flames away from oxygen equipment and tubing. Oxygen supports combustion, which means fires can start more easily and burn more intensely.

Never compromise on this precaution, even during festive decorations.

Sweets, Fasting and Blood Sugar During Diwali

Food is a big part of Diwali celebrations, and older adults with diabetes may find it difficult to avoid sweets when relatives keep offering them.

At the same time, some families observe fasts during the festive period. Both situations need a little planning, particularly for people taking diabetes medication.

How to Manage Sweets for an Older Person With Diabetes

You don’t necessarily have to stop your diabetic parent from enjoying every festive treat. What matters is portion size and how often they eat sweets.

A few practical steps can help:

• Offer a small portion after a regular meal rather than on an empty stomach.
• Serve sweets on an individual plate instead of keeping a large shared tray nearby.
• Explain their dietary requirements to relatives beforehand.
• Make sure someone in the family supports their food choices so they don’t feel pressured to eat more.

Take Extra Care If They Are Fasting

Fasting can increase the risk of low blood sugar in older adults taking diabetes medication, particularly insulin or sulfonylureas.

If your parent plans to fast, speak to their doctor beforehand. Their medication doses or timings may need adjustment.

Keep glucose tablets or another suitable source of sugar within reach, and watch for signs of low blood sugar, including:

• Sweating
• Shaking or trembling
• Confusion
• Irritability
• Sudden weakness

Salt intake is another thing to watch. Namkeen, pickles and restaurant meals can contain considerable amounts of salt, which may affect blood pressure, particularly in people with hypertension.

You can also read our guide to blood sugar levels and management to understand which readings need attention.

If Your Parent Has Dementia, Diwali Can Be Particularly Difficult

For someone living with dementia, a busy Diwali household can be overwhelming. More people, loud noises, bright decorations and changes to daily routines may increase confusion and restlessness.

Families sometimes notice that their parent becomes more confused or agitated during the evening. This behaviour is commonly known as sundowning.

It may become more noticeable when a person is tired, hungry, thirsty or surrounded by unfamiliar people. Poor lighting, shadows, noise and changes to their usual sleeping routine can also contribute.

A few changes around the house can make the celebrations easier for them:

• Maintain their routine: Try to keep meal and sleeping times as close to normal as possible.
• Encourage morning activity: Some daylight and gentle activity in the morning can help maintain a regular sleep routine.
• Avoid late caffeine and sweets: Offer these earlier in the day rather than close to bedtime.
• Improve lighting: Use night lights and close curtains at dusk to reduce confusing shadows and reflections.
• Keep evenings quieter: Reduce the number of people in the room, switch off the television and play soft music if they enjoy it.
• Create a familiar space: Keep one quiet room available where they can rest without interruptions.
• Avoid too many visitors at once: Ask relatives to visit at different times instead of arriving together.

Don’t Ignore Sudden Changes in Behaviour

One important thing to remember is that sudden confusion should not automatically be blamed on dementia.

A noticeable change over a few hours or days may be linked to another health problem. Urinary tract infections, dehydration, constipation, pain and medication-related issues are some possible causes.

If your parent suddenly becomes more confused than usual, arrange a medical assessment the same day rather than assuming it is simply a change in their dementia.

Hearing Aids and Loud Firecrackers: What Families Should Know

Loud firecracker sounds can be uncomfortable for older adults, particularly those who use hearing aids or already have difficulty tolerating noise.

Sudden loud sounds do not damage pacemakers or implanted cardiac devices. However, they can disturb sleep and cause considerable discomfort.

A few precautions can help:

• Adjust hearing aids: Hearing aids amplify sound, so loud firecrackers may feel particularly uncomfortable. Lowering the volume or removing them during the noisiest part of the evening may help.
• Keep a quiet room available: Choose an inner room with closed windows where your parent can sit comfortably.
• Protect their sleep: Try to maintain their usual bedtime as much as possible. Poor sleep can contribute to confusion, falls and changes in blood pressure.

Things to Keep at Home Before Diwali

A little preparation can make it easier to manage unexpected situations during the festive season.

Here’s a list of useful things to arrange before the celebrations begin:

Signs That Mean an Older Adult Needs Medical Attention

Some changes in an older person’s health should never be ignored, particularly during a busy festive period.

Arrange a medical assessment on the same day if you notice:

• New or worsening confusion, unusual drowsiness or difficulty waking them.
• A fall involving a head injury, especially if they take blood thinners.
• Chest pain or a feeling of heaviness in the chest.
• Breathlessness, new ankle swelling or waking up gasping for air.
• Fever with chills or fever accompanied by confusion.
• Burning while passing urine, difficulty passing urine or a noticeable reduction in urine output.
• Repeated vomiting or not eating and drinking for an entire day.
• A hot, swollen or painful joint.
• Hip or groin pain after a fall, or difficulty standing or putting weight on the leg.

Sudden weakness or numbness on one side of the body, facial drooping or slurred speech can indicate a stroke. These symptoms require emergency medical attention immediately.

Why a Head Injury Needs Special Attention

A head injury in an older adult can be serious, even if there are no immediate symptoms.

This is particularly important for people taking blood thinners. Bleeding inside the skull may develop gradually over several hours, so appearing fine immediately after a fall does not rule out an injury.

Seek urgent medical assessment after a head injury rather than waiting for symptoms to appear.

When Can Home Healthcare Help During Diwali?

Not every health problem requires a hospital visit. For older adults who find travelling difficult, getting medical attention at home can be a more convenient option when their condition is suitable for home care.

Depending on their needs, families can consider:

• Doctor visit at home: A doctor can examine an older person who has a fever, new confusion, breathing complaints or a fall that needs assessment.
• Nursing care at home: Nurses can help with injections, wound dressing, catheter care and other nursing procedures.
• Critical care at home: For selected patients who are clinically stable and suitable for home-based monitoring and treatment, critical care services may provide continued medical support.

Diagnostic Tests That Can Be Arranged at Home

Some tests can also be arranged without taking an older person to a diagnostic centre.

• Home sample collection: Blood samples can be collected at home. A full body health checkup may also help establish a general health baseline after the festive season.
• Vitamin D and calcium tests: These may be worth discussing with a doctor if falls or bone health are a concern. Both nutrients play an important role in maintaining bone strength.
• ECG: Helps assess the electrical activity of the heart when cardiac symptoms need investigation.
• Holter monitoring: Records heart rhythm over a longer period and can help investigate occasional palpitations.
• Ambulatory blood pressure monitoring: Records blood pressure throughout the day and night to identify patterns that a single reading may miss.

If your parent has already experienced a fall or feels less confident while walking, physiotherapy at home may also help.

Exercises that improve strength and balance can reduce the risk of future falls. Physiotherapy for joint pain may also help older adults manage stiffness and move around more comfortably.

Don’t Forget About the Family Caregiver

Looking after an elderly parent during Diwali involves much more than arranging medicines and keeping the house safe. There are meals to prepare, guests to manage, decorations to organise and daily routines to maintain.

When one family member takes responsibility for everything, exhaustion can quickly set in.

Lack of sleep and constant pressure can make it easier to miss a medicine dose, overlook a warning sign or become impatient with an older person who needs extra attention.

Try sharing responsibilities instead of managing everything alone.

One family member can look after medicines, another can handle night-time assistance, and someone else can take care of meals and household preparations.

If arranging a trained attendant for a few days gives you time to rest, there’s nothing wrong with accepting that help. Looking after your own health also makes it easier to care for your parent.

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