Radfield Homecare

Halloween and the Elderly (Safety Tips and How to Opt-out of Trick or Treat)

halloween and elderly

Thirty or forty years ago, Halloween and ‘trick or treat’ was always a popular night in the UK for childish mischief. A minority of kids would partake in silly pranks such as knocking on doors and running away but there was never a culture of visiting neighbours en masse expecting candy or money.

How things have changed.

In America, Halloween has always been a huge event and the second biggest celebration behind Christmas. This may have once been perplexing to Brits but ‘pumpkin fever’ has now traversed the Atlantic and spread through the UK.


Halloween in the UK, a growing trend


In the US, Halloween retail spend stands at £4.5 billion. In the UK, a little behind, spend is growing from £230 million in 2013 to £320 million (estimated) in 2017. Source.

In 2016, almost half of the population (46%) spent money on Halloween – a rise of 18% from 2015 – and this is only set to keep rising. Source.

In 2017, the UK spend on pumpkins alone was £25.15 million.


It’s official that Halloween is now a major celebration in the UK with children enjoying ‘trick or treat’ and visiting their neighbours for sweets and treats on the 31st of October.

Children excitedly dress up in costumes with many choosing to be mini zombies, witches, ghosts and ghouls and it’s a fun family evening. The anticipation of obtaining a large bag of sweets is enough for any child to be ecstatic about. It’s a light-hearted occasion centered around children and few would realise that for some it can be an evening of significant stress.


Halloween can be stressful for the elderly

Not everyone can imagine how a knock at the door can be intimidating or stressful for an elderly person who may be cautious of strangers or unexpected visitors.

A seemingly childish prank, such as knocking on a door and running away, shouting through a letterbox or even throwing eggs at a window can be psychologically damaging for a vulnerable person who sees their house as a ‘safe’ place. They may develop a negative association of being alone at home and become withdrawn and depressed.

Costumes, shrieks, screams and an unusual level of activity in the street can be disorienting to a person living with dementia who can have difficulty understanding what is happening.

Halloween could mean a sleepless night of stress and anxiety for the elderly or those with dementia.

To address the issue that Halloween is not a fun time of year for everyone, at the end of this page there are details for how anyone can leave a sign in their window to ask that they are respectfully left alone and that those escorting children ‘trick or treating’ can avoid visiting a house that displays the sign.

Go to download poster...


halloween can be stressful for the eldery

Living alone can make the elderly fearful

For many people, it’s difficult to understand how confidence declines as they age and that everyday incidents can become intimidating. Even walking down a street with someone a little too close behind can be alarming and the fear of answering the door to strangers amplifies as you feel more frail and vulnerable.

It’s a sad reality that older people are targets for crime and when incidents are sensationalised in the press and this feeds the cycle of fear. Living alone with reduced social contact has a negative effect on thinking and the mind can quickly spiral worry out of control.

Read about loneliness and the elderly…


Margaret’s fear made her believe pranksters wanted to attack her


Margaret* has lived alone since her husband died two years ago and has found the grief difficult to deal with. Her only son lives several hours drive away and she doesn’t see him very often, maybe two or three times a year.

Firstly, due to the grief, and then compounded over time she found herself becoming more isolated and lost confidence in leaving the house alone. As a result of being withdrawn, she became more fearful and her worrying began to overwhelm her thoughts and often her mind would blow incidents out of proportion.

Last year, on Halloween, Margaret heard a knock at the door. As it was dark outside, her initial reaction was of concern to answer the door to an unknown visitor. As she struggled to get there, she heard someone rattling the door and then shouting through the letterbox. Margaret felt terrified and froze behind the door.

She could hear laughter and shrieks outside the house and Margaret’s imagination ran wild. She imagined someone who may want to get her to the door so they could force their way in to attack her and steal her pension. She had read about the same thing in the paper.

Margaret spent the evening sat in the dark alone with genuine fear that someone would use Halloween as a pretense to get her to answer the door and then attack her. She didn’t sleep at all that night and in the following weeks her anxiety was so bad she couldn’t leave the house.

Thankfully, Margaret now has a Radfield carer who has helped her to deal with the isolation and anxiety. This year on Halloween, Margaret’s carer is going to stay with her to ensure that she is not alone or scared.


Alzheimer’s causes a blurred sense of reality

Alzheimer’s and dementia can cause a change of temperament in the person living with the disease. Outbursts of anger are attributed to parts of the brain that regulate inhibitions and these are affected by the disease. A person with dementia is not confrontationally aggressive, but rather because of a loss of inhibition, anger is their reaction to any distress or confusion they may feel.

People living with advanced Alzheimer’s can also have a different sense of reality as their memory becomes affected by the disease. A costume or mask can trigger confusion and distress as they lack the ability to differentiate between fantasy and reality.

A calm environment and routine are important when caring for a person with dementia. Unexpected knocks on the door at night, people in costumes and loud noises can all be disruptive and cause agitation and anxiety.

Read about how the brain is affected by Alzheimer’s…


Tom was distressed thinking ghoulish costumes were real


Tom* is living with Alzheimer’s disease and his wife Carol has cared for him at home but last year, as his cognitive function declined, she began to struggle. This was exaggerated at Halloween when trick or treaters came to the house.

Tom had been restless that day and become angry when Carol had tried to stop him from leaving the house. She hoped that a quiet evening and watching TV would settle him down. At about 7pm, a knock at the door startled Tom and he insisted on answering the door. Carol tried to stop him but he became more agitated and was clearly disrupted by an unexpected visitor at night as this was out of the ordinary.

They both answered the door to find three young teenagers wearing ghost masks and black cloaks from the horror film ‘Scream’. At first, Tom recoiled and then began to shout at the teenagers – clearly distressed by their appearance. Carol found his behavior alarming as he shouted and aggressively waved his arms at the children who ran away from the house. Tom then began to cower at the foot of the stairs crying and shaking.

Carol called her daughter and son in law David who quickly came to the house and helped her to get Tom into the living room and calm him down. Another knock at the door caused Tom to become agitated again and fortunately, David was able to persuade Tom to sit down whilst Carol went to the door to ask the visitors to leave.

That evening, David stood outside the front gate of the house asking trick or treaters to please avoid the house. Carol and her daughter sat with Tom and tried to distract him by looking at old family photographs. Tom seemed to go into decline after that evening and it was a few days before he settled down again.


Halloween safety tips for the elderly

Trick or treating may last a few days over the Halloween period but the evening of October the 31st will most likely have a steady stream of visitors knocking on the door.

  • On the evening, arrange to be with your relative or an elderly neighbor who lives alone, so that they are not intimidated and afraid about knocks at the door.
  • You could answer the door yourself to hand out sweets or, you can print a poster (below) for the front door to politely ask people not to visit.
  • If you are not able to stay for the evening then arrange for a carer to be in the house all night.


If your relative wants to take part in Halloween:

  • Consider a torch lit pumpkin over a candle to avoid fire hazards.
  • Don’t leave a candlelit pumpkin unattended and ensure it’s extinguished before going to bed.
  • Avoid eating too many sugary sweets and treats as it can cause issues with sleeping and medical conditions.


If your relative or loved one has dementia it might be best to avoid Halloween celebrations:

  • Instead, distract them with an engaging activity such as a jigsaw that you can do together.
  • Use headphones with their favourite (calm) music to block out any unusual noise.
  • Watch a favourite film to hold their attention and divert from any activity in the street.

trick or treat

The pumpkin rule

As Halloween has spread in popularity across the UK some areas carry an unwritten ‘no pumpkin’ rule. Children and families who are trick or treating will only visit houses that have a lit pumpkin at their door or in the window.

Unfortunately, not everywhere adheres to this rule so we recommend that on Halloween an elderly person or loved one is not left alone and they display the ‘No Trick or Treat’ poster (below).


How to ‘Opt-out’ of Trick or Treat at Halloween

For Halloween, Radfield Home Care is aiming to raise awareness of how the elderly and those living with dementia can be negatively affected by ‘trick or treating’.

Not everyone will realise that an elderly person may feel afraid and be intimidated by visitors and strangers at their door in the evening when it’s dark.

Not many people will be aware that for a person with dementia, scary masks and costumes are a blur of reality that can trigger confusion and distress. Or, that disruption to their routine and environment can be difficult for them to deal with.

Radfield stresses that they don’t want to stop anyone else having fun by celebrating Halloween but do ask that people show compassion and understanding for the elderly and vulnerable.

The objective is to raise awareness within local communities to respectfully avoid visiting the homes of any elderly people or those with dementia who want to ‘opt-out’ of Halloween.

Radfield have created a friendly and fun poster that anyone can put on their door to politely show that they would prefer to not have ‘trick or treat’ visitors on the evening.

From feedback on social media about other Halloween posters we have ensured the poster is:

  • Easy to print
  • Visible at night
  • Fun for children
  • Respectful for others

Download and print the A4 sized poster below. There’s a colour or a black and white version that doesn’t use too much printing ink.

halloween and elderly no trick treat posters



Click to open colour A4 poster...

Click to open black and white A4 poster...

Please display this clearly on your front door. If it’s raining we suggest covering it with cling film.

Radfield Dr Hannah MacKechnie opt-out of halloween poster

Dr. Hannah MacKechnie with the Radfield 'opt-out of Halloween' poster

“Halloween can prove to be a scary time for people living with dementia or physical limitations. Having strangers at the door and the fear of tricks being carried out can be very stressful.

The home should be a place of security and safety and the potential fear caused by trick or treating could create negative associations of being alone at home. This may then result in negative behaviour, withdrawing more from society, losing confidence and then being at a greater risk of falls and other age-related issues.

For older clients with dementia, Halloween costumes and the different noises of young people roaming the streets may cause an increase in disorientation and fear as they struggle to understand the altered world around them, and won’t necessarily have the cognitive ability to understand that it is time-limited.

It is so important as communities that we support and protect our older residents and being thoughtful and considerate at this time can make a significant difference to an individual’s sense of well-being and safety.”

Dr. Hannah MacKechnie GP and founder of Radfield Home Care.


*We have changed the names to respect the identity of our client.