Christmas with Complex Needs: Supporting Individuals with High-Risk Profiles During the Holidays

For many families, Christmas is filled with warmth, connection, and tradition. But for individuals with complex needs and high-risk behaviours, the festive season can be one of the most stressful and destabilising times of the year.

Whether it’s a young person in care with a trauma history, an adult with profound learning disabilities, or a child with multiple diagnoses including neurodivergent traits, the holidays can disrupt the systems that help them feel safe.

At Hand in Hand, we specialise in Level 3 and Level 2 Support Coordination in Melbourne, working alongside those who support some of the most vulnerable individuals in our communities. This guide is for carers, professionals, and families who are navigating the season with individuals whose needs often go unseen and whose challenges are rarely addressed in typical “Christmas support” guides.

Why the Holidays Can Be High-Risk for People with Complex Needs

1. Disrupted Routines Can Trigger Crisis

Many individuals rely heavily on structure and predictability. Christmas can bring:

• School closures or staff changes
  
• Unexpected visitors or outings
  
• Changes in sleep, mealtimes, or medication routines
  
  

This loss of routine can lead to:

• Escalation in aggressive or self-injurious behaviour
  
• Increased anxiety or withdrawal
  
• Risk-taking behaviours (running away, property damage)
  

2. Sensory Environments Can Overwhelm

The festive season often means:

• Flashing lights and decorations
  
• Loud music or crowded spaces
  
• Strong food smells or new clothing



For people with sensory processing differences, these stimuli can be overwhelming, causing meltdowns, shutdowns, or physical distress.

3. Emotional Triggers Are Everywhere

Many of the individuals we support have experienced:

• Early trauma or abuse
  
• Attachment disruption
  
• Unstable placements
  
• Neglect or loss



Christmas can resurface these wounds, especially when messaging around “family”, “magic”, and “togetherness” doesn’t match their reality.

4. Risk Behaviours Increase

During the holidays, individuals may:

• Lash out physically or verbally
  
• Run away or refuse to engage
  
• Engage in sexually harmful behaviour
  
• Struggle with suicidal thoughts or self-harm
  
• Experience mental health breakdowns



Without proper support and trauma-informed responses, things can escalate quickly.

7 Ways to Make Christmas Safer, Calmer & More Inclusive

1. Collaborate on a Predictable Plan

Work with the person to co-create a visual schedule or countdown calendar. Talk through:

• What to expect each day
  
• What will stay the same
  
• What’s optional (giving them some control)
  
  

Tip: Even adults with learning disabilities benefit from structure and visual aids.

2. Maintain Core Routines Where Possible

• Stick to regular meal and medication times
  
• Don’t disrupt bedtime routines unless necessary
  
• Keep support staff or keyworkers consistent
  
  

These anchors help reduce anxiety and give the person a sense of control.

3. Designate a Calm, Safe Space

Always have a quiet room or calm-down corner available. Equip it with:

• Fidget toys or weighted blankets
  
• Noise-cancelling headphones
  
• Familiar objects or comfort items
  
• A staff member or carer they trust
  
  

This should be offered proactively, not just once someone is already in distress.

4. Limit Sensory Input (Or Offer Sensory Alternatives)

• Avoid flashing lights or strong scents
  
• Lower music volume or use headphones
  
• Choose soft textures and low-stim visuals
  
  

Make activities optional; not everyone wants to join in Christmas lunch or unwrap gifts in a noisy group.

5. Address Emotional Needs Directly

Ask:

• “What makes Christmas hard for you?”
  
• “Do you want time alone or with someone safe?”
  
• “Would you like to make new traditions instead?”
  
  

For those who’ve experienced loss or trauma, validating their feelings matters more than cheer.

6. Have a De-escalation and Safety Plan

Ensure everyone (carers, family, key staff) knows:

• Early warning signs of distress
  
• Preferred de-escalation methods
  
• Where the person can go to feel safe
  
• Who to contact if things escalate
  
  

Keep risk assessments up to date and readily available.

7. Offer Flexibility Over Perfection

You don’t need to “get it right” every time. What matters is:

• Letting the person lead
  
• Checking in regularly
  
• Celebrating what works, and adjusting what doesn’t



If You're a Foster Carer, Keyworker, or Residential Staff…

Christmas may look different in a care setting, but that doesn’t mean it can’t be meaningful:

• Keep transitions and handovers consistent
  
• Include the person in gift shopping or decorating decisions
  
• Prepare for emotions around family contact or absence
  
• Avoid false promises or oversold “Christmas magic”
  
• Focus on safety, dignity, and quiet connection

Voices That Are Often Left Out

Let’s be honest: much of the mainstream advice about “Christmas and disability” focuses on mild needs or assumes the person can self-advocate, regulate, and participate easily.

But Hand in Hand specialises in:

• Individuals who are non-verbal
  
• Those with limited capacity for understanding danger
  
• People who may be receiving emergency support through crisis accommodation, short-term stabilisation placements (such as STA used in urgent contexts), or specialist residential care
  
• Those with intersectional needs (e.g. physical + behavioural + emotional)

These are the voices often left out of the conversation but they are the ones we show up for, every day.

Final Thought: Presence Over Presents

What people with complex needs need most at Christmas isn’t noise, gifts, or parties.

They need:

• Calm
  
• Safety
  
• Consistency
  
• To be understood, not judged
  
  

Let’s build a Christmas that meets them where they are, not where society expects them to be.