Friday, June 13, 2008

Wondering About Wandering?


Care giving for an Alzheimer's patient requires attention to every aspect of the disease. Family members and caregivers of patients should not disregard the potential act of wandering. Sixty percent of Alzheimer's patients are at risk for wandering, most commonly during the middle stages of the disease. Wondering why it is so important to be aware of this common behavior?

Although the average distance a wandering patient achieves is only half of a mile, it can be life-threatening. If not located within a 24-hour period, 46% of wandering individuals may die. Nearly half of wandering Alzheimer's patients may die if not found within one day.

Why do they wander?
•Attempting to leave because they no longer recognize the physical environment, i.e. trying to go “home” to a childhood home
•Restlessness/Boredom
•Confusion about time/place
•Over-stimulation from crowds, noise, and activities
•Argument with caregiver
•Fear caused by delusions, false beliefs, or hallucinations
•An inability to communicate basic needs to caregivers
•Went outdoors and couldn't find way home
•Looking for a spouse or child because relatives no longer look familiar
•Medication side effects
•A desire to meet former obligations that no longer exist, i.e. jobs, volunteering, etc.

According to the Alzheimer's Association's Safe Return program, there are
10 Tips to Reduce Alzheimer Wandering:

1) Be prepared. There’s no way to predict who will wander or when, or how it might happen. The best safety measure is to register a loved one in the Alzheimer’s Association’s Safe Return Program before a loved one gets lost.

2) Encourage movement and exercise. Make a shared exercise, such as walking, part of your daily routine together. This will reduce anxiety and restlessness. Also, allow the person with Alzheimer’s access to a safe, enclosed area.

3) Be objective. Don’t take the person’s wandering behavior personally.

4) Be aware of hazards. Places that look safe might be dangerous for someone with Alzheimer’s disease. Look in and around your home for potential hazards - fences and gates, bodies of water, pools, dense foliage, bus stops, steep stairways, high balconies and roadways with heavy traffic - and change what you can or block access.

5) Secure the living area. Do what you can to make your home safe and secure. Place locks out of the normal line of vision - either very high or very low on doors. Use doorknobs that prevent the person with Alzheimer’s from opening the door. Other safety precautions include placing locks on gates, camouflaging doors, fencing in the patio or yard, installing electronic alarms or chimes on doors and using familiar objects, signs and nightlights to guide the person around a safe area.

6) Communicate with the person. Regularly remind and reassure the person with Alzheimer’s that you know how to find him and that he’s in the right place.

7) Identify the person. Have the person wear a Safe Return identification bracelet or necklace. Use sew-on or iron-on labels or permanent markers to mark clothing. Place identification on shoes, keys and eyeglasses and in wallets and handbags.

8) Involve the neighbors. Inform your neighbors of your loved one’s condition and keep a list of their names and phone numbers handy in case of emergency.

9) Involve the police. Some police departments will keep a photo and fingerprints of people with Alzheimer’s on file. Have the following information ready for emergencies: the person’s age, hair color, eye color, identifying marks, blood type, medical conditions, medication, dental work, jewelry and allergies.

10) Be prepared for other modes of wandering. Although most wandering takes place on foot, some people with Alzheimer’s have been known to drive hundreds of miles - sometimes in a vehicle that belongs to someone else. To prevent this problem, keep car keys out of sight or temporarily disable the car by removing its distributor cap. People with Alzheimer’s also have traveled great distances by train, airplane and public transportation.

The Safe Return program provides individuals with identification jewelry that states that the individual is memory-impaired, provided with an ID number and Safe Return number. If a wandering person is found with this jewelry, the finder can call a toll-free crisis phone line. A national database allows the Safe Return program to contact the member's contacts, making sure the person is returned home.

If you are interested in enrolling for the Safe Return program, contact Alzheimer's Services at (225) 334-7494 or 1-800-548-1211.

What to do if you find a wandering Alzheimer's patient:

1) Remember to treat the person with respect and dignity
2) Avoid restraints if possible
3) Approach from the front and introduce yourself
4) Speak slowly and calmly
5) Keep the “climate” calm and supportive
6) Ask only one question at a time
7) Keep instructions positive
8) Substitute non-verbal for verbal communication
9) Avoid Shouting
10) Keep explanation simple
11) Call Safe Return if the person has the identifiable jewelry

For more information concerning this important issue, please call Alzheimer's Services of the Capital Area.