Thursday, February 24, 2011

Wandering

Behaviors That Often Precede Wandering
Two behaviors that typically occur before wandering are pacing and disorientation. If a person with dementia has a need, he is often unable to verbalize that need and will exhibit a sudden change in behavior instead. Check for clues that may indicate an unmet need.
  • Ensure that appropriate fluids are offered at regular intervals throughout the day.
  • He/she may be hungry if a mealtime is near.
  • He/she may pull at clothing if needing to use the toilet.
  • Check to see that clothing is suitable for the environmental temperature.
  • Consider pain medication if appropriate.
  • Providing a calm, predictable, and relaxed atmosphere may decrease anxiety.
  • Sudden increased disorientation, or delirium, may indicate an infection or medication reaction, so notify the healthcare provider if the change in behavior persists or is cyclic.

Watch for Patterns of Wandering in People with Alzheimer’s
Many people with Alzheimer’s disease have a pattern to their behaviors. By watching for patterns, caregivers may be able to distract the person with specific activities at those times. Watch for triggers in addition to physical needs above, such as the time of day and environmental changes. Many people with dementia tend to become increasingly agitated in the transition between daylight and darkness, a condition known as Sundowners syndrome. A new or change in a familiar environment may result in increased agitation – it is helpful to introduce changes slowly if possible. For example, brief visits to a future home or with a new caregiver may be helpful to help prepare for the change. If the behavior seems to be related to medications, immediately notify his or her healthcare provider.

Safety Suggestions for Those Who Tend to Wander Away From Home
Fewer than 4% of people with dementia can find their way home unassisted. This presents a major safety challenge, especially during weather extremes because a person with dementia may be inadequately dressed for environmental conditions. People with Alzheimer’s may be quite lucid at times and may be able to disarm many safety devices, so always ensure that the person with dementia is properly supervised.
  • Place a large sign on exit doors saying “Stop” or “Do Not Enter.".
  • Hide doorknobs with a color-matched cloth or a curtain.
  • Keep temptations, such as keys, out of sight.
  • Install motion sensors or a device that will alarm if an exit door is opened.
  • Provide reassurance and redirect conversations if he appears anxious or insists on “going home” or “going to work," or attempts to fulfill former responsibilities.
  • Keep a recent photo and detailed physical description of the person readily available.
  • Utilize programs designed to help track someone who is lost, such as MedicAlert+SafeReturn and Project Lifesaver International.

Ed Picard
Respite Center Coordinator

Wednesday, February 16, 2011

Finding Happiness…Today

Carol Fitch, a caregiver for her mother with Alzheimer’s, has so graciously allowed for me to share her heart-warming story. Her words show that a person can find happiness and comfort in present-day living, even when journeying with a loved one with Alzheimer’s.

Rashida Keith, MPA
Program Coordinator

An Angel Named Prissie
by Carol Wilson Fitch

I believe that angels appear in many different ways. I have probably been the very cause of some guardian angels asking for early retirement after being assigned to watch over me. But once again, I have been blessed with angel. One that I call my special Christmas angel, named Prissie.

You see, the past several months have been very difficult for me. After going through a tough time at work last year, I thought things would settle down and I would get back to renovating my old house (which I desperately want to finish). But late one Sunday night in August, my 86-year old mom, who has Alzheimer’s, broke her leg as she was getting out of bed. Little did I know from that moment on my life would change dramatically as I made the 911 call. After major surgery and a rehab stint, my mom was discharged from the hospital to come back home to recuperate.

Since my mom has Alzheimer’s, the operation and all that went with it accelerated her already declining mental condition. She could not remember she had broken her leg nor could she remember her surgery or hospital stay. Her sundowning had grown increasingly worse. Keeping her still with her leg propped up was quite an additional challenge in caring for her. At night I would sleep on couch cushions on the floor beside her bed to keep her from getting up. During the day I would block her chair in a reclined position so I could leave the room long enough to do something as simple as getting the mail. After about a month of sleep-deprivated caregiving, I realized that I could not continue doing this. My muscles were hurting from the lack of rest, my mind was hurting from the stress of coordinating and financing care while I worked, and my spirit was plummeting.

After being convinced that full-time care was the only option, on September 27th, my mom went to live at a nursing facility. Next to burying my dad in 1991, this was the saddest day of my life. I had lived with my mom for over eleven years, and had been taking extended care of her for the past five years after she was diagnosed with Alzheimer’s. I had utilized the support and resources of Alzheimer’s Services in Baton Rouge, read numerous books, attended many seminars and educational conferences, and talked to a lot of people who had been in the same situation of caring for a loved one with Alzheimer’s disease. But nothing prepared my heart for the devastated feeling of not being able to give my mom the complete care she needed at home as she was moved out of the place she had lived for the last 35 years. That evening as I unlocked the door to our home, I knew that I was beginning the long and painful journey of saying goodbye to the mom whom I had spent so many wonderful times.

The Christmas holidays were approaching, which is my mom’s favorite time of the year. My mom loves Christmas more than any person I know. She always thought the house could use another string of lights or the tree could use more ornaments or the mantle could definitely have more Santas. I would come home from work to find Christmas music playing at an almost intolerable level and her making fruitcakes or candy for everyone she knew. Getting into the spirit of Christmas was an intense struggle. Many lonely times I would find myself just wishing for the next year when I would have my house renovated and decorated for Christmas. Some days I just wish it were January.

Then on November 6th my life changed again. My daughter and I drove to my brother’s home in Lafayette to pick up my new dachshund puppy. I had already made a couple of trips to see her and had given her the name “Prissie”. She was now six weeks old and the cutest puppy I had ever seen. I was so excited that I cried with happiness as I held her.

To say that Prissie makes me smile is an understatement. She makes me laugh and act silly. She cheers me up when I’m down. She makes me get up when I don’t feel like moving. She gets into EVERYTHING and the entire house has become her playroom. Nothing is safe if it exists in any space of six inches off the floor. Then a friend of mine mailed Prissie a Christmas dress and asked me to take her picture wearing it. Nothing could ring truer than the saying that “a picture is worth a thousand words”. There is no way I could look at the above picture of this adorable puppy in her Christmas dress and not smile.

I decided to “pay forward” the smiles that Prissie gave me, so I sent this picture to my family and friends as my annual Christmas card. The results of the smile meter registered off the scale! My phone did not stop ringing with comments of how cute she was all dressed up for Christmas. And though Alzheimer’s robbed me and my mom from doing our normal Christmas traditions together, God sent Prissie to help lift my spirits. I did not realize this puppy would become my Christmas angel! Also know that while you are enjoying her picture, she is probably enjoying chewing on my slippers!