Thursday, December 29, 2016

Thinking of Holiday Dangers

The holidays can actually be dangerous time for those with Alzheimer's or another dementia causing disease.

If they live at home, the home may end up decorated for the holidays, introducing new objects such as a Christmas tree which may cause confusion.  Having many guests at once may also increase the person's anxiety and confusion.  The noise level goes up.  It is hard for them to follow one conversation much less multiple.  There is increased activity around them and they can become anxious.

If they live at a nursing home, they may be brought to a relative's home for a visit and not recognize the location.  When an individual with Alzheimer's doesn't recognize their environment, their anxiety can increase and, if the person is already starting to wander, they could feel an undeniable urge to "go home" but may be thinking of the home where they lived in their younger days.  The person doesn't have to be at the relative's home overnight to start wandering.  They could slip out quietly in the confusion of dinner preparations or when guests are arriving or when presents are being opened.

If they travel, traveling without a companion who will stay with them 100% of the time is outright dangerous.  I think of the elderly man I found wandering lost in the Los Angeles airport several years ago or the elderly woman who wandered away from the Reagan National Airport in Washington, DC and died walking distance from the airport.  I'm also thinking of the woman and her great granddaughter who got lost in VA as they drove from New Jersey to North Carolina.  They've been found and are safe.  While the various news stories indicate the lady had no known medical conditions, I'm wondering if dementia is a character in this story too.

Do these risks mean you shouldn't visit with an individual with dementia or have them visit in your home?  Not at all!  There are options available to help mitigate the risks associated with wandering and anxiety.

Some suggestions to consider:

  • Designate people to take shifts watching and serving as the primary care giver for the individual with dementia.  This will allow the effort to be spread across multiple individuals and alleviate the care load from any single individual.  This is, unfortunately, not always possible.  If it is, then consider it.  This may need to include overnight shifts, particularly if the person is prone to wandering.
  • Everyone needs sleep and dementia patients are not always tied into stable sleep cycles that correspond to the nighttime hours.  Technology can be a huge assist here.  Mattress alarms can alert if the person gets out of bed.  Door alarms can alert if they get a door open which should remain closed such as an exterior door.  If you use a door alarm, remember to also alarm the door to the garage.  The door may technically be internal but the person could open the garage door itself and get out that way as well.  Consider GPS trackers to help locate them if they get out and a medical ID to help identify them to anyone they may encounter.
  • Consider a smaller, more low-key visit in their nursing home.  This allows them to stay in their familiar environment and can satisfy your desire to include them in a holiday celebration.  Encourage others who would normally gather at your home to visit to swing by and pay a visit to the nursing home as well.  Spreading out the visit with all of the cousins can allow grandma to enjoy more focused time with each instead of feeling anxious over a busy visit with all at once.
  • Never let anyone who has been diagnosed with dementia or is starting to show the signs of dementia travel independently.  While they may find your insistence an intrusion, it really is about safety.
  • If you're looking at a visit over New Year's or the Fourth of July, consider the impact of the noise from fireworks.  Individuals with dementia often have auditory and visual hallucinations which can be quiet disorienting.  Taking them to see the fireworks may lead to an emergency if they try to escape the booming and flashing lights of the display.  Enjoying a televised viewing in a very well-lit room with the sound down low.  




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