The Alzheimer caregiver; or, the savior of misbehavior
You don’t have to be trained at the Behavioral Analysis Unit in Quantico to know that Alzheimer’s disease causes people to act differently that they used to do. Some of these changes in behavior can be dangerous to the person with Alzheimer and those around them. The caregiver must then take preemptive measures to makes sure that the patient doesn’t hurt himself while wandering or rummaging, or if they are having hallucinations, illusions, or delusions.
· Prevent falls and give the person free space to move by removing clutter and clearing room-to-room pathways.
· Floors must offer good traction. Wax the floor with non-skid wax or leave it unpolished. Secure rug edges, remove throw rugs, or install non-skid strips. Have the person wear non-skid shoes or sneakers.
· Place exit door locks out of the person’s field of vision, either high or low. Consider double locks that require a key.
· Place loose covers over doorknobs so that the former turn and not the latter.
· Safety devices sold in hardware stores can limit how much a window can be opened.
· Secure the yard with a fence and a locked gate, if possible. Loose bells above doors can serve as door alarms. There are also devices that ring when a knob is touched or a door is opened.
· Place small scenic posters on the door; removable gates, curtains, or brightly colored streamers across the door; or wallpapering the door to match any adjoining walls to distract the person with Alzheimer from using the door.
· Put signs that say STOP, DO NOT ENTER, or CLOSED on doors.
· Remove items that signal departure such as shoes, keys, suitcases, coats, and hats from sight.
· Fit the person with a medical bracelet that says ‘memory loss’ and has an emergency phone number. If the person is right-handed, put the bracelet on the right wrist to reduce the chance that they will remove it.
· If available, enroll the person in the MedicAlert + Alzheimer’s Association Safe Return Program.
· Label the person’s clothes to make identification easier.
· Keep an unwashed piece of clothing the person has used for dogs to sniff in case the person gets lost.
· Let the neighbors know that person tends wander and may get lost, so that they call you or the police if they see the person moving alone.
· Distribute a recent photo of the person with their name and info among local police, neighbors, and family members.
· Make a videotape of the person.
· Do not leave an Alzheimer’s disease patient with a history of wandering alone.
Rummaging or hiding things
· Keep dangerous or toxic products under lock and key, or at least out of reach.
· Clear the fridge and cupboards of expired food.
· Remove valuable objects and important documents that can be misplaced, lost, or hidden by the person.
· If you have fencing and a locked gate in the yard (see above), put the mailbox outside the gate. Consider a post office box if you can’t keep the person from hiding, losing, or throwing mail away.
· Establish an environment especially designated for the person to rummage, such as a chest of drawers, a bag of selected objects, or a basket of clothing to fold or unfold.
· Give the person a safe box, chest, or cupboard to keep special items.
· Restrict access to unused rooms.
· Check the house regularly for hiding places.
· Cover trash cans covered or out of sight, and check them for hidden or accidentally thrown away objects before emptying them.
· Paint walls a light, reflective color. Use solid colors. Patterns and bold prints may cause confusion.
· Dim areas may create confusing shadows or make it difficult to interpret daily objects. Keep rooms adequately lighted and keep additional bulbs in a safe place.
· Use soft lights or frosted bulbs, partially close blinds or curtains, and maintain adequate globes or shades on light fixtures to decrease glare.
· Mirrors can confuse and frighten people with Alzheimer’s disease; remove them or cover them.
· Do not furniture around so as to avoid potential visual confusion.
· Avoid violent TV shows which the person may believe are real.
· Have an exit strategy for when/if the person becomes aggressive. Confrontation is not recommended.
Special occasions/natural disasters
· Holidays are a sort of natural disasters for many people, and even more so for caregivers of people with Alzheimer’s disease who may behave unexpectedly during special occasions such as family gatherings – not to mention actual natural disasters.
· Weddings, family reunions, picnics, and other large gatherings may lead to anxiety. Favor smaller, more intimate reunions.
· Have visitors come one by one or in small groups.
· Prepare the person in advance for larger groups.
· Leave a separate space for the person to rest and be alone.
· Simplify the holidays. For instance, consider a potluck dinner instead of hosting a fancy Thanksgiving or Christmas dinner.
· Secure Christmas trees, lights, menorahs and other decoration to keep them from falling or catching fire. Keep in mind that elaborate holiday decorations may confuse the person.
· Have a plan of action in case a fire breaks out or an earthquake, flood, or tornado hits. The American Red Cross may be able to help with that.
· Become acquainted with neighbors and individuals who would be willing to help during a crisis.
· Provide neighbors with a list of emergency phone numbers of caregivers, family members, and primary medical resources.
· Inform the neighbors of the person’s disabilities (inability to follow complex directions, memory loss, impaired judgment, and probable disorientation and confusion) in advance.
· Provide examples of simple instructions the person can follow.
· Distribute tasks among household members – excepting the person with Alzheimer’s disease, of course – and stage regular emergency drills.
· Keep an additional week’s supply of food and water, medications, incontinence undergarments, hearing aid batteries, and the like, as well as an extra pair of the person’s eyeglasses.
· Never leave a person with Alzheimer alone during an emergency.