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February 4, 2002
Editor’s note: the following is an excerpt from the National Institutes of Health’s “Caregiver’s Guide.” NIH Publication No. 01-4013
Caring for a person with Alzheimer’s disease (AD) at home is a difficult task and can become overwhelming at times. Each day brings new challenges as the caregiver copes with changing levels of ability and new patterns of behavior. One of the biggest struggles caregivers face is dealing with the difficult behaviors of the person they are caring for. Many caregivers have found it helpful to use strategies for dealing with difficult behaviors and stressful situations. The following are some suggestions to consider when faced with patient wandering, home safety, driving, and visiting a person with AD.
Wandering
Keeping the person safe is one of the most important aspects of caregiving. Some people with AD have a tendency to wander away from their home or their caregiver. Knowing what to do to limit wandering can protect a person from becoming lost.
• Make sure that the person carries some kind of identification or wears a medical bracelet. If he or she gets lost and is unable to communicate adequately, this will alert others to his or her identity and medical condition.
• Keep a recent photograph or videotape of the person with AD to assist police if the person becomes lost.
• Keep doors locked. Consider a keyed deadbolt or an additional lock positioned up high or down low on the door. If the person can open a lock because it is familiar, a new latch or lock may help.
• Be sure to secure or put away anything that could cause danger, both inside and outside the house.
Home Safety
Caregivers of people with AD often have to look at their homes through new eyes to identify and correct safety risks. Creating a safe environment can prevent many stressful and dangerous situations.
• Install secure locks on all outside windows and doors, especially if the person is prone to wandering, and remove the locks on bathroom doors to prevent the person from accidentally locking himself or herself inside.
• Use childproof latches on kitchen cabinets and any place where cleaning supplies or other chemicals are kept.
• Label medications and keep them stored securely. Also make sure knives, lighters and matches, and guns are safe and out of reach.
• Keep the house free of clutter, and remove scatter rugs and anything else that might contribute to a fall. In addition, make sure there is ample lighting both inside and out of the house.
• Consider installing an automatic shut-off switch on the stove to prevent burns or fire.
Driving
Making the decision that a person with AD is no longer safe to drive is difficult, and it needs to be communicated carefully and sensitively. Even though the person may be upset by the loss of independence, safety must be the priority.
• Look for clues that safe driving is no longer possible, including getting lost in familiar places, driving too fast or too slow, disregarding traffic signs, or getting angry or confused.
• Be sensitive to the person’s feelings about losing the ability to drive, but be firm in your request that he or she no longer do so. Be consistent--don’t allow the person to drive on “good days” and forbid it on “bad days.”
• Ask the doctor to help. The person may view the doctor as an “authority” and be willing to stop driving. The doctor also can contact the Department of Motor Vehicles and request that the person be reevaluated.
• If necessary, take the car keys. If just having keys is important to the person, substitute them with a different set.
• If all else fails, disable the car or move it to a location where the person cannot see it or gain access to it.
Visiting a Person with AD
Visitors are important to people with AD. They may not always remember who the visitors are, but the mere human connection has value. Here are some ideas to share with someone who is planning to visit a person with AD.
• Plan the visit at the time of the day when the person is at his or her best. Consider bringing along some kind of activity, such as something familiar to read or photo albums to look at, but be prepared to skip it if necessary.
• Be calm and quiet. Avoid using a loud tone of voice or talking to the person as if he or she were a child. Respect the person’s personal space and don’t get too close.
• Try to establish eye contact and call the person by name to get his or her attention. Remind the person who you are if he or she doesn’t seem to recognize you.
• If the person is confused, don’t argue. Respond to the feelings you hear being communicated, and distract the person to a different topic if necessary.
• If the person doesn’t recognize you, is unkind, or responds angrily, remember not to take it personally. He or she is reacting out of confusion.
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