Safety and Care for Dementia

This past week we discussed some challenging behaviors that the care partner experience on a daily basis.  The hope was to provide useful tips for the provider, in particular, to redirect behavior to a more positive emotional outcome for the client and care partner.

Today, I would like to begin the discussion regarding safety and care for the dementia client, wandering behaviors.  It has been well documented that as the disease progresses, the needs of the client will change. The concern arises around the relationship between the safety of the client and the potential safety concerns in the near future.  Understanding triggers and redirection techniques can ensure safety of the client and the prevention of serious injury.

As reported by the Alzheimer’s Association(2011), it is estimated more than 60 percent of those with dementia will wander; furthermore, if the individual that wanders is not located within twenty-four hours, half will either experience injury or death. With these statistics it is essential for all caregivers to have a better understanding of wandering behaviors.

First, we should discuss types of wanderers:

1. Exit Seeker: wanderer has a specific goal. “Going Home”, or “Going to Work”.

2. Pacer: wanderer has excess energy and a need to move.

3. Explorer: like to touch door handles and doors.

4. Follower: follows other individuals/personal contact.

Environmental considerations that may assist in reducing the risk to wander.

~Camouflage exit doors with decorative wallpaper, curtains, painting door same color as adjoining walls. Remove lighting over exit door.

~Place locks high on exit doors so out of direct vision. Consider double locks with keys.

~Provide door chimes or “announcing system” over exit doors; alerting caregiver when door opens.

~Install window safety latches to limit how much windows can open.

~Secure the yard with high fence and locked gate.

~Ensure items to leave or travel are out of sight, i.e. keys, coats, shoes.

~Enroll in Medic Alert and Safe Return program with the Alzheimer’s Association.

~Place name labels in garments to assist with identification.

~Notify neighbors of the individual’s  potential to wander.

~Provide local police, neighbors, and relatives of recent photo, with pertinent information, i.e. medical.

~Ensure that the person with a history of wandering has adequate supervision.

Triggers and cues to wandering

~Have medication profile evaluated.  Is the medication contributing to increased motor activity? Is the individual with dementia experiencing pain?

~Assess the individual’s reality. Is the individual reliving a past memory, i.e. Is the individual looking to go to work?

~Provide a safe environment for the individual to move about; remove clutter, ensure adequate lighting.

~Provide structured program of exercise and movement as part of daily routine.

~Provide reassurance to redirect the individual to a different activity.

Caring Resources will provide assistance to the care provider in developing a safe environment through their Homestead Advantage Program. Under this option, Caring Resources provides a comprehensive Needs Assessment , and Wandering Assessment in order to assess the safest home environment for the individual at risk to wander. For more information, contact a representative at Caring Resources.

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