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Posted: April 12, 2004

Practical Caregiving

Guarding Against Elderly Wandering and Handling Siblings Who Ignore Caregiving Preparations

Watching your loved one?s mind and memory steadily disappear from the ravages of Alzheimer?s or dementia is especially stressful, but when that same person wanders away and doesn?t find their way home, stress quickly becomes almost unbearable worry for the caregiver. Miriam wants to know how to deal with her father?s wandering throughout the neighborhood, and she also will want to make his home secure and safe.

Meanwhile, George knows his elderly mother is going to need help and wisely wants to plan ahead for his mother?s future. Unfortunately, his siblings don?t agree with his planning approach. What to do about this very common situation? The answer might surprise you.

These questions are posed in the latest batch of emails pulled from my eMailbag. Write me at ASKJEAN@caregivershome.com and I?ll try to help.


Dear Jean:

My dad has suffered several TIA?s (Ed. Note: Transient ischemic attack; i.e., mini-stroke-like event). His dementia seems worse and he has fallen several times. He has walked out of the house and gone quite a distance. My mother and I are deeply troubled by this, but we have no idea how to stop him from taking these walks. It seems only a matter of time before he becomes one of these missing elderly people we see on the news that have wandered off. Any suggestions you have are truly appreciated. Thanks so much.

Miriam, Seattle, Washington

Dear Miriam:

Your worries are completely justified. Fortunately, there are several things you can do. And while wandering outside the house is your main concern, you should also be concerned that he doesn?t have a problem inside the house.

While taking action yourself, you should also check with your father?s doctor to determine whether his medicines might cause some of his wandering problems, and you should ask whether other medicines might actually help in this area.

At home, there are several areas you should look into to make sure he is safe.

One of the main safety measures is to install door locks he can?t open. I bought a slide bolt lock and put it at the top of the doors so Mom couldn?t open them.

There are also special doorknob covers you can buy to put on the outside of your round doorknobs to keep your father from opening them. These are often used to keep small children from opening doors, and the effect would be the same for your dad. They are loose fitting and turn without opening the door. Of course, there is a chance he might still open the door without taking the cover off -- parents do this all the time with young children ? so you still need to be watchful.

Make sure all the doors leading to any stairs are closed and locked so he can?t open them. You wouldn?t want him to open a door and fall down the stairs.

Install handrails around the house for him to hold onto when he walks between rooms. When Mom walked around and started falling, she sometimes would try to grab something to keep from falling. A lot of the time, though, she couldn?t react fast enough and simply fell. Try to move things out of the way so when he does fall, he won?t fall onto a sharp object like a fireplace poker. Make sure everything is picked up off the floor so he won?t stumble.

It is essential that he doesn?t wander into the kitchen and turn the stove on. Is there a way you can keep him from gaining access to the kitchen? He might turn the knobs simply because they turn. Can you remove the knobs from the stove? Some stoves have that feature. My son was going to cook something and had a pan sitting on the stove with oil in it, but the burner was not turned on. Mom walked into the kitchen and turned the burner on - starting a fire (I guess we were lucky she didn?t blow up the house!). My son put the fire out, but Mom couldn?t even move until it was out. That?s when she yelled, ?Fire!?

Look at every area of your house for safety concerns. Try to think of everything he might do while wandering that could cause harm to him, someone else or even your house. Check out my February 2004 column, Is Your Loved One?s Home Senior-Safe?

Tell your neighbors about the problem so they will know to return him home if they spot him outside the house or on the street. Buy a medical bracelet that says something like, ?I am an Alzheimer?s patient, please contact my family at . . .? Include his name and address, and your name and phone number. That way anyone who reads it will know he needs their help.

The Alzheimer?s Association has a nationwide program called Safe Return. This program has located and returned many registered patients who have wandered away. You can register for this program by calling 1-888-572-8566 any time, day or night, or by contacting your local chapter or visiting the website at http://www.alz.org/.

You can locate a local chapter of the Alzheimer?s Association by calling 1-800-272-3900. You can also ask your local Alzheimer's Association chapter about any programs available to cover the cost of registration, if this is a hardship for you.

Also, check out this Ask an Expert question-and-answer on our site, Elderly Behavior: When Dad Won't Sleep.

Hope this helps.


Dear Jean:

I am the youngest son of an 87-year-old mother who still lives alone in her home. I have a brother and a sister who live closer to our mother than I do. We have two different approaches to mother?s care. My approach is to look ahead as much as possible and make the environment as safe as possible. Their approach is to take things as they come. Any thoughts or suggestions?

George, Boulder, Colorado

Dear George:

Don?t argue with your family about your mother and her future. Pressing your point would only cause hard feelings and create problems between you and your mother, sister and brother. Not everyone wants to know what might happen or think about the future in the way you (rightly) do. They want to take care of things when something does happen.

I suggest you learn as much as you can about what to do in various situations that might befall your mother. However, at this time I wouldn?t tell the rest of your family what you are learning and what you intend to do. When the time comes that they need the answers you can step forward with the knowledge. You will never have all the answers and you will never use everything you learn, but you will be better prepared for what does happen.

And, actually, while your siblings might not say it, they will probably be very relieved that you have mentally made these preparations on their behalf ? and, of course, your mother?s behalf.

© 2004 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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Please send me your questions, comments and issues regarding the practical side of caregiving at ASKJEAN@caregivershome.com, and remember to take advantage of our professionals and experts in the Ask an Expert section of our website. You'll find it in the left column on our homepage.

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