It's An Emergency (Part 2): Taking Good Care of Your Loved One with Dementia While Evacuating
Over the past week, more crisis situations occurred that reinforced the need to think ahead in case of an emergency evacuation. Whether it's flooding in the United States Mid-West, an approaching hurricane, an earthquake in Peru, or a house fire (which is just as unfortunate, but which doesn't make the news), unexpected circumstances may force you to suddenly flee your home with your loved one who has dementia.
This second part of a two-part series deals with what to do when you are evacuating. (If you want to know about what to do prior to evacuation, please read my previous blog, "It's An Emergency: Planning on Evacuating with a Loved One with Dementia" (http://www.healthcentral.com/alzheimers/c/42/12332/loved-dementia/).
Ideas from the Alzheimer's Foundation of America
In the fall 2005 edition of Alzheimer's Foundation of America publication, CareADvantage (http://www.alzfdn.org/publications/ca_f05.pdf), authors provided the following helpful tips in case of an emergency evacuation:
- Report our loved one's health status, current location and any concerns to his or her regular healthcare provider. If that provider isn't available, find a nearby healthcare professional and pharmacy to take care of immediate medical needs.
- Remain calm, since loved ones with dementia take their cues from your behavior.
- Try to avoid tragedy-related media broadcasts and discussions. These may cause more confusion and anxiety. (NOTE: I personally can vouch for the importance of this suggestion since my mom was panicked about an imaginary grassfire at her nursing home after watching television news which showed grassfires in West Texas, where she used to live.)
- Have a knowledged caregiver with your loved one at all times, due to their higher risk of confusion and irritability.
- Keep the loved one on a structured routine concerning bathing, eating, etc.
- Involve your loved one in positive activities (singing, folding clothes, etc.)
- Keep multiple forms of identification on your loved one in case of wandering.
Alzheimer's Association's Safe Return Program
Because of the worry of wandering in a strange location, caregivers may want to take extra precautions. For instance, the Alzheimer's Association offers a Safe Return program (http://www.alz.org/we_can_help_safe_return.asp). This program, which has a nominal fee, includes a hot line which faxes photos and descriptions to law enforcement when a loved one is reported missing. In addition, the loved one is given a stainless steel tag listing a number to call if they're found wandering.
Expect a Period of Adjustment
In The 36-Hour Day, Nancy Mace and Peter Rabins warn that a period of adjustment normally will be needed right after a move. The amount of adjustment may depend on what stage the disease is in, since those who have less-severe dementia may adjust more rapidly. Mace and Rabins suggest placing signs on doors to help the loved one navigate a new setting. They also note that an additional sedative may be helpful so that the loved one sleeps through the night. (Note: be sure to consult a doctor about this additional medication.)
From Personal Experience
After watching the challenges of moving my mother to new settings (although not in an emergency), I would suggest the following in case of an emergency evacuation:
- Try to find hotel accommodations away from busy highways and other congested areas, if at all possible.
- Seek out a hotel that has indoor corridors (as opposed to rooms that open to the outdoors). That way, if your loved one does wander out, they will be in a confined space (at least for awhile) and you have a better opportunity to stop them before they get lost.
- Arrange to meet the front office staff and other key staff (such as the housekeeping and maintainance staff). Show them a picture of your loved one and share what's going on so that they can watch for them in case of wandering.
- Rearrange the hotel furniture (if possible) to make it more "friendly" for the loved one with dementia. Remove anything that could hurt them. Place recognizable keepsakes (in my mom's case, a brightly colored quilt) that will make them feel at home, even though they are in a strange location.
I also asked my friend Pam, who often travels with her husband who has a type of early onset dementia, what she would suggest to someone who has to evacuate a loved one with Alzheimer's disease in an emergency. Pam advised:
- Automatically build in rest breaks and bathroom stops every two hours while on the road, including snack breaks.
- After reaching a destination, take the loved one for a walk around the area and also acclimate the loved one to the bedroom, bathroom, and other areas of the living situation. (Plan on doing this several times.)
- Go over the itinerary each evening and morning while away from home.
- Always have someone accompany the loved one whenever he or she wants to go for a walk or to the pool.
- Set out key items, such as pajamas, house slippers, and toiletries on the counter so they are ready for your loved one.
- Limit the choices (such as where to eat) while traveling.
Many of these ideas sound logical and also simplistic, but are easy to overlook in the stress of having to evacuate during an emergency. By taking time to think through how you will handle this situation prior to an unexpected move, you are doing your loved one, yourself and your family a big favor. Take the time now to plan, so you aren't left in an even more precarious position if and when the time comes to leave quickly.