Alzheimer s Disease and Related Dementias: Wandering & Safety Issues Kelly A. Raach Southern Arizona Regional Director
What Are We Going To Cover? Basic disease overview Medications Driving Home safety Wandering Resources available
What Is Dementia? Dementia is an umbrella term that describes symptoms including loss of memory and other intellectual abilities serious enough to interfere with daily life.
Types of Dementia Vascular Dementia Frontal Temporal Dementia Lewy Body Dementia Parkinson s Dementia Korsakoff Syndrome Traumatic Brain Injury 70+ more..
What Is Alzheimer s? Alzheimer s (AHLZ-high-merz) disease is a progressive brain disorder that gradually destroys brain cells and affects a person's memory, ability to learn, make judgments, communicate, and carry out basic daily activities. Alzheimer s is not normal aging. It is a progressive, fatal disease and has no cure.
How Alzheimer s Affects The There are 100 billion nerve cells, or neurons, creating a branching network. Brain Signals traveling through the neuron forest form memories, thoughts and feelings. Alzheimer s destroys neurons.
Normal vs. Alzheimer s
1 in 9 Seniors Has Alzheimer s Half Do Not Know It
The Stages: Early Stage Moderate memory loss with increased loss of recent events Difficulty performing familiar tasks Problems with language Some difficulty with time and place Poor or decreased judgment Difficulty with problem solving Changes in personality, mood behavior Anxiety & depression about symptoms Loss of initiative Usually independent in daily living activities
The Stages: Middle Stage Increasing memory loss, confusion or shorter attention span Problems recognizing friends/family Disorientation to time, place & situation More impaired judgment & problem solving skills Difficulty organizing thoughts, actions and thinking logically Personality and behavioral changes May be suspicious, irritable, restless Loss of impulse control May see or hear things not present Will need more physical care from others (bathing, dressing, etc) Becoming more dependent on others
Severe memory loss Minimal or no speech The Stages: Late Stage Increased feeding and/or swallowing problems Knows only self NO judgment or problems solving skills Unable to control bladder or bowels May place items in mouth May not be able to walk or need maximum amount of assistance to walk May be prone to infection or skin break down May have seizures Dependent for all care needs
Arizona Facts & Figures 1 in 6 Arizonans age 45+ reported memory loss 77% have not talked to a health care professional 79% have at least one other chronic condition 40% report it interferes with work / household activities 23% with reported memory loss live alone.
Why Is This Important?
Safety and Alzheimer s Impairment in judgment Loss of sense of time and place Behaviors Trouble with physical abilities Impaired senses
Food For Thought As many as 1/3 of the people with Alzheimer s Disease or another related dementia in the community live alone..
Medications I have set up the medications for my mother for the last 2 years since her diagnosis. She set an alarm in her home to remind her when to take them, until the one day when the electricity went off and reset her clock. She couldn t reset the clock and ended up taking 3 days worth of medication in a 4 hour period - Caregiver
Medications: Working with the Doctor and Pharmacist Coordinate with all care providers Ask about possible drug interactions Get details Take as directed Ask if available in other forms (i.e. liquids) Avoid risk
Medications: Tips Consider pill boxes / dispensers Have emergency numbers accessible If refusing, stop and try later Make changes for safety Use clear instructions
Driving My wife has macular degeneration, so I still drive us everywhere we need to go. She will tell me when I need to turn on my turn signal or if I am going the wrong direction on the street. - Caregiver
Driving: Signs It Is Time To Stop Forgetting how to locate familiar places Failing to observe traffic signs Making slow decisions in traffic Driving at an inappropriate speed Hitting curbs Confusing gas and brake
Driving: Tips To Stopping Plan early Driving contract Transportation alternatives Consider having a driving evaluation Having the conversation What happens when the conversation does not go well???
Driving: Considerations A person with dementia may. be able to drive safely at times, but may not be able to react quickly leading to dangerous situations Be able to drive short distances during the day, but can get easily lost at night or with change
Driving: Considerations, cont. If a person with dementia continues to drive when they are no longer safe, someone could get hurt or even killed. You need to weigh the danger of driving against the feelings of the person. Seek help..
Wandering He has ridden his bike down the same streets since we moved into this community 20 years ago. I never thought that I would have to worry about him not coming home.until the day that I got a call from DPS that he ended up on I-10. - Caregiver
Wandering Quick Facts 1 in 6 people with dementia will wander Wandering is considered an emergency If not found within 24 hours 50% of people risk serious injury or death Wandering happens on foot, by car or via other forms of transportation People who have wandered are difficult to locate paranoia, lessened sensory
Wandering: Who Is At Risk Returns later than usual from walk or drive Tries to go home or go to work Restless, pacing, or doing repetitive behaviors Asks about family / friends from past Lost within own home Appears lost in unfamiliar places
Tips to Prevent Wandering Carry out daily activities / regular schedule Identify most likely times of day for wandering Offer reassurance Ensure basic needs are met Avoid busy places that can be confusing Use door chimes / camouflage doors
Make A Plan In The Event of Wandering Who will you call? Talk with neighbors / friends / community Keep a current photo handy Keep a list of places they might go Provide ID jewelry GPS tracking tools
Tips on Searching For Someone Who Has Wandered Start searching immediately Look in the immediate area most found within 1-5 miles of home Search at prior residences or workplaces Look short distances from the road Search smart.not loud Consider the pinball effect / dominant hand theory
MedicAlert + Safe Return This nationwide program provides identification and education that mobilizes first responders should the individual become lost. The program provides peach of mind to caregivers as well as information on home safety and wandering prevention.
Home Safety
Home Safety: General Tips Assess your home Lock hazardous areas Be prepared for emergencies Make sure safety devices work Install locks Keep walkways well lit Remove / disable weapons Remove tripping hazards Support the persons changing needs
Programs 24 Hour Helpline Family Care Consultation Education Early Stage Programs Support Groups Safety Services
Helpline / Information & Referral 1-800-272-3900 24 Hours a day, 7 days a week Callers can speak confidentially with a trained Helpline specialist who will provide information, support and referrals to local resources. We have a wide range of free educational materials that are available to assist.
Information & Referral, (cont.) Resource Libraries Offer the loan of books and videos. Conveniently located throughout the Southern Arizona region including: Tucson: Southern Arizona Regional Office Tucson: TMC Senior Services Nogales: South East Arizona Area Health Education Center (SEAHEC) Sierra Vista: Sierra Vista Regional Medical Center Wellness Depot Safford: SEACUS Office Green Valley: Casa Community Services Yuma: Yuma County Library
Family Care Consultation A professional Care Consultant will assist the person with the disease, their families and caregivers with individualized guidance on care options, interventions and resources to address immediate needs and plan for the future. This is a confidential service that offers ongoing support throughout the course of the disease, free of charge. Staff is available by phone and/or through scheduled office and home visits. Limited respite funds also available.
Support Groups Currently, we have 27 caregiver support groups across the Southern Arizona Region. The groups are led by trained volunteers to share information and experiences, build new skills and offer peer support and ideas. Some important things to highlight about these groups: Meet different days & times to cater to the needs of the individuals we serve Bilingual groups are available Group for caregivers of individuals of Younger-Onset Some groups include PWD / activities for PWD running concurrently
Education Education Programs are created and designed to increase awareness and knowledge about the disease and are held throughout the region on a regular basis. Topics of these sessions include: basic disease education, addressing behavioral challenges, long-term planning and many more. Education Programs are available for professionals, first responders and direct care workers CarePRO classes 10 week intensive trainings for family caregivers providing 4 or more hours of care to a person with memory loss a day and find this to be overwhelming Memories in the Making Program collaborative partnership with Tucson Museum of Art providing 4 week sessions of art classes and workshops for individuals with dementia
Early Stage Programs Early Stage programming helps to engage and education persons diagnosed with Alzheimer s disease and their loved ones. The programs consist of specific activities focused on engaging, encouraging and empowering impacted individuals to fully utilize their strengths and capacities. Early Stage Support Groups Connections Plus / Social Engagement Volunteer Opportunities EPIC
Research
Advocacy Alzheimer advocates play an important role in improving the quality of care and quality of life for people with Alzheimer s disease and their families by working to improve dementia care and services; improve access to community-based care; improve quality care in residential settings; and expand funding for research and public programs serving people with dementia. National Plan to Address Alzheimer s disease HOPE Act, Health Outcomes, Planning and Education Alzheimer s Accountability Act of 2014 Congressional Task Force on Alzheimer s Disease
Annual Education Conference Wednesday, March 4, 2015
Wine To Remember April 12, 2015
Thank you For more information visit www.alz.org/dsw 800.272.3900 Southern Arizona Regional Office 1159 N. Craycroft Tucson, AZ 85712