Preventing Wandering in Alzheimer's Patients

Patty McKinney, OTR

Alzheimer's Disease causes a number of changes in the brain and body that may affect safety. Depending on the stage of the disease, these can include changes in judgment, abstract thinking, sense of time and place, and behavior.  As the disease progresses the person's abilities will change, so situations that are not a concern today may become potential safety issues in the future.

One danger to be aware of is wandering in Alzheimer's patients. According to the Alzheimer's Association, about 60 percent of the nation's 5 million Alzheimer's patients will wander. If you are caring for a loved one who suffers from Alzheimer's, these are things to keep in mind to minimize risk and keep your loved one safe.

Wandering is more likely in certain situations, like when someone with dementia is in unfamiliar surroundings. People with Alzheimer's and other forms of dementia often leave clues that they're about to wander. If your loved one says, "It's time to go to work," she might truly be headed out the door in a few minutes. "I want to go home" might mean he's about to go in search of his childhood home, and you have to stop him.

Learn to distract them. Avoid saying, "Dad, you haven't worked in 30 years." Reasoning is not effective, but distracting is a good strategy. For example, if they say they want to go to work, encourage them to go and find their shoes, or to have breakfast first. The distraction is usually sufficient to take their mind off of going to work.

Block or disguise the exits. For safety reasons, never lock a person with dementia in a home alone. Doors can be blocked if a caregiver is with them. Other ideas include placing a mirror or a stop sign on the door.

Another strategy to prevent wandering is to label your rooms. Sometimes people with dementia will go wandering off in search of the bathroom or a glass of water, get distracted and actually leave the house. The Mayo Clinic suggests putting a picture of a toilet on the door to the bathroom or food on the door to the kitchen, so they can more easily find what they need.

Alzheimer's patients sometimes wander out of boredom, or because they are not receiving attention. Engage your loved one in activities to whatever degree you can. For example, washing dishes or folding clothes together. 

Have your loved one take a walk or exercise with you. The physical effort is usually calming. Even if they're not tired afterward, the social engagement of the walk might be enough to keep them from wandering in search of company.

Consider technology as a help in your safety precautions. You can attach a Global Positioning System (GPS) device to your loved one on a bracelet or shoe. If he or she wanders, you can go online to find them on a map. Some devices alert you if a door is open in the house. The Alzheimer's Association has an overview of electronic devices that can help keep track of Alzheimer's patients. 

Finally, many families aren't sure they can safely keep their loved one with dementia at home. The Alzheimer's Association has a guide to determining what kind of care a person needs, and a guide for finding professional assisted living facilities or other long-term care options. Check http://www.alz.org for additional information and resources.

Patty McKinney, Occupational Therapist, is the owner and operator of Glenwood Springs Harmony House, an assisted living facility with peaceful accommodations and professional, qualified personal caregivers.

www.glenwoodspringsharmonyhouse.com

970-404-0551

Depression in Older Adults and the Role of Occupational Therapy Treatment

Patty McKinney, OTR

The job of the occupational therapist (OTR) is to help people of all ages and stages of life participate in the things they want and need to do. Through the therapeutic use of everyday activities, known as "occupations" in this context, the work of an occupational therapist helps lead to measurable gains in quality of life for the patients they treat. Because of their work helping people achieve and maintain quality of life, treating depression is an emerging niche in occupational therapy practice. Often, an OTR works with a senior population, and OTRs can be especially effective in both identifying, and mitigating, depression in seniors through the work that they do.

Recent data suggests that about 20 million Americans suffer from depression, but not all seek treatment. Treatment can include medications, counseling, and increasingly, occupational therapy. Occupational therapy can assist people in restructuring their daily lives. People with depression, and especially aging adults, can benefit from the support and problem solving that occupational therapy brings to their care. Often, occupational therapy helps people access and be successful with  those day-to-day things that they value, and the net result is a happier and more fulfilled individual. In addition, OTRs are trained in identifying the differences between depression in older adults and the early signs of dementia, which can look very similar.

Depression isn’t always easy to spot. It may be expressed through behavioral changes, emotional changes, physical changes, or a combination of these things. Older adults who are depressed are often experiencing a culmination of losses—not just loved ones, but sometimes their health. Many housebound seniors suffer from Seasonal Affective Disorder (SAD), which is characterized by the onset of depression during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but not all individuals with SAD get better with light therapy alone.

People with depressive illnesses do not all experience the same symptoms. The severity, frequency, and duration of symptoms vary depending on the individual and his or her particular illness.

Some signs and symptoms of depression include: 

• Persistent sad, anxious, or "empty" feelings
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness, or helplessness
• Irritability, restlessness
• Loss of interest in activities or hobbies once pleasurable
• Fatigue and decreased energy
• Difficulty concentrating, remembering details, and making decisions
• Insomnia, early-morning wakefulness, or excessive sleeping 
•  Overeating or appetite loss
• Thoughts of suicide, suicide attempts 
• Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.  

If you or an aging loved one may be suffering from depression, please seek treatment. Your primary care physician, counselor, and possibly an occupational therapist, are there to help.

Patty McKinney, Occupational Therapist, is the owner and operator of Glenwood Springs Harmony House, an assisted living facility with peaceful accommodations and professional, qualified personal caregivers.

www.glenwoodspringsharmonyhouse.com

970-404-0551