Safety and ALZ. I would like some advice on how you keep an ALZ patient from wandering. - AgingCare.com

Safety and ALZ. I would like some advice on how you keep an ALZ patient from wandering.

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I would like some advice on how you keep an ALZ patient from wandering. This has not happened yet, but our LO is getting up at 2 or 3 am and trying to start her day. Her elderly caretaker says he has it under control because he listens for her to get up and will get up with her if she is doing more than a nighttime bathroom run. I asked what he planned to do if she tried to take a walk and he said "She won't." I was wondering if anyone had any suggestions. I'd like a Plan B to "I'll hear her." We asked him to consider an overnight aide so he could get a good night's sleep but....he's not ready for that.

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Aaaand while I was typing up my response I see another post from Marcia7321 which indicates the caregiver is "quite hard of hearing." Unless the alarm is loud enough to wake him, that will not work. Also, if this is a spouse and he is sharing the bedroom, could that alarm startle/frighten the LO??
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Reply to disgustedtoo
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Shakingdustoff says:

"another day, another fire hose of abuse from this for the most part hellbent so called support group. most of you should be ashamed; almost all of you come across as money grubbing control freaks."

THAT seems to be a rather sanctimonious comment coming from someone who apparently considers themself to be a good Christian... If you think this is a "so called support group", why do you bother coming here? If you think we are so bad and such "money grubbing control freaks", what is YOUR purpose for coming here? Everyone has an opinion, everyone shares suggestions or caring that might help, even if it is only to commiserate. Lambasting people because YOU think you have been dissed is YOUR opinion, but calling other people names and criticizing them serves no purpose AND would appear to me to be rather unchristian-like. BTW, how is someone laughing at a comment a "fire hose of abuse"? You seem to be rather sensitive...or you do not know the REAL definition of abuse.

Marcia7321 asked a legitimate question and a chuckle on an answer that is really a non-answer was not uncalled for. She clearly knows the caretaker well and would certainly know better than you if that person has the "situation under control." It was pretty much implied that it was NOT under control.

Although the wandering "has not happened yet", anyone who knows dementia and in particular has raised children know you MUST stay one step ahead of both. Wandering IS a big concern and although it does not always happen, when it does the consequences can be devastating. YOU even state "the situation {is} under control...for now", the key phrase there being "for now". Do you wait for the horse to get out of the barn before securing it? You also say "it's impossible to predict in advance, almost anything with dementia patients. they're all somewhat unique and all fairly unpredictable is my understanding and experience." and THAT is the point of Marcia7321's concern - it COULD happen and there is NO crystal ball to say IF or WHEN. It is better to be prepared to protect (even if it is never needed) rather than to prepare the funeral. It is unclear what you mean by "taking care of a forgetful person with some peculiar habits is one thing, an end stage incontinent bed bound dementia patient who can't put a sentence together is a totally different answer." as the person of concern here is clearly NOT bed bound...

Marcia7321 graciously apologized for any perceived insult and went on to say: "There isn't one answer that fits everyone's situation. This forum is a useful place to see things from other viewpoints." THIS is what the forum is all about.

While I think the alarms and door knob child covers might work, a big concern several have raised is if the caretaker is deep asleep and does not hear the alarm or the LO getting up and about, then the alarm may not be useful. I was going to suggest using a keyed deadbolt on any doors leading outside (keep the keys in a place handy for quick exit, such as in the event of a fire or CO2, but out of sight/reach of the LO.) Others had concerns about getting out in the event of fire with the knob covers, however LO does not live alone! I can sleep through my phone alarm, but never could sleep through those fire alarms!! Peel me off the ceiling when those go off (at least the electronic ones, not so sure about the battery operated ones as my previous home had electronic ones and they are LOUD!)

If there are stairs with no barrier, that should be taken care of as well. A door with a lock would suffice, but many stairwells have no door, so a gate, high enough to prevent falling or climbing over, should be installed.

Unfortunately there is no one-size-fits-all and no way to know in advance what will happen. The best we can do is anticipate based on the known common behaviors of those with dementia and try to circumvent them BEFORE they happen. Again, in this case the LO might never wander, but we don't know that for sure. It would be better to be proactive.
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Reply to disgustedtoo
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Here are some websites of Stop Signs made especially as visual deterrent for wandering. Many of the signs are attached with Velcro-like fasteners so that you can take them off anytime you want to. The sign will need to be remove or at least unfasten on one side of the sign so that it hangs down beside the doorframe prior to your loved one going out the door. That way your loved one will not think that it is okay to go through that door when the Stop Sign is up. The "Stop Sign" in the doorway or on the door is very effective and I really haven't seen too many Dementia/Alzheimer's people who did not obey the sign.

www.alzstore.com/stop-sign-banner-p/0134.htm
www.caregiverproducts.com/posey-stop-sign-door-banner.html
www.mindcarestore.com/stop-sign-banner-p/mc-0134.htm

I like the idea of the floor mat alarm and it might be the easy for the caretaker to accept as it will need little or no adjustments.

Black mats or slip-resistant rugs work as previously mentioned-- the person with dementia/Alzheimer's think that the black spot on the floor is a hole in the floor. If you want your loved one to walk over the black mat, you will need to remove it from in front of the door or put another non-black rug over the black mat.

You might try a paper "Stop Sign" or a paper black hole to see how your loved one responds prior to purchasing the "Stop Sign" . This is tough situation because you have to convince the caretaker to use the product after you purchase it. Good Luck!
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Reply to DeeAnna
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Buy a floor mat alarm. I have one next to my mom's bed (it can be moved to either side) and the alarm is in my room. When she stands on it the alarm goes off. She doesn't hear it so it doesn't startle her. There is a few second delay in the alarm but this thing works great. The mat is wireless and runs on a special battery, that last a little over a year. The alarm receiver can be plugged into a wall or you can use batteries. I have both so if the electricity goes out the alarm still works. The receiver sits on my nightstand or I take it out to the family room if I'm up before her. You can place the alarm mat anywhere in the house. It has beveled edges so their feet don't get caught on it. I found it on Amazon. NOTE: be sure to get one where the alarm can go into a separate location.

Some people don't like this idea but it's worked for us. We have installed a security door on the front door and it has a double sided deadbolt. We keep it locked at all times. The key is hidden nearby for easy access. She can go to the door, look out and see what's happening but the door will not open.

I've also heard that placing a black rug in front of a door will keep them back because their depth perception is bad and it looks like a giant hole. This might scare them so you would have to see how they react and go from there. Plus putting posters over doors.
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Reply to Jessica40
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Bed alarms work great and can be purchased pretty inexpensively on Amazon. In addition, a baby monitor can be placed in her room. The key is once they start wondering they will not stop and nothing you can do will stop them. If he’s not ready for an overnight aid in addition to bed alarms there should be a lock very high on all external doors that she cannot reach. It’s very important that she not see the bed alarms be put on her bed nor that she sees the baby monitor or the lock. If she’s wandering and has a gas stove the knobs on the stove should be removed at night as well as all sharp objects removed and hidden. During the day the key to wandering is to keep them contentedly involved. Meaning if they are sitting and staring out the window and their content then so be it, let them stare out the window and be contentedly involved. I teach dementia and Alzheimer’s classes and I go into depth with caregivers on wandering and contented involvement as well as many other things. Please don’t hesitate to reach out to me with any questions or concerns 575-388-1319
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Reply to dblgee53
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DeeAnna. Something very low tech has a higher probability of being accepted by the caretaker. Do you find the Do Not Enter or Stop sign loses it's impact if it is permanently displayed on a door that is often used to enter/exit? Should the sign only be put up a night? I think he might also agree to the Doorguards. He will be familiar with them from hotels. Any kind of audible alarm system will be hit or miss as he is quite hard of hearing. Hence the "I'll hear her" response seemed out of touch with reality!
He is having a hard time accepting this. He thinks she just needs a stronger medication. He thinks she's making choices to do or not do things. He said "She always listens to what I order and then she wants the same thing!" or "She doesn't want to put sheets on her bed anymore." We are very lucky they can still stay in their home for now. Together.

We bought her a very pretty pendant from the Safe Return program but I have not seen her wear it. The wander guard ankle bracelet is offered at a very reasonable price by the local sheriff department but there is no way he will agree to that at this point. He will need to have a scare before he agrees to that. This is all so sad. Not getting a good night's sleep has to be hard on the caretaker's health. So many caretakers are doing this job alone overnight. My heart goes out to them.
Thank you all for your many responses.
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Reply to Marcia7321
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This elderly client needs a bed alarm, a door alarm, and/or a "wander guard" ankle bracelet. It's only a matter of time before he starts wandering outside (in all types of weather) and gets in trouble. When a caregiver is in a certain "stage" of the sleep cycle, they will not hear a person get up during the night. (A classic example is a spouse who is sound asleep and does not even hear the person sleeping next to them get up to use the bathroom.) Please get some alarms!
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Reply to dragonflower
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Not everyone with dementia wanders. My husband did not. But a large percentage do, and it is good to think ahead about this possibility. This very brief article by the Mayo Clinic provides some good background information:

www.mayoclinic.org/healthy-lifestyle/caregivers/in-depth/alzheimers/art-20046222

My mother often got up to start her day at totally unreasonable hours. I would intercept her in the hallway and say, "Mom, it is 3:30 in the morning. It is too early for breakfast." She'd answer, "Oh well then, I'm not getting up now!" as if someone expected her to. I got a clock that projected the time on the ceiling. It took a few times of taking her back to her bedroom and pointing out the time and also the "AM" designation, but she stopped getting out of bed at inappropriate times so I assume she started figuring out the time for herself.

If your LO is trying to start her day because she is confused about the time, give a projecting clock a try! This may or may not have any impact on a tendency to wander, but it may allow her caretaker to have a better night's sleep, which would be a good thing in itself.
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Reply to jeannegibbs
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My husband never wandered & I always heard if he opened the front door until one nite 2 am two policemen walked in my house w my husband in pj's & stocking feet in Feb. I was in a deep sleep & never heard a thing. I then got from amazon a lock for front door & a friend no longer needed, a laser beam that would make med. Or loud noise on a movable object. Both pieces are movable. I place the beam part on floor so if he walks by the noise is on other part which I move to where I am. I once saw it advertised at Harbor Freight like $25. Luckily my husband had an ID medical bracelet w 4 phone numbers. The police called my daughter 1200 miles away & she gave them our address. He has not wandered since but am now prepared.
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Reply to mlface
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My dad just started doing something similar. He "hears" the doorbell ring at 2 or 3 am. At first, I would hear him yelling my name on the baby monitor. I would go in his room and he would tell me that the caregiver has been ringing the doorbell. I would tell him the time and he would say "Oh!," and turn his head and close his eyes. Then things changed. Next I woke up hearing the house alarm say, "Front door is open." This happened three times, each time he would say someone was ringing the doorbell...all three times it was between 2-3 am. Fortunately, he has a gate around his front entry. I got a lock for the gate for nights. He is unable to climb over it, so that's one area that I feel comfortable. He could still escape a fire (unlike the childproof door handle). I have an alarm on his bedroom door that sounds in my room and is discreetly placed on his bedroom door. The house alarm is now set so if the exterior doors are opened, the alarm will sound. Ring is pretty inexpensive compared to other home alarms, maybe it's time for that sort of investment. I will admit, there was one time that I was asleep in the living room (prior to the alarms) and I woke up to my dad walking back inside the house at 2 am. That was my wake up call. I have my father registered with the local Sheriff's Department. They have a safe return program so if ever he gets out Day/night, they can check their system and contact me. Most police departments have a program for the elderly.
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