Alzheimer’s Disease & Home Safety

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Finding Support & Innovative Solutions


The Week ofAugust 26th isNational Safeat Home Week

“The home environment involves the needs, feelings, and

lifestyles of the caregiver, family, and the person with Alzheimer's Disease. Disability affects all family members,

and it is crucial to maintain your emotional and physical welfare

in addition to ensuring a safe environment.”

National Institute on Aging


Brainwriting is…• a fun, engaging way to brainstorm• sharing as many ideas as possible within a short timeframe Brainwriting Process• Listen for our questions• When prompted, enter your solutions using the webinar chat function• Don’t overthink or agonize…There are no right or wrong answers Brainwriting Outcomes• Peer-to-peer learning and sharing• A publication that benefits others who are living with Alzheimer’s Important• Avoid sharing any information that you would not want others to see

BRAIN WRITINGSolutions

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Our Goal for Today1. Empower those living with Alzheimer’s disease

2. Share common home safety challenges

3. Create a safe home setting that drives improved quality of life for all


Presented by:

Bridget Scheidler, OTR/L Fox Occupational Therapist Fox Rehabilitation

Keith Lerner Family caregiver

Chris Kelly, MEd Director of Learning & DevelopmentGriswold Home Care

Keith Lerner Family caregiver

Chris Kelly, MEd Director of Learning & Development

Lit Review

Social Media

Advocacy

Solutions Webinar & Toolkit


Thank you for your courage, energy, and dedication!

Professional CaregiversHealthcare Providers

Family Caregivers Clients


Alzheimer’s Disease is a brain disorder that can cause changes in the brain that impact…


…and cause life-threatening safety issues.

Judgment anddecision-making

About Alzheimer’s Disease & Home Safety

Orientation to person, place and time

Senses: vision, depth perception,sense of touch/temperature

Motor skillsand coordination

Memoryloss

??

?

Agnosia:Inability to Recognize the Purpose of Objects


“It is as if I have been taken to another

world where nothing makes sense. Everything looks foreign.

I know things should make sense – but they don’t. I stare at items

in the bathroom and have moments where I don’t

know what to do.”

- Person with AD


The Safety Challenge

Ingesting hazardousmaterials orchemicals

Fire hazards

Misunderstandingtraffic signals and

road signs

Eating/choking onnon-food items

Sources: http://www.amazon.com/books/dp/0306454602 http://www.ninds.nih.gov/disorders/brain_basics/know_your_brain.htm

Changes in the parietal lobe of the brain can cause agnosia. Safety issues can include:


The Emotional Side

People with Alzheimer’s Disease often feel...

Family/professional caregivers feel…

• Anxious, embarrassed, confused, isolated, depressed, loss of dignity, treated like a child

• Shocked, frustrated, confused, anxious, exhausted, isolated, depressed• Like they “can’t turn away for a second”


In the early and middle stages…

As AD progresses and reading is impaired...

Home Safety Solutions

Use written signs or labelswith short phrases in large print

Remove/hide all objects that could cause physical harm

Visit: http://1.usa.gov/16oTo3q to find a home safety checklist that you can use to ensure that each room of your home is safe.

- Lou Gehrig

“I just can't understand. I am not sick. My eye is sharp, yet I was not swinging as of old. I reduced the weight of my bat from 36 to 33 ounces, thinking a change might work to my advantage, but it didn't.”

- Lou Gehrig


Real Stories

Bridget Scheidler, OTR/L Fox Occupational TherapistFox Rehabilitation

Keith Lerner Family caregiverKeith Lerner Family caregiver


A Search forSomething Familiar

? ?? ?

Wandering: "These things can happen at any given time.

All it takes is a caregiver who’s working really hard, to turn

around for a second and the person can wander.”

- Beth Kallmyer Vice President of Constituent Services Alzheimer's Association



Traffic accidents

Changes in the prefrontal cortex, frontal lobe and hippocampus in the brain can cause wandering and pacing. Safety issues can include:

Hypothermia(during winter

months)Drowning

Missing importantmedications

Wandering by foot, car,train, bus or planeHeat exhaustion


Heat exhaustion FatigueWeight loss


Pacing is a repetitive symptom caused by restlessness. Safety issues can include:



The Emotional Side



• Anxious and confused • Shock, fear, frustration, confused• Exhausted – “can’t turn away for a second”


• Create a safe walking path• Set up “rummaging stations” with familiar work/ hobby-related items• In some cases, wandering can only be safely managed in a facility that offers a safe walking path


• Set up “rummaging stations” with familiar work/ • Set up “rummaging stations” with familiar work/

Visit: http://bit.ly/19vEMBv, http://bit.ly/18xJRol and http://bit.ly/1cgQDRL to enroll in programs that help to locate a person with AD who has wandered.


Real Stories




Depth Perception, Balance and Coordination

Falls: "Ever since my mother fell, I cannot get the sight and

sound out of my head. I feel like I can’t turn my attention away or sleep for a second. Of course,

this is impossible...but I try anyway.”

- Family caregiver



Changes in the frontal lobe, occipital lobe and cerebellum in the brain can cause falls. Safety issues can include:

Some people with AD are often driven to move


Other people with AD become weak from not moving due to other health conditions

Falls can lead to fractures and head trauma


The Emotional Side



• Afraid of falling again• Embarrassed• Fear of shiny floors• Fear of walking causes isolation

• Afraid of another fall, frustrated with loved one• Exhausted – “can’t turn away for a second”



• Occupational therapy (OT)• Physical therapy (PT) • Yoga/tai chi • Staying active can improve balance, strength and mobility• Talk to your healthcare provider prior to starting a new activity

Adaptive equipment can improve balance


Visit the following links to learn more about reducing the risk of falling:• http://bit.ly/14NSqhI • http://1.usa.gov/1daFEKV • http://bit.ly/1daFGCK


"Muscles don't get dementia. They can still be strengthened to prevent falls due

to weakness."My Past Is Now My Future: A Practical

Guide to Dementia Possible Careby Lanny D. Butler, MS, OTR


Real Stories



Vision, Judgement and Reflexes

Driving issues: “It was very difficult giving up things such as a car

when I’m still working…without my wife taking me to work in the morning and a driver taking me home in the afternoon, I would

be pretty much stuck in the house every day.”

- Person with AD, Voices of Alzheimer’s Disease, Alzheimer’s Association Town Hall Meeting




Changes in the prefrontal cortex, frontal lobe, parietal lobe and occipital lobes of the brain can cause impaired…

Depthperception Judgement


Reflexes

Insight into driving issues/ need to stop driving



When is a person with AD unsafe to drive?

Driving and AD combine to create a unique, challenging dilemma for…


• Law enforcement• Legislators• Driving testing centers

• People with AD• Family caregivers• Healthcare providers


The Emotional Side



• Driving is key to independence• They are safe to drive• Aware of their issues, but reluctant to “give up the keys”

• Concern about safety• Guilt• Frustration when person with AD lacks insight• Want someone to own responsibility

• Concern about safety• Guilt• Frustration when person with AD lacks insight• Want someone to own responsibility


Ask your healthcare provider about a comprehensive driving evaluation

Visit: http://bit.ly/17Q2fqy for a great guide to understanding and managing driving issues.



Real Stories

Keith Lerner - Family caregiverKeith Lerner

AdvocacyHome SafetyCare Team

It is important to surround yourself with experts in the fields of AD and Home Safety

Your care team should include: • Home Care

• Geriatric Care Manager

• Adult Day Care

• Family Doctor/ Nurse Practitioner• Occupational

Therapist

• Physical Therapist

• Visiting Nurse

• Advocacy and Support Groups



Support Groups Can HelpThe most practical home safety strategies can be found through support groups.

Here are links that can help you to find support groups in your area:

• http://bit.ly/17f6UVU • http://bit.ly/143u1Pm


Real Stories

Keith Lerner - Family caregiverKeith Lerner


Symptoms vs. Behaviors


We have avoided the term “behaviors” – This is intentional, because this term - although commonly used - alludes to intent or “misbehaving”. – When a person has chest pain due to heart disease, we use the term “symptom”. – When a person has shortness of breath due to lung disease, we use the term “symptom”. We should use the term symptom with Alzheimer’s Disease as well.

This will help to drive the empathy, patience, and accommodation that is key to care, support and quality of life for people with Alzheimer’s Disease and their family/professional caregivers.


Key Takeaways

Points to remember

The symptoms of Alzheimer’s Disease (AD) are caused by changes in the brain, and often create serious safety issues

It is important to surround yourself with experts and use proven home safety tools and approaches

There are things you can do to adapt the home setting to reduce the risk of safety issues and improve quality of life


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Alzheimer’s Disease & Home Safety