Helping people diagnosed with Alzheimer’s in case of emergency

By Micha Shalev

People with dementia are especially vulnerable to chaos and emotional trauma. They have a limited ability to understand what is happening, and they may forget what they have been told about a particular disaster. First responders, neighbors and family members assisting with an evacuation should be alert to potential reactions of someone with dementia in disaster situations.

If you’re faced with a disaster like Hurricane Sandy, a tornado or a major earthquake, what’s the best plan for helping a loved one with Alzheimer’s? Even for those of us who don’t live in hurricane territory, the devastating effects of recent storms should serve as a valuable reminder: disasters can pose a special set of challenges for caregivers. A clear action plan for helping people with Alzheimer’s can make disaster preparedness easier for both caregivers and their charges.

1. Plan ahead

• Write an emergency checklist and keep it in an easy-to-remember location.
• If your loved one with Alzheimer’s is living alone, arrange for a family member or neighbor to assist them during a disaster.
• Familiarity is key – remember that it can be difficult and disorienting for someone with Alzheimer’s to cope with a stranger coming into their home.
• Know where the gas and water valves are in their home, and how to turn them off.
• Keep a list of prescription medications and know where they’re kept in the house.

2. Keep calm

• For best results in communicating with someone with Alzheimer’s during an emergency, stay calm and try not to appear frantic.
• Don’t talk directly about the disaster. People with Alzheimer’s are likely to pick up on your distress without understanding the situation itself. In such cases, they may react by wanting to stay where they are, in a familiar environment, rather than going to a safer location.

3. Stay positive

• Help the person envision something that delights them, or encourage them to picture a favorite family member or activity. Then use that vision as an enticement to leave the house. For instance, if your loved one has a grandchild, you could say, “We need to go see the grandbaby—let’s go.”
• Another way to increase the responsiveness of someone with Alzheimer’s is to focus on how they can be of help to you, instead of the other way around.

4. Focus on the person

• Focus on getting your loved one out of the house first, especially if gathering up belongings in front of them would disturb the person. Gather the items out of view, go back for them later, or ask a friend or neighbor to help.
• Some important items to gather: copies of crucial documents, insurance cards, address book, clothes the person likes, favorite items such as a coffee cup or photos, a favorite blanket, any valuables they worry about being stolen.

5. Be patient

• Don’t be surprised if your loved one repeats information about the disaster. They may become glued to the television, but not understand the time frame of the emergency. Try turning off the TV or finding something else to watch.
• You may find that your loved one asks you to explain the situation over and over, especially if they don’t remember what you’ve already said. Be patient with their concern.

During an episode of agitation:

• Approach the person from the front at eye level and use his or her name.
  • Use calm, positive statements and a patient, low-pitched voice. Reassure.
  • Respond to the emotions being expressed rather than the content of the words. For example, say, “You’re frightened and want to go home. It’s OK. I’m right here with you.”
  • Don’t argue with the person or try to correct them. Instead, affirm his or her experience, reassure and try to divert attention. For example, “The noise in this shelter is frightening. Let’s see if we can find a quieter spot. Let’s look at your photo book together.”

Of course, it’s always possible that someone may not want to leave their home. In cases when your loved one isn’t responding rationally, be prepared for the possibility that you may have to physically remove them if their safety is at issue. Make sure to consult the primary care physician, mental health director or local social workers about steps to be taken to minimize any transfer trauma.

Micha Shalev, MHA CDP CDCM CADDCT, is the co-owner of The Oasis at Dodge Park, Dodge Park Rest Home and The Adult Day Club at Dodge Park located at 101 and 102 Randolph Road in Worcester. He holds a master’s degree in healthcare management and is a graduate of the National Council of Certified Dementia Practitioners program and a well-known speaker covering Alzheimer’s and dementia training topics. He can be reached at 508-853-8180 or by email at m.shalev@dodgepark.com. View more information online at www.dodgepark.com.