"Prudentialism is a moral principle based on precautionary principles that are acting to avoid a particular negative effect."
Recently I noticed a woman walking aimlessly near my home. As I watched her amble in the cold and fading daylight I realized that it was an elderly neighbor from a couple of blocks away. I knew her. She was a college friend of my mother's and like my mother has Alzheimer's disease. This is not someone who should be wandering alone so I gingerly approached her, introduced myself to her and asked if I could help her. She graciously refused my assistance explaining that she was out for a walk. "I'm fine" she proclaimed in a thin voice, "I'm not ready to go home".
I didn't want to scare or upset the wandering neighbor. This is not the first time I have seen her out and about. I know her husband is also up in years but I also know that they have a caregiver. I called their home and explained to the husband that I had seen and talked with his wife but she refused my help. He thanked me and said that they were looking for her and would take care of bringing her home.
Shortly thereafter I got a call from a police officer asking me where I had seen the neighbor as he was helping to locate her. Later I got a call from the husband to let me know the wanderer was home and to thank me once again.
This time there was a happy ending. I'm still worried about their situation because what will happen the next time if they don't make any changes to their environment.
"Roaming" is a particularly frightening problem with dementia patients but it is only one of many serious yet preventable dangers not only for dementia patients but for the elderly at large. There are many tricks, aids and gadgets to solve the common threats. The time to become familiar with them is before you need them. The time to implement them is also before they are needed.
The issue of roaming can be easily addressed both for prevention and recovery. For prevention, there are inexpensive electronic alarms that can be placed on exit doors. You can even place them on internal doors for nighttime monitoring within the home. These simple, battery powered alarms sound if a door is opened to alert you. They can be purchased over the internet, from your local Radio Shack and even from "As Seen on TV" at your local mall.
Recovery devices are more expensive but there are GPS services available. The patient wears a bracelet with a GPS device that you can track from home.
Safety in the home:
The average home is filled with hazards. Danger lurks around every corner. The first danger to address is the one place we should all feel safest: the bed. I have heard so many stories from fellow caregivers about parents falling out of bed. Some have found a parent on the floor hours or even days after the fall. If your love-one isn't ready for a full hospital bed you can easily and inexpensively outfit a normal bed with side-rails. They can be found at stores that sell infant and children's furnishings, major chain toy stores, on the internet and through surgical supply stores. They are simple to install and to use and worth any cost to prevent injuries.
If the patient is still self-ambulatory it is imperative that you install rails at key locations around the home. Showers, toilets, stair landings and near entry doors. These may require pro installation but they are a must.
Stairs pose a particularly worrisome challenge. There is a remedy. It is costly but effective and safe. It will extend the time your loved-one can safely move about the house, prolonging "normalcy". It is the stairlift. They can be either purchased or rented and there are many styles to suit your needs and your home. We have had ours for over 10 years and it was well worth the investment. These are available from specialty sources which can be found on the internet or in your phone directory yellow pages.
The next item may seem daunting but it for the benefit of both patient and caregiver. The Hoyer Lift. This is a pneumatic winch and sling system used to lift and transport a bed-bound patient. The patient can be lifted in either a seated or prone position. One person can easily lift the patient for bed changes or to aid in transport from bed to chair, etc. This has been a back-saver for me and I think my mother actually enjoys the ride. Medicare will pay for this rental if it is medically prescribed.
Of course there are also small precautions to be taken such as removing obstacles and scatter rugs. Another precaution is to check the temperature of your hot water. Make sure it is not hot enough to scald if the patient dials it up to high.
Please evaluate your home or your loved-ones' home and make any improvements you think are necessary. This will save you hours in the ER as well as fending off feelings of guilt.
"An ounce of prevention" really is "worth a pound of cure".