Mindfulness Meditation Helps Caregivers, Loved Ones Live in the Moment

Mindfulness training is a form of meditation that helps people reduce stress by focusing on the present moment. Studies show that this practice can benefit the health of family caregivers whose loved one has Alzheimer’s or a related disorder, helping them cope with the stress and depression that can weaken their immune system and raise the risk of many health disorders.

Northwestern University researchers recently showed that people with memory loss can also benefit from mindfulness training — and they can attend the same sessions as their caregivers. A group of patients and their caregivers participated in the study during which they took a class designed to meet the needs of both patients and caregivers. Participating patients had been diagnosed with Alzheimer’s disease, mild cognitive impairment, memory loss due to stroke, or frontotemporal dementia. The family members included spouses, adult children and in-laws.

Patients and caregivers alike gained individual benefits, and the training also helped with their day-to-day relationship. Mindfulness training was found to be particularly beneficial when it came to one major challenge of dementia caregiving: communication. Said study co-author Prof. Sandra Weintraub, “One of the major difficulties that individuals with dementia and their family members encounter is that there is a need for new ways of communicating due to the memory loss and other changes in thinking and abilities. The practice of mindfulness places both participants in the present, and focuses on positive features of the interaction, allowing for a type of connection that may substitute for the more complex ways of communicating in the past.”

Said lead author Prof. Ken Paller, “The disease is challenging for the affected person, family members and caregivers. Although they know things will likely get worse, they can learn to focus on the present, deriving enjoyment in the moment with acceptance and without excessive worry about the future. This is what was taught in the mindfulness program.”

The study appeared in the American Journal of Alzheimer’s Disease and Other Dementias.

Source: Illuminage Communications Partners reporting on study from Northwestern University. Copyright 2015 IlluminAge.

Top Ten Things to Discuss As Your Parents Grow Older

Discussing important and very private issues with loved ones who are growing older can be a challenge. Studies show that few families have these types of conversations until a major event occurs—a sudden health crisis, the loss of a spouse, or even a holiday visit by children during which it becomes apparent that Mom or Dad is having trouble living independently.

But waiting until a crisis occurs is not a good planning strategy. Although it is critical to bring up these subjects before a crisis arises, it’s best to keep the conversation casual. Don’t overwhelm Mom and Dad; let them feel your love and concern. And remember: helping your parents to plan for the future is not only important for their well-being as they age, but it will make a difference in your financial, emotional and physical health as well.

Topics to think about and discuss as a family:

  1. Living options—Do your parents want to stay in their current home as long as possible? Or are they considering “downsizing” or moving to a senior living community? Discuss what they would prefer if they were to experience a decline in health and need greater assistance with the activities of daily living. Home care? Adult day services? Assisted living?
  2. Home modifications—Is your parents’ home keeping up with their needs? What repairs and modifications could make their house, apartment or condominium safer and more convenient?
  3. A plan to stay physically active—Study after study shows that regular physical activity is the most important contributor to healthy aging. No matter what a person’s condition, adding exercise is of benefit. Encourage your loved ones to add more exercise to their lifestyle.
  4. A goal to remain socially connected—Meaningful social interaction is vital to the physical, emotional and intellectual health of people of every age. For most seniors, spending time with children is richly rewarding—but did you know that recent studies show that seniors who socialize not only with family members but also with non-family members have better emotional, intellectual and physical health?
  5. Estate planning—Do your parents have an up-to-date will? If their plan is to pass property to family members, have they talked to a financial advisor about the best way to do that? How can their assets help provide for their own care in case of a decline in health or incapacity?
  6. Advance healthcare planning—Have your parents completed advance directives for healthcare, including a healthcare power of attorney and living will? Have you discussed with them what their wishes are if they were to be incapacitated and unable to make their own healthcare decisions?
  7. Medicare, Social Security, VA benefits, retirement—Are your parents taking advantage of all the benefits available to them? Do they have the best supplemental Medicare policy? Part D drug plan? Do they know the deadlines to sign up for benefits in order to avoid penalties?
  8. Long-term care insurance—Many people erroneously believe that Medicare pays for a nursing home or home health care services. But in reality, long-term care is not covered by Medicare, and paying for it can quickly deplete financial resources. Investigate whether your parents are good candidates for long-term care insurance. And if they already have a policy, is it from a reputable company?
  9. Fall prevention—Especially if they have already experienced falls, many older adults are reluctant to discuss this topic. But did you know that fall protection is actually an important part of planning for the future? Falls are one of the leading causes of incapacity…and this is one risk factor for incapacity that we can take proactive steps to avoid.
  10. Avoiding crime and fraud—Unfortunately, criminals and con artists often target vulnerable seniors. Scams and unethical sales methods aimed at older people can cause serious financial loss. Seniors who have been victimized are often ashamed to discuss the incident. So bring up the subject and educate yourself and your parents about crooked sweepstakes, identity theft and unscrupulous salespersons.

These topic suggestions are intended to provide a framework for seniors and family members as they talk and plan together. And if the “teamwork” aspect isn’t working as well as you’d like, consider adding outside new members to the team! Your loved one’s healthcare provider, a geriatric care manager, financial planner or eldercare attorney can all provide valuable help and guidance.

Remember that you share a common goal in this planning: that you and your loved ones are able to live life as fully and joyfully as possible.

Source: IlluminAge. Copyright 2014 IlluminAge

Dining Out When Your Loved One Has Alzheimer’s

Most people with Alzheimer’s benefit from getting out of the house. Being cooped up all the time can lead to boredom, increased agitation and sleep disturbances. If your loved is in the earlier stages of Alzheimer’s and enjoys going to restaurants, and you are still comfortable taking him or her out to eat, here are a few tips to make the special meal even more relaxed and pleasant for everyone.

Choosing the eatery

Which restaurants has your loved one always liked? Familiar places may be preferable to a brand-new setting. Here are some things to consider:

Is the place too noisy—or maybe too quiet? Do they have a big-screen TV or loud music? This can be disturbing for people with dementia; hearing loss makes it even worse. On the other hand, many caregivers report that if a restaurant is too quiet or formal, they feel more self-conscious if their loved one talks loudly or makes unexpected comments. When tables are too close together, this can also make everyone uncomfortable.

Will you have to wait longer to be seated and served than is comfortable for your loved one? Is the waiting area chaotic or crowded? Can you make a reservation, and will the restaurant understand your situation and ensure that you are seated promptly? A place where service is relatively fast is usually better than one with a leisurely pace between courses.

Is the space suitable for your loved one’s mobility or sensory challenges? Are there stairs to navigate? If your loved one has difficulty walking, or uses an assistive device such as wheelchair or cane, select a restaurant that can accommodate them comfortably. Are restrooms accessible and easy to reach? A single-stall restroom provides privacy and convenience if you need to assist your loved one with using the toilet and adjusting clothing.

Does your loved one have food restrictions, such as low salt or low fat? Can the kitchen accommodate those special requests? Some offer detailed nutritional information; in others, servers are able to provide information about the ingredients of a particular dish. What about food preferences? Your loved one may be more sensitive to foods that are too hot, spicy or sour. Do they offer senior size or other smaller meals?

Is the restaurant well lit? This is a big consideration. Many stylish bistros feature mood lighting, which can put your loved one in a bad mood if they cannot see the table well. Low lighting also creates a fall risk.

Choosing the time

You know your loved one’s daily rhythms best. Is he or she most alert first thing in the morning? Brunch might be a good choice, and eateries tend to be less crowded early on. If your loved one naps, it might be good to go after he or she wakes up.

As with any outing, it’s best if you can be flexible as you plan a restaurant outing.  Is your loved one having a good day? Maybe this is a good time for an impromptu meal out! On the other hand, if you’ve planned to dine out but your loved one seems tired and upset, it’s better to postpone.

Other tips

It’s good to establish a relationship with the staff of an eatery if you’ll go there often with your loved one. An understanding and helpful server can help put your loved one—and you—at ease and help things go smoothly. Help the server know what your loved one needs, such as a bowl, extra napkins and spoons or filling glasses only halfway.

If your loved one won’t be able to read the menu, make suggestions of things they might enjoy to make selection easier. If the restaurant has an online menu, you might want to peruse that ahead of time and make your selection before you arrive.

Bring along items you might need, such as special utensils and serving ware that your loved one uses, a towel or wipes and any bathroom items.

Ask for a table in a quieter, out-of-the-way part of the restaurant, near the restroom if possible. It may help to have your loved one face away from the kitchen, front door and other more busy areas.

If the meal won’t arrive quickly, ask for a bread basket or an appetizer to be served right away.

Special venues for people with dementia

Food service research shows that the baby boomers and their parents are dining out more often than they used to; indeed, senior diners are the fastest growing group to take more of their meals out. More restaurants are focusing on the needs of senior diners.

In addition, many venues now offer special dining events for people with dementia and their caregivers. These “Alzheimer’s cafes” can be a lovely occasion to relax, make friends, and enjoy your loved one’s company in a nonjudgmental setting.

Source: IlluminAge. Copyright 2016 IlluminAge.

Pain Often Untreated in Seniors With Dementia

Older adults are apt to suffer from a variety of painful health conditions, including arthritis, osteoporosis, urinary tract infections, diabetic neuropathy, tooth problems, constipation and many others. It’s important to address this discomfort and work with the person’s healthcare provider to arrive at the most effective treatment for pain. Treatments might include medication, exercise and managing conditions that cause the pain.

But when a person also has Alzheimer’s disease or other dementia, it can be very challenging to realize that the person is in pain, and what is causing the pain. As Alzheimer’s and other dementias progress, patients lose the ability to communicate what they are feeling. Consequently, they may express pain in ways that aren’t readily understood by family or even by medical personnel—and their pain may go untreated.

People with dementia may express pain in nonverbal ways, such as wincing, shouting, rocking, eating or sleep problems, or aggression. According to experts from the University of Alberta, family often assume that these behaviors are just a part of their loved one’s dementia. Said the researchers, “It is important for those who live or work with persons with dementia to know how to identify when an elderly person is experiencing pain.” The University of Alberta team offers an excellent online tutorial for families; it can be accessed here; a simple registration is required.

Dr. Alexia Torke of the Indiana University School of Medicine calls for increased access to hospice and palliative care for people with dementia. Said Torke, “Although the general public and many physicians do not associate palliative or hospice care with dementia, dementia is a terminal disease and should be respected as such. Palliative care is needed throughout the illness and can provide those who are unable to communicate their needs with a better quality of life as well as lowering the stress the illness places on caregivers and the entire family.”

A recent study by University of California, San Francisco School of Nursing researchers sought to better understand the issue of pain in people with dementia. The team found that while pain in nursing home residents had been studied, little was known about pain treatment for people with dementia who live at home. Said lead author Lauren Hunt, RN, MSN, “As a hospice nurse caring for people in their homes, I have seen many patients with dementia who suffer from distressing pain. I was motivated to conduct this research study to understand the issue from the broader national prospective. It turns out that pain is very common in this population and is frequently severe enough to limit activities.”

The researchers reported that people with dementia actually are at higher risk of pain, with 63 percent experiencing “bothersome pain” and 43 percent having “pain that limited activities.” The team reported that access to treatment was a big hurdle; many of the patients found it difficult or impossible to get to healthcare appointments, and had little access to care at home.

The study, which appeared in the Journal of the American Geriatrics Society, called for increased awareness of this important issue. Said UCSF professor Dr. Alexander Smith, “The extensive challenges associated with the assessment and treatment of pain in older adults with dementia will require creative solutions from researchers, clinicians and policymakers to ensure pain is being adequately managed in this vulnerable population.”

Source: IlluminAge AgeWise reporting on studies from University of California, San Francisco, University of Alberta and Indiana University School of Medicine.

Five Fun Things That Offer Surprising Brain Health Benefits

Most of us know the importance of taking care of our brains through healthy eating, exercise and regular healthcare appointments. Neurologists also have found that regular mental stimulation lowers the level of harmful proteins in the brain that increase the risk of Alzheimer’s disease. Luckily, brain care isn’t just a matter of hard work. Many activities that we find pleasurable also stimulate the growth of new cells and connections in the brain.

  1. Music. Neurologists are learning more about the complex way music works across many areas of the brain. Music helps people with Alzheimer’s disease and brain injuries access memories and even remember new material. Recent studies show that taking music lessons when we are young may have a protective effect on our brains—but it is never too late to take part in this beneficial activity! Buy a harmonica, take piano lessons, join a community choir or load up your music player with interesting new tunes to give your mind a stimulating boost.
  2. Video games. Brain fitness programs are now a multibillion dollar industry. But even popular mainstream video games can be protective against cognitive decline. For example, a recent study in the Archives of Neurology showed that the wildly popular Angry Birds game provides a good brain workout. And researchers from North Carolina State University found that playing the World of Warcraft online role-playing game improved cognitive function in senior test subjects. Next time you’re tempted to chide your grandkids about their gaming, offer to join them instead!
  3. Dog walking. Contact with animals offers emotional benefits, encourages socialization and decreases stress. And dog owners have a built-in incentive to go for a brisk brain-boosting walk or two each day. Just a few precautions: the National Institute on Aging reminds seniors to stay safe during Fido’s daily constitutional: Dress in layers when it’s cold, bring water on hot days, and check for ticks after walks in the woods. A leash-training class for rambunctious dogs will help avoid falls.
  4. Do a good deed. We humans are wired to take pleasure in helping others. Now, neurologists have discovered that altruism—selfless acting for the good of others—is linked to greater longevity, a lower stress level and reduced depression. Dr. Stephen G. Post of Stony Brook University School of Medicine says that if there were a pill that provided the same results as doing good for others, “It would be a best seller overnight.”
  5. Bingo. Last but not least, a new look at an old favorite! Activities professionals who work in nursing homes and adult day centers sometimes complain about the “bingo stereotype,” but research from Case Western Reserve University shows that the game provides good mental exercise and improves thinking skills, even for players who have Alzheimer’s disease. So next time you call out B-I-N-G-O, remember that the real prize is a boost to brain health!

Source: IlluminAge. Copyright 2016 IlluminAge

Grieving for a Loved One Who Has Alzheimer’s Disease

One of the most common aspects of caring about someone who has memory loss is that grief comes in waves. The initial diagnosis can bring on anticipatory grief – feeling loss over the challenges that lie ahead. Then, as the disease brings about changes and challenging behavior in a long-familiar person, families feel the grief of losing a connection with someone who used to be so close.

These bouts of despair can be exacerbated because, for the most part, they are private moments. When a parent or loved one passes away, most people will experience an outpouring of love and support from friends, coworkers, and other family members. It’s much harder to tell someone, “My mom didn’t recognize me last night,” and harder still to get the same level of empathy and support, even though the feeling of grief can be just as profound.

Additionally, the gradual losses you experience may bring on mixed emotions, including anger, sadness, frustration and complete numbness. The first thing to know is that whatever you’re experiencing is normal. There is no wrong way to grieve. Fortunately, there are some things you can do to cope with the pain you’re feeling and to start healing.

Treat yourself with kindness. Accept that what you’re feeling is normal and give yourself permission to feel whatever it is you’re feeling. You may even experience anger at the person you love, feeling like they’ve given up on life or aren’t trying hard enough to be “normal” – and then feel guilty for having such thoughts. During these moments, recognize that what you’re experiencing is normal and that these feelings are a natural part of losing someone you care about.

Acknowledge your grief. Though there will be those around you who don’t understand what you’re going through, it’s important to acknowledge – at least to yourself – that you’re grieving. Consider a creative outlet – such as journaling, painting, or photography – to help work through the onslaught of emotions. Talk to friends and other family members and tell them how you’re feeling. Once they understand what you’re going through, they may be better able to help you through your grief.

Stay connected. Grief can be very isolating and often, one’s desire is simply to be alone. But healing is enhanced by sharing your experience with others. So, call up a friend or see a counselor. Consider joining a support group or join a support group. Being in the company of others who are experiencing the same emotions you are can be very healing, and you will also benefit by offering support to others. A good place to find a support group near you (or online) is the Alzheimer’s association (www.alz.org).

Take care of yourself. In the midst of grief, it’s easy to let other things slide – going to the gym and grocery store or even having coffee with friends. But one of the best ways to combat grief is to stay healthy, physically, emotionally, mentally and spiritually. It’s important to eat well, exercise, get enough sleep, socialize, and to continue to feed your soul – whether that means going out dancing, taking a walk through your local park or going to your faith community.

Get help. The above suggestions may be well and good, but many family caregivers are hard pressed to find any time to tend to their own needs. You can’t do this alone. Respite care is vital. Can friends lend a hand? What help is available from government and volunteer organizations? Consider an adult day center specializing in caring for clients with memory loss, which can can free up hours during the day where you can recharge your emotional batteries, and in the process be a better caregiver for your loved one.

Source: IlluminAge. Copyright 2016 IlluminAge.

Healthier Heart and Lungs, Healthier Brain?

We’ve learned a lot about brain health during the past decade. We know more about things we can do to lower the risk of Alzheimer’s, stroke and other conditions that threaten cognitive well-being. Positive lifestyle choices include good nutrition, getting enough sleep, reducing stress, protecting ourselves from head injury, and taking part in mentally stimulating activities.

And on the very top of that list is to stay physically active. For years we’ve known about the important benefits of exercise for our hearts and lungs. And research continues to confirm that what benefits the heart and lungs also benefits the brain.

In November, a University of Illinois study added to our understanding of the complicated relationship between having a healthy heart and lungs and a healthy brain. The research team, headed  by researcher Michelle Voss, compared the brain health and cardiorespiratory health of a group of young and older people.

They measured brain health by using brain imagery (functional magnetic resonance imaging) to measure the strength of connections between different parts of the brain. Cardiorespiratory fitness was determined by how efficiently a person’s body used oxygen during physical activity. They found, as expected, that the brain connections were stronger in younger people. They also showed that among older people, those who were physically fit also had stronger brain connections.

Unfortunately—or fortunately, depending on your genes—when it comes to the amount of activity needed for cardiorespiratory fitness, it would seem that there isn’t a level playing field. The University of Illinois team report that some people can maintain better fitness than others, regardless of activity level. Said Voss, “The idea that fitness could be related to brain health regardless of one’s physical activity levels is intriguing because it suggests there could be clues in how the body adapts for some people more than others from regular activity.”

This doesn’t mean that some people can be complete slackers, though. Exercise has brain benefits for everyone. According to Voss, who is currently an assistant professor at the University of Iowa, “An encouraging pattern in the data from our study and others is that the benefits of fitness seem to occur within the low-to-moderate range of endurance, suggesting that the benefits of fitness for the brain may not depend on being extremely fit.”

Almost everyone can take part in an exercise program, no matter what their physical and cognitive condition. A good brain-protective exercise program includes aerobic, muscle-strengthening, flexibility and balance training activities.

Talk to your healthcare provider about an exercise program that’s right for you. Lace up your sneakers and build up your brain!

Source: IlluminAge AgeWise, with material from University of Illinois. Brain Awareness Week is sponsored by the Dana Foundation (www.dana.org/BAW).

Improve Memory By Spring Cleaning Your Mind

Those little memory lapses we experience as we grow older can worry us. We’re introduced to someone but promptly forget their name. We look all over the place for our reading glasses, only to realize they are perched on our head. We save a document, but forget into which folder.

We might joke about “senior moments,” but of course, we worry. Could we be developing Alzheimer’s disease or another condition that affects our thinking and memory? The good news is, in most cases, memory lapses like this are perfectly normal as we grow older, representing an age-related change in memory function that begins around age 40. And we can take comfort in the fact that, in some respects, older brains are even more competent, with more of the qualities that we think of as “wisdom.”

Part of the problem, say experts, is that we simply have more information stored in our brains! It takes a little longer to find a piece of information as we accumulated a lifetime of memories.

Another change to be aware of is that our brains are less able to filter out “static” and clear out previous memories as we grow older. Multitasking becomes more challenging. An experiment performed by Concordia University in Quebec asked older and younger test subjects to perform a working memory task that included recalling and processing different pieces of information. Participants were shown a set of images and instructed to respond to each image in a certain way. The younger participants outperformed their older counterparts, because the seniors were more likely to offer the response that was appropriate to a previous image.

Head researcher Mervin Blair reported, “Basically, older adults are less able to keep irrelevant information out of their consciousness, which then impacts other mental abilities.”

What can seniors do to enhance short-term memory? Blair, who is now serving as a neuropsychology fellow at Parkwood Hospital in Ontario, suggested that focusing and reducing “mental clutter” may help. “Reduce clutter,” he said. “If you don’t, you may not get anything done.”

Here are five techniques that can help clear the clutter:

  1. Practice “mindfulness.” Take a class in meditation, listen to a relaxation tape, or try yoga or tai chi. These techniques can help even chronic multitaskers turn off a racing mind and focus better on one thought at a time.
  2. Turn off your gadgets. Nothing overloads our brains so much as our little electronic leashes that interrupt us in the middle of one task to focus on another. Go ahead, power down your smartphone for an hour—you’ll survive! And unless you are really paying attention, turn off the TV and radio talk shows. There is no use in adding a competing information stream.
  3. Listen to music to relax. Music can help us banish unwanted thoughts. To promote a tranquil state of mind, pick music that is calming and soothing. No matter what type of music you like, there are choices that will help you unwind.  But here’s an important caveat: as we grow older, it’s harder to filter out background sounds. If you’re trying to concentrate on something, it’s probably best to turn off the music. Teens can study while music blares; older adults, not so much.
  4. Write things down and put them aside. Are you fretting about tomorrow’s tasks even though there is nothing you can do about them today? Do you work problems over and over in your mind, obsess about past events, or compile an ever-growing mental “to-do” list? Keep a notebook where you can write down the thoughts that are swirling around in your head. The list will still be there when you need it.
  5. Get some exercise and spend some time in nature. Physical activity is a great way to clear the mind, and spending time in green spaces provides a calming sense of perspective. Much research in “ecopsychology”—the relationship between human beings and the natural world—shows the benefits of being outdoors, whether it’s a walk in the woods or a cup of tea in the garden.

With a little practice, you’ll be able to move some of that useless clutter out of your mind, leaving room for things you really need.

If you continue to have concerns about your memory, be sure to discuss this with your healthcare provider. Early diagnosis of Alzheimer’s disease and related conditions allows for the best possible treatment to slow the progression of memory loss. And it’s important to rule out reversible conditions that affect the memory, such as depression, chronic stress or the side effects of medications.

Source: IlluminAge AgeWise

What Values Are Important for People With Alzheimer’s Disease?

Loved ones who suffer from mild to moderate dementia and their family caregivers often have different perceptions regarding the amount and quality of care given and received. A study by researchers at Penn State University and the Benjamin Rose Institute on Aging examined a major source of those differences: Caregivers may not understand the things that are important to their relatives with dementia.

“Family caregivers often become the surrogate decision makers of relatives who have dementia, so the two groups need to communicate well and understand each other,” said study leader Steven Zarit, head of the Department of Human Development and Family Studies at Penn State. “Unfortunately, in our study we found that family caregivers and their relatives often do not understand each other well when it comes to the values they hold about giving and receiving care.”

The team interviewed 266 pairs of people, each composed of an individual with mild to moderate dementia and his or her family caregiver. To participate in the study, caregivers had to be the primary family caregiver of the dementia patient and the dementia patient had to be living in his or her own home.

The researchers interviewed members of the pairs separately, asking questions related to how much worth they placed on five core values: autonomy, burden, control, family and safety. For example, one question focused on the level of importance the dementia patients placed on the ability to spend their own money in the way they wanted.

“Our results demonstrate that adult children underestimate the importance that their relatives with dementia place on all five core values,” said Zarit. “For example, the person with dementia might think it is very important to continue to be part of family celebrations, but his or her caregiver might not.”

According to Zarit, a major reason for differences in these perceptions is that caregivers come to view people with dementia as unable to make their own decisions about daily life. “That is something that does happen as the disease progresses, but the people in our study remained capable of making decisions for themselves and could express their values in a clear and direct way,” said Zarit. “Caregivers who still saw the person with dementia as able to direct his or her daily life were also more in tune with that person’s values and beliefs.”

Source: Penn State University. This work was supported by the Administration on Aging, the Robert Wood Johnson Foundation, the AARP Andrus Foundation, the Retirement Research Foundation, the National Institute of Aging and the National Institute of Mental Health.

When People With Alzheimer’s Disease Wander

Wandering is one of the greatest challenges faced by family caregivers whose loved one has Alzheimer’s or other memory loss. Over 60 percent of Alzheimer’s patients will become lost at some time. Most are gone only briefly, though long enough to frighten their loved ones. Others may be lost for an extended period of time, and unfortunately, there are news reports each year of missing Alzheimer’s patients who are never located. It is a sobering fact that if a person with dementia is lost for over 24 hours, he or she is likely to suffer a fall or other serious injury, or even death from injury or exposure. Reports one family caregiver, “The thought that Dad would climb onto a bus at the corner and we would never find him again keeps me awake at night, even on nights when he is getting a good night’s sleep.”

Why do people with dementia wander?

For people with Alzheimer’s or other memory loss, confusion and disorientation make it increasingly difficult to recognize familiar faces and places, even a spouse or child, or a lifetime home. Geriatricians point out that the term “wandering” is something of a misnomer, because many times, in the person’s mind, his or her activity is not purposeless. She may be looking for the bathroom but be unable to find it. He may think it is time to leave for work, even if he retired years before. A great-grandmother might be searching for her children, in the belief that they are still small and in need of her care.
Other factors that contribute to wandering include restlessness, agitation and stress; boredom and lack of a sense of purpose; sleep disorders; physical pain; and the side effects of medications.

Keeping loved ones safe

When a loved one with dementia wanders, family often decide that a nursing home or other residential memory care is the best choice for the person. However, many patients fare much better at home, in familiar surroundings. How can families keep their loved one safe at home, for as long as possible? Here are some strategies recommended by professionals:

Observe your loved one’s patterns. The first step is to understand as best you can the reason for your loved one’s wandering. What are his “triggers”? Where does he usually try to go? During what time of day is he most restless? Does he seem to be looking for something, someone, or someplace?

Adapt the home to keep your loved one safe. Beyond the usual “aging in place” home modifications, you can add special locks to doors, safety gates to prevent exit, and an alarm that will sound if the front door is open. See the resources at the end of this article for information about other home modifications.

Be sure your loved one always carries ID, and a medical alert to tell others he has memory loss. If he doesn’t consistently carry a wallet, try a bracelet, pendant, or clothing labels. Contact your local Alzheimer’s Association office to learn about their Safe Return program. In addition, more and more families are also using a GPS or other tracking device to help locate loved ones quickly.

Notify neighbors and local merchants about your loved one’s condition. Ask them to contact you if they see your loved one alone when he shouldn’t be. Having this conversation with you makes it more likely that others will recognize the problem and feel comfortable getting involved.

Find out if your state has a “Silver Alert” program, similar to the “Amber Alert” for missing children. As law enforcement agencies recognize the needs of growing numbers of adults with dementia, more states are implementing this broadcast notification system.

Try “behavior modification” strategies. If your loved one expresses feelings of being lost or abandoned, reassure him he is safe. Redirect him to safe activities that fill his need for a sense of purpose. If “sundowning” (restlessness at night) is a problem, limit daytime naps. Dementia-care professionals have found that “correcting” a dementia patient frequently can increase agitation. “Don’t correct—redirect” is their guideline.

Have your loved one’s medications reviewed. A person with Alzheimer’s may take medications for the disease itself, for mood or other behavior changes, and for other medical conditions they might have. It is important to take medicines correctly, and it is just as important to be alert for side effects that might increase wandering and other difficult behaviors.

Provide appropriate activities to reduce boredom and isolation. Boredom is stressful for people with dementia, and increases wandering. Art activities, crafts, household tasks, singing, cooking simple foods and socializing all promote well-being and a sense of purpose, which makes it less likely that your loved one will wander.

Get the help of professionals. Family caregivers need a break to renew their energy and take care of other responsibilities. In the earlier stages of the disease, home care or an adult day center can be a good choice. As the disease progresses, a residential care community specializing in care for residents with memory loss is often the safest choice, providing condition-appropriate activities, socialization and supervision for people with Alzheimer’s and related conditions.