For many seniors, getting to a regular doctor can be an exhausting and daunting experience, especially as they are rehabilitating from a recent illness or coping with a decline in overall health. Many seniors and their families are not aware that there are physician practices that make housecalls, accepting Medicare assignment Medicare supplement insurance plans. The cost is comparable to a regular office visit and the physician comes to your home equipped to treat virtually any medical problem that would bring you to their office or an emergency room.  Mobile medicine means that most blood tests, x-rays, EKGs, etc. can all be done in the comfort of your own home. Often, seniors are hospitalized for treatment that can very successfully be conducted in their own home, many times with fewer complications and less chance for infection. One example of this would be the treatment for pneumonia, typically a week’s stay in the hospital.

You don’t have to give up your regular physician.

Having to give up your physician is a very understandable concern. Many seniors mistakenly believe that by accepting the care of a mobile physician, they will be giving up their primary care doctor. In reality, the housecall benefit will apply for as long as getting to your regular doctor’s office is unreasonably difficult. When you are able to make it to your regular doctor again, there is no need to ‘switch back’ to your regular physician.

Plan ahead.

Trying to set up services during a crisis can be difficult and stressful. Before you need services, locate a mobile doctor practice in your area and register with them. Work with them ahead of time to determine what your insurance covers, what copays (if any) you can expect and the usual response time you can expect. Many mobile home doctors can respond fairly quickly and this is expedited if all paperwork has been taken care of ahead of time.

It is important to note that these services are not a replacement for true 911 emergencies, however they can be so valuable for chronic or urgent care situations.

Submitted by Gabriela F. Brown, CSA
Constant Companions Home Care, San Diego and S. Riverside
P:888.883.8393
T:@ConstCompanions
email: gbrown@constantcompanions.net
Web: www.constantcompanions.net

Nearly half (53%) of all informal caregivers reporting a decline of health
affecting their ability to provide care.  In an effort to be there for the health
of a loved one, many caregivers sacrifice their own health

Caring for an aging loved one can be a challenging experience. It can be difficult to
slowly watch a family member lose their independence and often, their mental
capacities. More often than not it is a middle aged family member who takes on
the responsibility of being the primary caregiver for their parents. Without
additional support, this caregiver can quickly find themselves overwhelmed and
depressed. While many caregivers find themselves up for the challenge, others
may find it more difficult to adjust to the constant demand of being a home
care provider.

Stress and depression can come in many forms. Often, caregivers have to take a leave of absence from work, or they have to cut back their hours to be at home more often. As a result, both parties have to sacrifice and do without. The
loss of monthly capital can lead to stress as it becomes harder to pay the
monthly bills. Additionally, the loss of personal interactions with colleagues
in the workplace can leave a caregiver feeling lonely and isolated. Managing
one’s family can also be difficult and being a caregiver can also lead to
stress in the marriage and immediate family. To avoid sacrificing one’s health
and family for the care of a family member, a caregiver must provide care for
themselves first so they may be able to care for another

There are various ways for a caregiver to stay positive during the time they spend caring for someone. Rather than feeling trapped, a caregiver should do their best to encourage social interactions for both themselves and their aging parents or patients. Dinner socials, poker/bridge nights, and birthday parties should all be encouraged to maintain a festive attitude throughout the home, and to avoid it from feeling like a prison. Maintaining a clean home can help keep good spirits and inviting visitors will
give you a good reason to clean and to stay positive. The caregiver should also make an effort to invite their family to these events to help maintain closeness and to promote family interaction during this time of change.

While maintaining social interactions can help a caregiver stay healthy, many others find success by turning inwards and focusing the time on improving themselves. Some may choose to take up a hobby or learn a new skill, while
others may choose to begin an exercise regimen to improve their own health.
This can be light to moderate exercise; just enough to get your blood pumping.
Feel free to invite your aging family member to also get moving as much is
safely possible. Regardless of age, most seniors can benefit from staying
active.

Submitted by Gabriela F. Brown, CSA
Owner, Constant Companions Home Care
Website: http://www.constantcompanions.net
gbrown@constantcompanions.netPhone and Fax: 888.883.8393

Last year, I received a call from Sharon, the adult daughter of a potential client, Bette. Her father, Burt, had passed away a little over a year ago from an extended battle with cancer and Bette had been his primary caregiver.  Until his passing, Bette was
mobile, energetic and rarely sick. Once Burt passed away, Bette became a ‘different person’ rarely leaving the house. Her sunny, upbeat disposition had turned into an apathetic approach to everything and everyone in her life.

Sharon shared that she admired her mother more than anyone she had ever met for being able to ‘handle anything’. She had always met life’s challenges with strength and
optimism, being able to formulate a plan to overcome any obstacle put in her way. Now, she was little more than a shadow of her former self and unable to properly maintain the house, herself or any of her relationships. Sharon was concerned because she was unable to ‘snap out of it’ and Bette was beginning to decline physically.

Because Sharon’s life was so hectic, she felt terrible that she could only get over to her mother’s house a couple of times a week, and when she got there she was overwhelmed with what needed to be done, grocery shopping, cleaning out the fridge, making sure there was easily accessible meals to be prepared and questioning whether she was taking her medications as prescribed, etc. The house itself was also being neglected severely, with the bare minimum being done to keep things going.

While both Sharon and Bette would benefit from a home care worker, there were deeper issues that needed to be addressed. Bette had been the primary caregiver to her husband of 60+ years as he lost the battle with cancer. She had focused all of her energy and purpose into his care for several years. When he passed away, Bette faced a dual life transition. She had lost her life status as a caregiver and she was no longer Burt’s wife of 60+ years. With his death she was faced with excruciating loneliness and loss of purpose.  Her family had been there for her right after his death to help but had assumed that she was adjusting well and would be able to handle things. A year later, it was clear that what may have started out as a normal bereavement and grief period had extended beyond a healthy timeframe. At this time, she felt dependent on her family for care and this new dependence pushed her even deeper down.

It is not uncommon for the ‘strong and capable’ family member in this situation to experience depression due to their history of being ‘strong and capable’. Often, those around them and they themselves have the expectation that after a ‘normal’ period of time, they will ‘pull themselves up by their boot straps’, as they always have. Paradoxically, this is the person that is least likely to ask for help may be suffering silently. It is as if they are unable to see themselves as needing any help or being unable to ask for it. Additionally, physicians tend to overlook signs of depression with seniors and many assume that depression is a normal part of loss. Old assumptions and patterns are tough to overcome.

After speaking with Sharon, I advised her to make an appointment immediately with Bette’s physician regarding her decline. She also had to have a gentle talk with her mother about the possibility of being able to see a brighter world through possible interventions of medication and counseling.

We did provide a caregiver for Bette for about 4 months. In the meantime, Bette’sdoctor found the right medications and she participated in support groups. After a while, Bette turned the corner and was increasingly able to care for herself and her home again. She now does her own grocery shopping enjoys making her meal and even invites others, primarily from her support group, over for meals. Now, when her family visits, they are able to enjoy her company and provide the companionship that only family can provide. They no longer are in the role of caregiver, which is really helping to restore Bette back to her old self.

Every bereavement experience is unique, but if you have aloved one that is not improving after about two months, a visit to their physician may be in order in addition to grief counseling. Counseling and/or medications can make the fog of depression lift allowing them to slowly begin to feel pleasure and purpose again, the two reasons we ALL need to lead a satisfying life.

Submitted by Gabriela F. Brown, CSA
Owner, Constant Companions Home Care
Website: http://www.constantcompanions.net
email: gbrown@constantcompanions.net

Here are some key tax points to consider:

1.Claiming your parent as a dependent. You must be paying more than half the cost of your parent’s care. If qualified, there’s a reduction of your taxable income. Your parent does not have to live with you. But to qualify, your parent’s annual income must be less than $3,700. See IRS Publication 501: Exemptions, Standard Deduction, and Filing Information for more details.

2.Claiming modifications to your home. You may claim a medical expense for modifications made to your home in order to accommodate their medical needs. However, your parent must have been your dependent at the time (either expenses were paid or medical services were rendered). Be sure to consult your tax professional as other rules apply to claiming modifications as a medical expense.

3.Deducting the costs for medical expenses. If you are able to claim your parent as a dependent, then the IRS may allow you to claim a deduction of your parent’s medical expenses. The expenses for your parent’s medical care must exceed 7.5 percent of your adjusted gross income to qualify.

4.Deducting the costs for assisted living or in-home care. For your parents to qualify for tax considerations, a licensed health care practitioner must have formally determined during the last 12 months that your dependents are unable to care for themselves. It’s important to meet with a tax preparer to go over all of the requirements of deductions associated with your parent’s care. Remember, in each case, you must provide adequate documentation for the IRS to qualify. Taking care of your parents can be challenging. Knowing that you can ease your own burden come tax time makes it easier to opt for the right level of care for the ones you love.

Source: ElderCarelink.com

Submitted by Gabriela F. Brown, CSA

gbrown@constantcompanions.net

www.constantcompanions.net

Most senior home care service companies do their best to assure that the personnel that they are sending into your home are honest by conducting background and reference checks. Here is the problem, background checks are great for weeding out the prior offenders, however, no background check can detect if someone has never been caught or predict if they are going to steal in the future. Simply put, there is no way
to guarantee that you will not be a victim of theft or financial abuse.

There are things that you can do, BEFORE a crisis (right now) to prepare yourself:

1. Locate all valuable items, i.e., jewelry, checks, credit cards, etc.  Inventory what you have and identify if you are currently missing something. This will prevent confusion after the fact if you go look for something and it isn’t where you thought it was.  Why? We once had a client who insisted that she had left some diamond earrings in her bathroom. She accused her caregiver of stealing them. Of course, we immediately removed the caregiver and reported the worker to Adult Protective Services.  Two months later, we received a call from her daughter, apologizing that her mother had found her earrings in a different spot and hadn’t recalled moving them there.
2. Once you do need someone caring for you at home, secure all financial instruments and jewelry in a lock box in your home. Put the key where only you would know where it is and give a copy of the key to a trusted individual or in a safety deposit box.
3. Never give your PIN to anyone in your employ.
4. Never allow anyone to go to the bank for you to take out cash, via check, etc.
5. Report all suspicions or missing items as soon as possible to any company coming in and out of your home. If you are working with a home care agency make sure they are responsive to your concerns and act quickly to resolve the issue.
6. Do not give cash or check bonuses directly to home care workers, make sure that the agency they work for is notified and has an opportunity to copy the bonus check and document the gift to avoid any future misunderstandings or opportunities for financial exploitation.
7. If a caregiver asks you for money directly for ANYTHING, immediately report it to their agency. As benign as this may seem, it is considered ‘abuse of
   position’ and is covered under the law as follows:

Financial Exploitations –Financial exploitation means a situation in which a caretaker or any other person who is in the care or custody of, or who stands in a position of trust
to, a resident, takes, secretes, or appropriates their money or property, to
any use or purposes not in the due and lawful execution of his or her trust. In
the simplest terms, the person who is acting as a caretaker unlawfully takes
money or property of the resident. This also includes a request for transfer of
property by the resident that was not carried out.

Most caregivers are good people interested in your well-being. They are also
hyper-aware that they are most likely to be blamed if something goes missing in
your home. If you follow the above guidelines, it should protect both you AND the
people working for you.

If you find that you are a victim of financial abuse or theft, PLEASE follow through with filing a complaint with Adult Protective Services and any charges against the person suspected of committing the crime. It is up to you or your family to see that charges are filed. This may be very uncomfortable and stressful but it is VITAL. Without convictions and a subsequent record to detect on a future background check, there is nothing to
prevent that same person from moving on to another agency or to hire themselves
out privately and continue their predatory ways.

Submitted by Gabriela F. Brown, CSA, Owner of Constant Companions Home Care, San Diego and S. Riverside. Website http://www.constantcompanions.net email: gbrown@constantcompanions.net

Nearly one-third of people over the age of 65 are
hard-of-hearing while nearly 50% of people over the age of 85 suffer from some
form of hearing loss. Because hearing loss is usually a gradual process that
begins in one’s forties, it is commonly not recognized until it is significant.
It is important to be able to recognize signs of hearing loss, have it
diagnosed and treated.

Symptoms of hearing loss:

• Have trouble hearing over the telephone

• Find it hard to follow conversations when two or more
people are talking,

• Need to turn up the TV volume so loud that others complain,

• Have a problem hearing because of background noise,

• Sense that others seem to mumble, or

• Can’t understand when women and children speak to you.

Hearing loss in seniors can lead to others mistakenly
thinking that seniors are confused, difficult or apathetic. Additionally, the
senior may be embarrassed by the loss and resist seeking out medical help. The
inability to fully communicate can lead to frustration and isolation. The key
here is communication and enlisting the following strategies to bring these
seniors back into the conversation:

• Make sure that you are looking at the listener and you are
in a well-lit area.

• Don’t shout, this can often create increased sound
distortion.

• If there are 2 or more people present, make sure that only
one person is speaking at a time.

• Address them directly by saying their name before starting
a conversation so they have time to focus.

• Many people with hearing loss rely on lip-reading. Keep
your hands away from your mouth and avoid smoking, chewing gum or eating while
talking.

• Slow down a little but not too much. A natural and
unhurried rate of speech allows the hearing impaired person to capture more
words, read lips and facial expressions.

• If one ear is better than the other, make sure you are
directing your speech to the better ear.

• Hearing loss can include certain sound distortions. They
may hear your voice but not be able to decipher certain words or pitches.

• Minimize extra noise in the environment when have a
discussion, like turning the TV or dishwasher off.

• If possible, avoid having discussions in settings that may
have sudden loud sounds like busy streets, near construction areas or near
airports.

• Depending on the level and type of hearing loss, certain
words are almost impossible to understand, try rephrasing the sentence or find
a different word. Don’t repeat the word or sentence over and over again.

• Avoid sudden changes of topic. When the subject is changed
clearly state the new topic and look for acknowledgement before proceeding.

• Write specific information, such as appointments,
directions and schedules down, if you are talking over the phone, have them
repeat the information back as many words and numbers sound similar.

• Understand that illness or tiredness may affect any person’s
ability to follow a conversation.

• If the listener looks confused, clarify that they
understood what you were saying.

The best course of action to take if you suspect hearing loss
is to see a doctor as soon as possible to determine the cause and treatments
available. If you suspect hearing loss in a senior that you are caring for or
that you care about, remember to be compassionate about discussing the
possibility of hearing loss. It is important to be supportive regarding the
options and opportunity for treatment. Motivation for the decision to seek
treatment should be to increase their quality of life by providing the ability
to participate in all social interactions to the best of their ability.

Gabriela Brown, CSA
Constant Companions Home Care
www.constantcompanions.net
gbrown@constantcompanions.net

Posted by Gabriela Brown, gbrown@constantcompanions.net, http://www.constantcompanions.net

•Married Veteran-$2,019.00
•Single Veteran-$1,703.00
•Surviving Spouse-$1,094.00

These benefits are tax-free to eligible veterans and may help families defray 40-80% of their monthly long-term care expenses! Please note that the VA must see proof that the veteran or surviving spouse is paying out-of-pocket for their care, before their claim will be considered. In other words, the VA requires objective evidence of long-term care expenses. We provide these “Care Expense Statement” forms in all of our claims application attachments.

Refer all of your families/inquiries to this site: www.seniorvet.org and review the short video from Brian Williams of NBC News. Families can get information, complete VA claims applications as well as detailed instructions instantly through our user-friendly site. Best of all, our services are provided FREE of charge and overseen by a Accredited VA Claims Agent.

Forwarded from email sent to Constant Companions Home Care, San Diego, from Senior Veterans, LLC

Trust is the foundation of our success in San Diego and S. Riverside. We are continually updating our hiring and supervisory practices. Rest assured that all of our caregivers are thoroughly screened and supervised to enhance your confidence and trust.

Each caregiver must go through a 4 part application process including:

Step 1:

Initial application: Employment history, references and background check are completed. If results are good, Step 2.

Step 2:

Employment Questionnaire, consisting of 17 questions addressing personality and professionalism is administered. If results are good, Step 3

Step 3:

Interview. If results are good, Step 4

Step 4:

Orientation.

From the first placement the process in ongoing, with surprise supervisory visits, satisfaction survey reviews (from clients) and necessary intervention regarding training and policy review.

If our caregivers are unable to reach or maintain our standards, they are warned once and then dismissed on the second violation of any issues regarding professionalism and demeanor in the home. If the caregiver is deficient or unprofessional in any way that violates the law or many of our standards of professionalism, they are terminated immediately and not eligible for rehire. These practices may cost the agency a little more in unemployment claims and hiring costs, but we feel that it is in everyone’s best interest to refrain from ‘recycling’ caregivers that should not be working in anyone’s home.

-Gabriela Brown
gbrown@constantcompanions.net

www.constantcompanions.net

Researchers, doctors, and eldercare professionals are still discovering and refining what works and what doesn’t when it comes to dementia care. A lot of different techniques and strategies have been tried, some with more success than others, but clinicians have found that there are some principles and practices of dementia care that can and do work more often than not. For example:
• One of the long term goals of dementia care is to encourage and maintain the independence of the person with dementia for as long as possible. Studies have found that a technique called graded assistance, combined with practice (as in “practice makes perfect”) and positive reinforcement (encouragement and rewarding the desired behavior) can go a long way to maintaining that functional independence. Graded assistance is a method of helping someone accomplish a task with the least amount of aid possible, using a spectrum of assistance from verbal prompts to physical demonstration, physical guidance, partial physical assistance, and complete physical assistance.
• Researchers have also found that music can be very effective in reducing problem behaviors such as agitation and aggression, especially during mealtimes and bathing. However, it’s important to note that the music should be something that the person with dementia prefers, not necessarily what the caregiver thinks would be nice to listen to. Sometimes people assume that the best choices may be “soothing” classical music, but this is not always the case. Soothing or relaxing music can work, but playing your loved one’s favorite types of music is much more likely to be an effective form of dementia therapy.
•Other strategies of dementia care, such as pet therapy, lighting manipulation, and group therapies that concentrate on cognitive skills and/or social activities have also been tried to varying degrees of success.1

The following information is adapted from Caregiver Guide: Tips for Caregivers of People with Alzheimer’s Disease, published by the National Institute of Aging (NIA).2 Although it was originally written specifically for Alzheimer’s care, much of the information is applicable to other types of dementia care, and we have included it here for your reference and information. Remember to consult with your doctor about what is appropriate to your loved one’s condition before following any advice or recommendation.

From the NIA’s Alzheimer’s Care Guide:

Finding out that a loved one has Alzheimer’s disease (AD) can be stressful, frightening, and overwhelming. As you begin to take stock of the situation, here are some tips that may help:
• Study your day to see if you can develop a routine that makes things go more smoothly. If there are times of day when the person with AD is less confused or more cooperative, plan your routine to make the most of those moments. Keep in mind that the way the person functions may change from day to day, so try to be flexible and adapt your routine as needed.
• Consider using adult day care or respite services to ease the day-to-day demands of caregiving. These services allow you to have a break while knowing that the person with AD is being well cared for.
• Begin to plan for the future. This may include getting financial and legal documents in order, investigating long-term care options, and determining what services are covered by health insurance and Medicare.

Communication
• Choose simple words and short sentences and use a gentle, calm tone of voice.
• Avoid talking to the person with AD like a baby or talking about the person as if she weren’t there.
• Minimize distractions and noise—such as the television or radio—to help the person focus on what you are saying.
• Call the person by name, making sure you have her attention before speaking.
• Allow enough time for a response. Be careful not to interrupt.
• If she is struggling to find a word or communicate a thought, gently try to provide the word she is looking for.
• Try to frame questions and instructions in a positive way.

Bathing

For some people with AD, bath time can be a frightening, confusing experience. Advance planning can help make bath time better for both of you.
• Plan the bath or shower for the time of day when the person is most calm and agreeable. Be consistent. Try to develop a routine.
• Respect the fact that bathing can be scary and uncomfortable. Be gentle and respectful. Be patient and calm.
• Tell the person what you are going to do, step by step, and allow him to do as much as possible.
• Prepare in advance. Make sure you have everything you need ready and in the bathroom before beginning. Draw the bath ahead of time.
• Be sensitive to the temperature. Warm up the room beforehand if necessary and keep extra towels and a robe nearby. Test the water temperature before beginning the bath or shower.
• Minimize safety risks by using a handheld showerhead, shower bench, grab bars, and nonskid bath mats. Never leave the person alone in the bath or shower.
• Try a sponge bath. Bathing may not be necessary every day. A sponge bath can be effective between showers or baths.

Dressing

For someone who has AD, getting dressed presents a series of challenges: choosing what to wear, getting some clothes off and other clothes on, and struggling with buttons and zippers.
• Try to have the person get dressed at the same time each day so she will come to expect it as part of the daily routine.
• Encourage her to dress herself to whatever degree possible. Plan to allow extra time so there is no pressure or rush.
• Allow the person to choose from a limited selection of outfits. If she has a favorite outfit, consider buying several identical sets.
• Arrange the clothes in the order they are to be put on to help the person move through the process.
• If the person needs prompting, provide clear, step-by-step instructions.
• Choose clothing that is comfortable, easy to get on and off, and easy to care for. Elastic waists and Velcro enclosures minimize struggles with buttons and zippers.

Eating
• Ensure a quiet, calm atmosphere for eating. Limiting noise and other distractions may help the person focus on the meal.3
• Provide a limited number of choices of food and serve small portions. You may want to offer several small meals throughout the day in place of three larger ones.
• Use straws or cups with lids to make drinking easier.
• Substitute finger foods if the person struggles with utensils. Using a bowl instead of a plate also may help.
•Have healthy snacks on hand. To encourage eating, keep the snacks where they can be seen.
• Visit the dentist regularly to keep mouth and teeth healthy.

Activities

Finding activities that the person with AD can do and is interested in can be a challenge. Building on current skills generally works better than trying to teach something new.
• Don’t expect too much. Simple activities often are best, especially when they use current abilities.
• Help the person get started on an activity. Break the activity down into small steps and praise the person for each step he completes.
• Watch for signs of agitation or frustration with an activity. Gently help or distract the person to something else.
• Incorporate activities the person seems to enjoy into your daily routine and try to do them at a similar time each day.
• Take advantage of adult day services, which provide various activities for the person with AD, as well as an opportunity for caregivers to gain temporary relief from tasks associated with caregiving. Transportation and meals are often provided.

Exercise

Incorporating exercise into the daily routine can benefit both the person with AD and the caregiver. Not only can it improve health and help everyone sleep better, but it can also provide a meaningful activity for both of you to share.
• Think about what kind of physical activities you both enjoy, perhaps walking, swimming, tennis, dancing, or gardening. Determine the time of day and place where this type of activity would work best.
• Be realistic in your expectations. Build slowly, perhaps just starting with a short walk around the yard, for example, before progressing to a walk around the block.
• Be aware of any discomfort or signs of overexertion. Talk to the person’s doctor if this happens.
• Allow as much independence as possible, even if it means a less-than-perfect garden or a scoreless tennis match.
• See what kinds of exercise programs are available in your area. Senior centers may have group programs for people who enjoy exercising with others. Local malls often have walking clubs and provide a place to exercise when the weather is bad.

Incontinence

As the disease progresses, many people with AD begin to experience incontinence, which can be upsetting to the person and difficult for the caregiver. Sometimes incontinence is due to physical illness, so be sure to discuss it with the person’s doctor.
• Have a routine for taking the person to the bathroom and stick to it as closely as possible. For example, take the person to the bathroom every 3 hours or so during the day. Don’t wait for the person to ask.
• Watch for signs that the person may have to go to the bathroom, such as restlessness or pulling at clothes. Respond quickly.
• Be understanding when accidents occur. Stay calm and reassure the person if he is upset. Try to keep track of when accidents happen to help plan ways to avoid them.
• To help prevent nighttime accidents, limit certain types of fluids—such as those with caffeine—in the evening.
• If you are going to be out with the person, plan ahead. Know where restrooms are located, and have the person wear simple, easy-to-remove clothing. Take an extra set of clothing along in case of an accident.

Sleep Problems

Nighttime can be a difficult time. Getting the person to go to bed and stay there may require some advance planning.
• Set a quiet, peaceful tone in the evening to encourage sleep. Keep the lights dim, eliminate loud noises, even play soothing music if the person seems to enjoy it.
• Try to keep bedtime at a similar time each evening. Developing a bedtime routine may help.
• Encourage exercise during the day and limit daytime napping.
• Restrict access to caffeine late in the day.
• Use night lights in the bedroom, hall, and bathroom if the darkness is frightening or disorienting.

Hallucinations and Delusions

As the disease progresses, a person with AD may experience hallucinations and/or delusions.4
• Sometimes hallucinations and delusions are a sign of a physical illness. Keep track of what the person is experiencing and discuss it with the doctor.
• Avoid arguing with the person about what she sees or hears. Try to respond to the feelings she is expressing, and provide reassurance and comfort.
• Try to distract the person to another topic or activity. Sometimes moving to another room or going outside for a walk may help.
• Turn off the television set when violent or disturbing programs are on. The person with AD may not be able to distinguish television programming from reality.
• Make sure the person is safe and does not have access to anything she could use to harm anyone.

Home Safety and Wandering

Creating a safe environment is one of the most important aspects of caregiving and can prevent many stressful and dangerous situations. Caregivers of people with AD often have to look at their homes through new eyes to identify and correct senior home safety risks, as well as to prevent wandering, a dangerous tendency of people with AD.
• Install secure locks on all outside windows and doors and keep them locked, especially if the person is prone to wandering. Consider a keyed deadbolt or an additional lock up high or down low on the door. If the person can open a lock because it is familiar, a new latch or lock may help.
• Remove the locks on bathroom doors to prevent the person from accidentally locking himself in.
• Be sure to secure or put away anything that could cause danger, both inside and outside the house.
• Use childproof latches on kitchen cabinets and any place where cleaning supplies or other chemicals are kept.
• Label medications and keep them locked up. Also make sure knives, lighters and matches, and guns are secured and out of reach.
• Keep the house free from clutter. Remove scatter rugs and anything else that might contribute to a fall. Make sure lighting is good both inside and out.
• Consider installing an automatic shut-off switch on the stove to prevent burns or fire.
• Make sure that the person carries some kind of identification or wears a medical bracelet. If he gets lost and is unable to communicate adequately, this will alert others to his identity and medical condition.
• Keep a recent photograph or videotape of the person with AD to assist police if the person becomes lost.

Driving

Making the decision that a person with AD is no longer safe to drive is difficult, and it needs to be communicated carefully and sensitively. Even though the person may be upset by the loss of independence, safety must be the priority.
• Look for clues that safe driving is no longer possible, including getting lost in familiar places, driving too fast or too slow, disregarding traffic signs, or getting angry or confused.
• Be sensitive to the person’s feelings about losing the ability to drive, but be firm in your request that she no longer do so. Be consistent—don’t allow her to drive on “good days” but forbid it on “bad days.”
• Ask the doctor to help. The person may view the doctor as an “authority” and be willing to stop driving. The doctor also can contact the Department of Motor Vehicles and request that the person be reevaluated.
• If necessary, take the car keys. If just having keys is important to the person, substitute a different set of keys.
• If all else fails, disable the car or move it to a location where the person cannot see it or gain access to it.

Visiting the Doctor

It is important that the person with AD receive regular medical care beyond Alzheimer’s care. Advance planning can help the trip to the doctor’s office go more smoothly.
• Try to schedule the appointment for the person’s best time of day. Also, ask the office staff what time of day the office is least crowded.
• Don’t tell the person about the appointment until the day of the visit or even shortly before it is time to go. Be positive and matter-of-fact.
• Bring along something for the person to eat and drink and any activity that he may enjoy.
• Have a friend or another family member go with you on the trip, so that one of you can be with the person while the other speaks with the doctor.

Source: National Institute on Aging, www.nia.nih.gov

1 For more information on the most up-to-date findings that might help you, talk to your doctor.

2Information provided by the NIA is free of copyright and in the public domain. Additional information can be found at the NIA website: http://www.nia.nih.gov/.

3Please also see the reference to research findings on the use of music, located at the beginning of this article.

4 In some types of dementia, such as Lewy Body Dementia (LBD), hallucinations can occur at the first onset of symptoms. For additional information on LBD, please refer to our article on dementia: Understanding Dementia: A Basic Overview.