(BPT) - Virtually all parents have experienced the terror of looking up from what they were doing only to realize their child has wandered off. Your pulse races, your heart pounds and you can't relax until your child is back in sight. As children grow up, they learn to stay put - or at least let you know where they're going - and your fears fade.
However, if you become a caregiver for a parent, grandparent or other loved one with dementia, you may find yourself having the same fear if your loved one begins to exhibit a concerning symptom of dementia - getting lost or wandering.
The Alzheimer's Association says six out of 10 people with Alzheimer's experience episodes of wandering. The behavior can take many forms, from leaving the house without telling anyone to leaving and then becoming too disoriented to find their way home. Wandering can also occur at night, when a person with Alzheimer's gets out of bed and wanders inside the house - or more concerning, goes outdoors - in the dark.
"Wandering is one of the potentially most dangerous symptoms of dementia," says Juliet Holt Klinger, senior director of dementia care for Brookdale Senior Living. "The Alzheimer's Association notes that up to half of those who wander will suffer serious injury, or even die, if not found within 24 hours. It's important for caregivers to understand why and how wandering happens, when it occurs and what they can do to prevent or minimize occurrences."
Why wandering occurs
To understand why your loved one may be wandering, look for a pattern, Holt Klinger advises. Does he wander at a particular time of day or night? Is she trying to communicate with you? Do they have an unmet physical or psychological need, like being hungry or thirsty, or feeling lonely? Is an undiagnosed medical problem, such as a urinary tract infection, prompting the person to get out of bed at night?
Sleep patterns change as we age, and those changes can be pronounced and concerning for people with dementia. Your loved one may get up during the night because he or she has trouble sleeping. People with Alzheimer's may wake in the middle of the night and get confused, thinking that it is time to get up and go somewhere, such as work or running errands.
Wandering safety tips
Observing when and why your loved one wanders can help you take steps to keep him or her safe. Common coping strategies for night-time wandering include:
* Help people with Alzheimer's differentiate between day and night by making sure they're exposed to plenty of natural light during the day. This can help circadian rhythms that dementia disrupts and age-related changes in sleep patterns.
* Encourage at least 30 minutes of exercise every day, but not within four hours of bedtime. Exercise can keep people more awake and alert during the day, and promote better sleep at night.
* Discourage daytime sleeping by keeping people with Alzheimer's engaged in meaningful activity. Allow a good balance between activities and rest.
* Avoid serving alcohol, caffeine or large meals as bedtime approaches.
* Encourage a bathroom visit right before bedtime.
* Avoid screen time (white light) directly prior to bedtime and use amber colored night lights which do not disrupt REM sleep patterns.
* Practice relaxation methods like a short, light massage, warm bath, hot milk or herb tea, or reading aloud. These activities are soothing and can help a person calm down for better sleep.
* For extreme wandering concerns, consider investing in a monitoring system that will alert you when a loved one gets out of bed at night.
For daytime episodes of wandering, try:
* Hiding car keys. This can prevent loved ones from leaving the house, getting in the car and losing their way. If your loved one's car operates with a key fob, removing the battery or distributor cap may be another option.
* Keeping doors locked. Some people with Alzheimer's are unable to operate locked doors. At the very least, a locked door may provide a delay long enough for a caregiver to intervene.
* Equipping doors with an alarm to signal when it is opened. This can be as simple as putting a bell on the door.
* Staving off wandering impulses by taking your loved one for frequent walks outdoors.
* Occupying your loved one with a relatable, doable task that provides a sense of purpose. For example, if someone worked in an office, give her papers to organize. If he loves animals, have him brush the dog.
"Sometimes, despite your best efforts and precautions, wandering can remain a concern," Holt Klinger says. "If that happens, it may be time to consider a move to a senior living community that specializes in caring for people with Alzheimer's and other dementias. Brookdale's Clare Bridge communities are secured and designed to promote a sense of independence, safety and purpose."
(BPT) - Silver screen icon Bette Davis once famously pronounced "getting old ain't for sissies." Caring for yourself or a loved one with age-related health issues is no picnic, either. Of all the health issues you may face as you age, vision problems can be particularly devastating. Yet, a new study reveals that many people still don't understand the leading cause of legal blindness for older Americans - a condition that could seriously affect their quality of life.
Age-related macular degeneration (AMD) is the leading cause of vision loss in Americans aged 60 and older, affecting an estimated 15 million people, according to Macular Degeneration Partnership. Prevent Blindness America estimates that 2 million Americans are living with an advanced form, or end-stage macular degeneration, where central vision is completely blocked in both eyes and that number is expected to increase as the baby boomer cohort ages. Damage to the macula - the part of the retina that perceives color and fine detail - results in the inability to see images in straight-ahead vision, and, therefore, affects a person's ability to read, drive, watch TV, focus on small objects, and even see the faces of family and friends.
Despite the prevalence of macular degeneration - more than 40 percent of older Americans have it or know someone who does - three out of four people don't know it's the leading cause of blindness in people older than 60, according to an awareness survey by Wakefield Research. What's more, 66 percent say they aren't confident they could care for a loved one if he or she developed AMD.
As macular degeneration worsens and vision diminishes, the need for caregiving increases. In fact, more than a third (35 percent) of people who know someone with macular degeneration say they frequently assist the patient, the survey found.
"As their visual acuity decreases, AMD patients may feel the need to ask for help with tasks of daily living, such as shopping, writing checks, or reading menus, hinders their independence," says Dr. Mark Milner, associate clinical professor at Yale University School of Medicine, and the co-founder and co-medical director of the Eye Center of Southern Connecticut and Precision LASIK Group. "This puts them at higher risk of feeling depressed, and makes it critical for patients, their caregivers and their physicians to develop an individualized management plan that incorporates a range of treatment and caregiving strategies."
As the need for care increases, the patient becomes more at risk of developing depression and anxiety, a study in Clinical Ophthalmology found.
Milner offers some tips for people with AMD and their caregivers:
*Make the most of every dialogue with your doctor. Prepare a list of questions to discuss, asking about your specific diagnosis and available treatments
*While there is no cure for AMD, lifestyle changes may help slow its progression. If you smoke, quit. Try to lose weight if you need to, and monitor your blood pressure. Be sure to talk to your doctor about these health concerns, too. Simple changes like adjusting lighting and investing in an e-reader that allows you to enlarge print can also make everyday life easier.
* Have a serious conversation with your doctor and your family about whether it's still safe for you to drive.
* Seek support. You can find low-vision resource centers and AMD awareness groups across the country. Online resources like the new website, AMDAffectsMe.com, sponsored by CentraSight, can offer comprehensive information about how AMD is diagnosed and treated, as well as stories from caregivers assisting their loved ones living with end-stage AMD.
* Research the latest treatments. Medical science is always making progress toward treating incurable conditions like AMD. For example, an FDA-approved and Medicare-eligible surgical device is available for patients today living with the most advanced form of the disease. The implant magnifies images approximately three times their size onto the healthy portion of the retina, enabling patients to discern the object of interest. To learn more about the implant, visit www.CentraSight.com or call 1-877-99-SIGHT.
"As you grow older, it's important to monitor your vision health, since the early and intermediate stages of macular degeneration usually have no symptoms," says Dr. Samuel Masket, a clinical professor at the David Geffen School of Medicine at UCLA. "Only a comprehensive, dilated eye exam can detect AMD. The good news is that preventive and treatment options for patients with macular degeneration have advanced remarkably just in the past 10 years. Now these patients may be able to improve their vision and maintain as much of their independence as possible."
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