Alzheimer’s Disease & Home Safety

2. © 2013 Griswold International, LLC The Week of August 26th is National Safe at Home Week “The home environment involves the needs, feelings, and lifestyles of the caregiver, family, and the person with Alzheimer's Disease. Disability affects all family members, and it is crucial to maintain your emotional and physical welfare in addition to ensuring a safe environment.” National Institute on Aging

3. © 2013 Griswold International, LLC Brainwriting is… • a fun, engaging way to brainstorm • sharing as many ideas as possible within a short timeframe Brainwriting Process • Listen for our questions • When prompted, enter your solutions using the webinar chat function • Don’t overthink or agonize…There are no right or wrong answers Brainwriting Outcomes • Peer-to-peer learning and sharing • A publication that benefits others who are living with Alzheimer’s Important • Avoid sharing any information that you would not want others to see BRAIN WRITING Solutions Orange Arrow Button: Minimizes or expands the GoToWebinar control panel.

4. © 2013 Griswold International, LLC Our Goal for Today 1. Empower those living with Alzheimer’s disease 2. Share common home safety challenges 3. Create a safe home setting that drives improved quality of life for all

5. © 2013 Griswold International, LLC Presented by: Bridget Scheidler, OTR/L Fox Occupational Therapist Fox Rehabilitation Keith Lerner Family caregiver Chris Kelly, MEd Director of Learning & Development Griswold Home Care Keith Lerner Family caregiver Chris Kelly, MEd Director of Learning & Development

8. Alzheimer’s Disease is a brain disorder that can cause changes in the brain that impact… © 2013 Griswold International, LLC …and cause life-threatening safety issues. Judgment and decision-making About Alzheimer’s Disease & Home Safety Orientation to person, place and time Senses: vision, depth perception, sense of touch/temperature Motor skills and coordination Memory loss

9. ? ? ? Agnosia: Inability to Recognize the Purpose of Objects © 2013 Griswold International, LLC “It is as if I have been taken to another world where nothing makes sense. Everything looks foreign. I know things should make sense – but they don’t. I stare at items in the bathroom and have moments where I don’t know what to do.” - Person with AD

10. © 2013 Griswold International, LLC The Safety Challenge Ingesting hazardous materials or chemicals Fire hazards Misunderstanding traffic signals and road signs Eating/choking on non-food items Sources: http://www.amazon.com/books/dp/0306454602 http://www.ninds.nih.gov/disorders/brain_basics/know_your_brain.htm Changes in the parietal lobe of the brain can cause agnosia. Safety issues can include:

11. © 2013 Griswold International, LLC The Emotional Side People with Alzheimer’s Disease often feel... Family/professional caregivers feel… • Anxious, embarrassed, confused, isolated, depressed, loss of dignity, treated like a child • Shocked, frustrated, confused, anxious, exhausted, isolated, depressed • Like they “can’t turn away for a second”

12. © 2013 Griswold International, LLC In the early and middle stages… As AD progresses and reading is impaired... Home Safety Solutions Use written signs or labels with short phrases in large print Remove/hide all objects that could cause physical harm Visit: http://1.usa.gov/16oTo3q to find a home safety checklist that you can use to ensure that each room of your home is safe.

13. - Lou Gehrig “I just can't understand. I am not sick. My eye is sharp, yet I was not swinging as of old. I reduced the weight of my bat from 36 to 33 ounces, thinking a change might work to my advantage, but it didn't.” - Lou Gehrig © 2013 Griswold International, LLC Real Stories Bridget Scheidler, OTR/L Fox Occupational Therapist Fox Rehabilitation Keith Lerner Family caregiver Keith Lerner Family caregiver

14. © 2013 Griswold International, LLC A Search for Something Familiar ? ? ? ? Wandering: "These things can happen at any given time. All it takes is a caregiver who’s working really hard, to turn around for a second and the person can wander.” - Beth Kallmyer Vice President of Constituent Services Alzheimer's Association

15. © 2013 Griswold International, LLC The Safety Challenge Traffic accidents Changes in the prefrontal cortex, frontal lobe and hippocampus in the brain can cause wandering and pacing. Safety issues can include: Hypothermia (during winter months) Drowning Missing important medications Wandering by foot, car, train, bus or planeHeat exhaustion

17. © 2013 Griswold International, LLC The Emotional Side People with Alzheimer’s Disease often feel... Family/professional caregivers feel… • Anxious and confused • Shock, fear, frustration, confused • Exhausted – “can’t turn away for a second”

18. © 2013 Griswold International, LLC • Create a safe walking path • Set up “rummaging stations” with familiar work/ hobby-related items • In some cases, wandering can only be safely managed in a facility that offers a safe walking path Home Safety Solutions • Set up “rummaging stations” with familiar work/• Set up “rummaging stations” with familiar work/ Visit: http://bit.ly/19vEMBv, http://bit.ly/18xJRol and http://bit.ly/1cgQDRL to enroll in programs that help to locate a person with AD who has wandered.

20. © 2013 Griswold International, LLC Depth Perception, Balance and Coordination Falls: "Ever since my mother fell, I cannot get the sight and sound out of my head. I feel like I can’t turn my attention away or sleep for a second. Of course, this is impossible...but I try anyway.” - Family caregiver

21. © 2013 Griswold International, LLC The Safety Challenge Changes in the frontal lobe, occipital lobe and cerebellum in the brain can cause falls. Safety issues can include: Some people with AD are often driven to move Sources: http://www.amazon.com/books/dp/0306454602 http://www.ninds.nih.gov/disorders/brain_basics/know_your_brain.htm Other people with AD become weak from not moving due to other health conditions Falls can lead to fractures and head trauma

22. © 2013 Griswold International, LLC The Emotional Side People with Alzheimer’s Disease often feel... Family/professional caregivers feel… • Afraid of falling again • Embarrassed • Fear of shiny floors • Fear of walking causes isolation • Afraid of another fall, frustrated with loved one • Exhausted – “can’t turn away for a second”

23. © 2013 Griswold International, LLC • Occupational therapy (OT) • Physical therapy (PT) • Yoga/tai chi • Staying active can improve balance, strength and mobility • Talk to your healthcare provider prior to starting a new activity Adaptive equipment can improve balance Home Safety Solutions Visit the following links to learn more about reducing the risk of falling: • http://bit.ly/14NSqhI • http://1.usa.gov/1daFEKV • http://bit.ly/1daFGCK

24. © 2013 Griswold International, LLC "Muscles don't get dementia. They can still be strengthened to prevent falls due to weakness." My Past Is Now My Future: A Practical Guide to Dementia Possible Care by Lanny D. Butler, MS, OTR

26. Vision, Judgement and Reflexes Driving issues: “It was very difficult giving up things such as a car when I’m still working…without my wife taking me to work in the morning and a driver taking me home in the afternoon, I would be pretty much stuck in the house every day.” - Person with AD, Voices of Alzheimer’s Disease, Alzheimer’s Association Town Hall Meeting © 2013 Griswold International, LLC

27. © 2013 Griswold International, LLC The Safety Challenge Changes in the prefrontal cortex, frontal lobe, parietal lobe and occipital lobes of the brain can cause impaired… Depth perception Judgement Sources: http://www.amazon.com/books/dp/0306454602 http://www.ninds.nih.gov/disorders/brain_basics/know_your_brain.htm Reflexes Insight into driving issues/ need to stop driving

28. © 2013 Griswold International, LLC The Safety Challenge When is a person with AD unsafe to drive? Driving and AD combine to create a unique, challenging dilemma for… • Law enforcement • Legislators • Driving testing centers • People with AD • Family caregivers • Healthcare providers

29. © 2013 Griswold International, LLC The Emotional Side People with Alzheimer’s Disease often feel... Family/professional caregivers feel… • Driving is key to independence • They are safe to drive • Aware of their issues, but reluctant to “give up the keys” • Concern about safety • Guilt • Frustration when person with AD lacks insight • Want someone to own responsibility

30. © 2013 Griswold International, LLC Ask your healthcare provider about a comprehensive driving evaluation Visit: http://bit.ly/17Q2fqy for a great guide to understanding and managing driving issues. Home Safety Solutions

32. Advocacy Home Safety Care Team It is important to surround yourself with experts in the fields of AD and Home Safety Your care team should include: • Home Care • Geriatric Care Manager • Adult Day Care • Family Doctor/ Nurse Practitioner• Occupational Therapist • Physical Therapist • Visiting Nurse • Advocacy and Support Groups © 2013 Griswold International, LLC

33. © 2013 Griswold International, LLC Support Groups Can Help The most practical home safety strategies can be found through support groups. Here are links that can help you to find support groups in your area: • http://bit.ly/17f6UVU • http://bit.ly/143u1Pm

35. Symptoms vs. Behaviors © 2013 Griswold International, LLC We have avoided the term “behaviors” – This is intentional, because this term - although commonly used - alludes to intent or “misbehaving”. – When a person has chest pain due to heart disease, we use the term “symptom”. – When a person has shortness of breath due to lung disease, we use the term “symptom”. We should use the term symptom with Alzheimer’s Disease as well. This will help to drive the empathy, patience, and accommodation that is key to care, support and quality of life for people with Alzheimer’s Disease and their family/professional caregivers.

36. © 2013 Griswold International, LLC Key Takeaways Points to remember The symptoms of Alzheimer’s Disease (AD) are caused by changes in the brain, and often create serious safety issues It is important to surround yourself with experts and use proven home safety tools and approaches There are things you can do to adapt the home setting to reduce the risk of safety issues and improve quality of life

39. © 2013 Griswold International, LLC National 24x7 Care Line: 800-GRISWOLD www.GriswoldHomeCare.com Brought to you by: Extraordinary Home Care at Affordable Rates Since 1982 Griswold Home Care offers access to affordable non-medical care options to assist your loved one. CareAssure Screening System™ The Griswold Golden Rule: We only approve caregivers we would trust in our own homes. QuickCare Placement™ We give each family access to the most experienced caregivers available. ValueCare Commitment™ Simple Rates. Unmatched Value. Our all- inclusive rates are among the most affordable.