Safety of the patient

This is the fifth in a series of articles written by Frank S. P. Yacino regarding Alzheimer’s disease.  He is the husband and caregiver for his wife Barbara who has been struggling with this disease for over fifteen years.

Somewhere between Stages 3 and 4 safety issues of the Alzheimer’s patient will need to be considered at home. This article will address the ways in which we had to ensure the safety of my wife Barbara as she changed stages.

Barbara liked to wander and leave the house so one of the first things we did was to get alarms for the doors to the exterior of the house. The alarms were placed at the top of the door and would go off when the door was opened. The alarms were purchased at Home Depot at minimal cost and are easy to install. The alarms work well, unless you were vacuuming in the house. Unfortunately the alarm signal couldn’t be heard over the noise of the vacuum cleaner and on two separate occasions Barbara did skip out on me. When I realized she was gone I ran outside and looked both ways and saw her walking down the street. I was lucky both times that she didn’t get too far away from the house and that each time a neighbor was outside and was able to stop her until I got to where they were. There were also times the alarm would go off and Barbara would just walk right out of the house. I’d be in a different part of the house and upon hearing the alarm would run out the door and she’d be in the driveway.

Another suggestion for the doors is to purchase plastic covers that go over the door knobs that are designed not to let the knob turn unless you put pressure at certain points of the knob cover. These covers are also found at Home Depot. They are also used for children so they cannot open the door.

At this stage of the disease the patient may have no fear, and touching a hot stove or flame would be a disaster. When I began the cooking duties Barbara would always come near the stove (gas) and I’d immediately escort her away fearing she would touch the hot pot or pan I was using. During her different stages we managed to prevent any medical emergencies around the stove. Care must be used around electric stoves as well, especially the new flat-top burners. It would be nothing for a patient to walk up to the stove and put their hand down and get burned.

At night before going to bed I’d make sure the alarms were on and check the gas stove knob’s to be sure they were off and Barbara hadn’t turned them on. For a short period of time I used to take the knobs off and place them in a drawer. (At this point Barbara was still able to walk freely around the house.)

Barbara was still driving at this time and I would tell her not to go anywhere when I’d go off to work. (I was overseeing construction work at this time.) However, many times when I’d come home I’d put my hand on the hood of the vehicle that she used to drive and it would be warm. So finally one day when I went to work I decided to unplug the electric cord going to the overhead door button, thus when she’d push the button nothing would happen. To be doubly sure the vehicle wouldn’t leave the garage I used to put the gears to the transfer case in neutral (we had a 4-wheel SUV). If the vehicle was in neutral in the gear box no matter what position she put the shift lever into the engine would only rev up and go nowhere. It only took her one time to discover the vehicle was immobile and she didn’t try taking it any more. It wasn’t too long after that when she had to surrender her license. (That situation will be taken up in a future article.)

When Barbara was able to get up at night it was necessary for me to install a floor- mounted alarm in the hallway out of the bedroom to alert me that she was up, if I didn’t hear her get up. This type alarm may be purchased at Radio Shack.

Two other safety items that are very important for the patient upon diagnosis of this disease are the Medic Alert Medallion (1-800-363-5985) and the Safe Return Medallion (1-888-572-8566) in case the patient gets lost or is in an auto accident. Barbara has both. The medic Alert Medallion has her name, address, phone number, and disease on it. The Safe Return Medallion has her name, disease, a phone number to call, and Barbara’s I. D. number. She is registered with the Safe Return organization. If she were to get lost and then found, just by calling the number on her medallion would eventually alert the local police and ultimately our family. At the time we did this the cost for Barbara was $40, and for an additional $5 the caregiver is also allowed to obtain a medallion with the same phone number to call if the caregiver is in an accident. Barbara’s I.D. number is also on my medallion. It’s a miniscule cost to save a lot of aggravation if something were to happen to the patient, especially if the patient happened to be non-verbal at the time. It certainly is a worthwhile investment and could be a matter of life and death. Hopefully they may never be needed, but it gives everyone a sense of safety and security.

At night, or even during the day if the patient naps, there may come a time when it’s necessary to install bed-rails to prevent the patient from falling out of bed.

The safety issues I’ve described pertain to the issues that we’ve had with Barbara and may or may not be similar to every patient, as no two are exactly alike. These comments are meant to be a general guide for the caregiver’s information.