Wednesday, September 7, 2011

How to take care of Alzheimer’s Patient before, during, and after natural disasters?


A seasoned caregiver has most likely faced some kind of traumatic natural event at one time or another. Be it a hurricane, tornado, flood, wildfire or other phenomena, most everyone knows that it pays to be prepared for the worst. It's not enough that caregivers stock food, create a disaster medical kit and make shelter plans. Family member carers, as well as paid caregivers, also have to know how to reduce the worry and stress for persons with special needs during a disaster.

Advance Warning Helps Targeted Hurricane Victims Prepare

People normally experience worry and anxiety in the face of a hurricane – the most dangerous of all storms. Thanks to advance warnings from national and local weather services, residents in the projected strike zone have ample time to evacuate or carry out last-minute details at home. Time to act reduces some of the anxiety and fear of being caught unprepared when a major storm hits.

When making a hurricane disaster plan, don't automatically rule out evacuation just because you think it's too much trouble to pack up and leave. Keep in mind that emergency medical crews may not be available for hours – or even days – after a hurricane strikes. Plenty of people will need help, but downed power wires, fallen trees and debris will slow rescue efforts.

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Be sure to get ready to the potential natural disaster ahead of time by enrolling the patient in MedicAlert + Alzheimer’s Association Safe Return, a 24-hour nationwide emergency response service for individuals with dementia that wander or who have a medical emergency (find more information at 1.888.572.8566 or visit www.alz.org). If the patient is already enrolled in MedicAlert + Safe Return, make sure his /her information is up to date, especially in preparation for storm season.

Caregivers and patients cope with sudden natural disasters

Tornadoes present a different set of problems; residents often have only minutes to seek safe shelter before the storm hits. Tornadoes can do monstrous amounts of damage in a very short amount of time. Homes may be lost and whole towns shattered. Stress, anxiety and raw emotions can run high for weeks and months after a storm. Caregivers can help by offering encouragement and compassion. Professional help services and support groups can also help both caregivers and patients.

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Earthquakes happen suddenly and occur with no warning. An earthquake along a coastal region can mean a possible tsunami, so extra precautions and planning are necessary. Earthquakes aren't defined by a season like hurricanes, so residents have to stay prepared. Living close to one of the Earth's many fault lines is enough to cause anyone anxiety. A caregiver can ease a patient's worry by keeping silent about any news of a possible earthquake.

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Forest fires can break out almost anywhere, but are prone to spread quickly in areas where there is little rain. Evacuating at the first sign of trouble will help keep ease the stress. Extreme summer heat can present problems – especially for elderly people and young children. Caregivers should know beforehand what to do in any of these situations. Paid caregivers should also have instructions from family members or other qualified source so they'll know what to do in the event a sudden disaster strikes.

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Tips for reducing patient stress and anxiety caused by natural disasters

There are tips caregivers can follow to reduce excessive worry in the wake of extreme weather or other natural disaster. It's tough to stay composed, but the caregiver who keeps her wits about her during a traumatic event will have a better chance of surviving, and so will her patient. In addition to the plans and preparations that everyone should automatically have in place, caregivers can use the following suggestions:
  • Do your best to remain calm, as you set the tone for your loved one. Provide frequent reassurance.
  • Decide how much information to give the patient. It may be best to watch or listen to the news in another room if graphic pictures or reports might upset the individual. Avoid elaborate details. Provide information using concrete terms and follow brief explanations with reassurance.
  • Keep caregiver duties as close to routine as possible while staying alert to conditions. Make sure your loved one takes medications as scheduled. Be ready to act should the situation suddenly change and worsen.
  • Keep the patient's routine as close to normal as possible. Try to schedule regular meals and maintain a regular sleep schedule.
  • Find outlets for anxious energy-engage the person in simple tasks, distract/talk about memories, etc. Redirect the person’s attention if he or she becomes upset.
  • Avoid alcohol, drugs and excessive smoking. Alcohol and certain drugs can cloud or distort a caregiver's judgment. Avoid chain-smoking as a way to calm jumpy nerves.
  • Move the person to a safer or quieter place, if possible. Limit stimulation. This is one of the important reasons to consider special needs/emergency shelters an absolute last resort. A person with dementia may not do well in the crowded, chaotic environment.
  • Delegate jobs to other family members if possible.
  • Accept water, food and offers of help only from qualified sources (Red Cross, Salvation Army, military help and so forth).
  • Pay attention to cues that the person may be overwhelmed, such as fidgeting or pacing.
  • Remind the person that he or she is in the right place.

Tips for dealing with severe episode of agitation

  • Approach the person from the front and use his or her name.
  • Use calm, positive statements and a patient, low-pitched voice. Reassure.
  • Respond to the emotions being expressed rather than the content of the words, as the person may not be able to verbalize his/her true feelings.
  • Don’t argue with the person or try to correct perceptions. Instead, affirm his or her experience, reassure and try to divert attention.
  • Under no circumstances should a person with Alzheimer’s be left alone following a natural disaster. Do not count on the individual to stay in one place while you go to get help.

Get ready for evacuation

If there are reasons to believe that you may need to evacuate someone with Alzheimer’s due to the natural disaster, be ready and act carefully to minimize the risk for the patients health:
  • Have an emergency kit prepared with items you may need. If the kit is not ready, quietly gather supplies (flashlight, wallets, water, power bars or crackers and peanut butter, blankets and pillows if you can) and don’t wait too long. It’s best to give yourself plenty of time and try not to rush. Know where you’re going—shelter, hotel, other family member’s house—and let others know you’re A, B, and C plans. Remember the anxiety and physical situation may bring on different needs for your loved one.  You may need additional incontinence products, consider what comfort items might help, and talk to your loved one’s doctor beforehand about anxiety or behavioral concerns and needs. Make sure you bring contact information, brief medical history, copy of all insurance information –as well as house insurance since many times you can’t get back into the house to get policies.
  • Keep medications in grab and go containers for quick evacuation. Take it all–who knows when you’ll be able to get back to normal.
  • Evacuate early and be extra cautious.  Being stuck in long traffic delays or feeling rushed is not good for your loved one with dementia.
  • Inform other family members or trusted friends. Keep a calm attitude and stay as upbeat as possible. If you cannot contact other family members before leaving the house write with a lipstick or sharpie marker on your front door who is with you and where you’ve gone—it’s awful to panic and worry that your loved ones can’t be found
  • People with dementia are especially vulnerable during chaotic times. They have a limited ability to understand what is happening. Be alert to potential reactions that may result from changes in routine, traveling or new environments.
  • When appropriate, inform others that your loved one has dementia and may not understand what is happening. Consider printing up some small cards that you can discretely hand to someone with a brief explanation.

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Basic Emergency Supply Kit

        Water, one gallon of water per person per day for at least three days, for drinking and sanitation.
        Food, at least a three-day supply of non-perishable food.
        Battery-powered or hand crank radio and a NOAA Weather Radio with tone alert and extra batteries for both.
        Flashlight and extra batteries.
        First aid kit.
        Whistle to signal for help.
        Dust mask, to help filter contaminated air and plastic sheeting and duct tape to shelter-in-place.
        Moist towels, garbage bags, and plastic ties for personal sanitation.
        Wrench or pliers to turn off utilities.
        Can opener for food (if kit contains canned food).
        Local maps.

Stress after Natural Disaster

Family members must face the possibility that paid caregivers won't be able to show up for work after a disaster strikes. As a last resort, a critical-needs patient may have to go to a local hospital for care. It may be days or weeks before paid workers can get back on schedule again.

Relocating after a disaster is going to be stressful; there's no way around it. The added burden of being responsible for mobility equipment, patient supplies, oxygen, medications and prosthetic devices can be exhausting and overwhelming. Home caregivers can make it easier for family members by looking ahead to better times. It may also help to talk about old memories and even to write them down in a journal.

Careful planning is a key to caregiver and patient survival in the event of a natural disaster. Keep a master list updated and handy to make sure nothing is forgotten. Have an escape plan ready to execute on the spur of the moment. Know where hospitals are located in neighboring towns. Disaster preparedness is a sure way to keep stress levels in check and keep anxiety to a minimum. Planning now will ease the fear and reduce the chances any unwelcome surprises.

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