Wandering worries caregivers

Sharp eyes help them deal with Alzheimer's symptom

Emma Goza says she sleeps with one eye open.

That level of watchfulness is just part of what it takes, she said, to make sure her 95-year-old stepfather does not wander from the Raleigh home they share.

Goza, 73, said she sleeps across the hall from her stepfather, Simon Berry, so she can wake up when he gets up in the night. Keeping Berry safe at home despite his increasing dementia involves everything from having locks and alarms installed to promising trips to a favorite spot.

"I can honey him up," she said. "I'll say, 'Let's go out to Mama's grave' -- he loves to go there."

Like many Triangle residents, Goza was alarmed and saddened to hear about Mildred Early Rogers, 76, an Alzheimer's patient who died late last month after walking away from her Raleigh home. Police found her body more than two miles away in a boggy area near Crabtree Creek.

Goza has researched dementia and the problems that memory diseases can cause, with a wealth of information from the Eastern North Carolina chapter of the Alzheimer's Association.

"For people that have loved ones like I have my stepfather, it should be a concern," Goza said. "If you have that kind of issue, you should be getting the right kinds of components in place so it doesn't happen to your loved one."

When a patient walks restlessly about the house and shows disorientation about time and place, there is a greater chance that he or she will try to leave the home unsupervised, said Dr. Daniel Kaufer, an associate professor of neurology and director of the memory disorders program at UNC-Chapel Hill.

"They may think they need to get home -- that could motivate people to go outside of the house," Kaufer said. "Sometimes they feel like they have to find someone, like a dead relative."

Goza said Berry sometimes goes to the front door in the night and says someone was knocking and calling for him -- someone Goza can't hear. So far, she said, he has not left the house unattended.

"Sometimes, the first time is the only time you get," said Teepa Snow, director of education at the Alzheimer's Association in Raleigh.

Kaufer and Snow say that equipping a house with locks that a person with dementia can't open might be the only option for keeping the person safe. Patience and understanding are important, but keeping the person alive is No. 1, Kaufer said.

"There's a fundamental balance between autonomy on one hand and safety on the other hand," he said. "To me, whenever those come into conflict, safety wins."

It is important to plan for fire or other emergencies when locking up. Goza keeps a key to a deadbolt within reach of her front door, which is equipped with an alarm.

Sometimes a precaution as simple as a coat rack concealing the front door can keep a loved one from wandering, said Lou Paules, coordinator for Alzheimer's respite care for the Center for Volunteer Caregiving.

Paules will be among those offering information to families and volunteers at a training session Thursday in Raleigh.

"I had one family that went to a support group and learned, 'If you see it, you can do it,' " she said, referring to a door. "They had a coat rack, and they put it in front of the door, so abundant with coats you couldn't see the door."

Safety ideas

People who work in the field offer additional suggestions:

* Arrange for someone to be with the person as often as possible. "You can say, 'Come on, I'll be happy to walk with you,' " Snow said. "Or you can arrange for partners."

* Be creative. "I had one fellow who followed his wife in his car" when she went for a walk, Paules said. "When she got tired, he said, 'Come on, let's go get some ice cream,' and she'd get in the car."

* Try to determine what is driving the behavior. Someone with dementia might have anxiety or trouble sleeping because of physical or mental ailments.

* When trying to reorient someone from an unsafe behavior, don't push too hard, Kaufer said. "You can try to reorient but not to the point that you force the issue if the patient is not responding," he said.

* Explore high-tech solutions. "If you've got an issue, you can put a video camera near your exit so that you'll at least know when the person left," Snow said. Putting a GPS-equipped cell phone in a patient's purse could allow him or her to be tracked.

* Remember: No technique is likely to last forever. People with Alzheimer's can be wily and creative if they really want to get away from their situations.

* If you're a caregiver, devote time to your own health. "I can't take care of my husband or my stepfather or anyone else if I don't care of me," Goza said.