Disasters and Evacuations Present Even Higher Risk for Those with Dementia
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People with dementia are especially vulnerable to chaos and emotional trauma. They have a limited ability to understand what is happening, and they may forget what they have been told about a particular disaster. First responders, neighbors and family members assisting with an evacuation should be alert to potential reactions of someone with dementia in disaster situations.
• Law enforcement, EMS and fire authorities should be informed about community members with dementia as they may get confused and not understand what is happening, putting themselves and first responders at additional risk.
• The person with dementia should not be left alone. It only takes a few minutes to wander away and get lost, creating an even higher risk situation.
• Changes in routine, traveling and new environments can cause:
-An increase in behavioral symptoms, including hallucinations, delusions and sleep disturbance.
• Those assisting someone with dementia should try and remain calm themselves. The person with dementia will respond to the emotional tone set by those around them.
Facilities and individuals caring for someone with dementia in their home should have an emergency plan. Being prepared in case of an emergency is crucial. Register as someone with special needs with your local law enforcement agency so evacuation orders can include a visit to the person’s home and assistance offered in person. Having an emergency kit in an area that is easily accessible and stored in a watertight container should be part of the overall plan.
Emergency kits should contain:
• Copies of important documents, such as legal papers, a list of medications and dosages, insurance information and contact information for physicians, next of kin, etc
• Several sets of extra clothing, including gloves and a hat
• Extra medication
• Incontinence products
• Identification items, such as a MedicAlert® + Alzheimer's Association Safe Return® ID bracelet and clothing labels
• A recent picture of the person with dementia
• Bottled water
• Flashlight with extra batteries
• Favorite items or foods
If the person with Alzheimer's or other dementia uses a walker or portable oxygen, emergency evacuation plans must accommodate these needs. If an individual lives in a residential facility, family members should be knowledgeable about the facility’s disaster/evacuation plans and know contact information for those in charge of evacuating the person in the event of an emergency.
Locations for alternate accommodations and health care needs should be identified. In the case of an evacuation, having predetermined alternate housing can help eliminate stress. Additionally health care facilities might be impacted by the disaster so finding alternative sources for care ahead of time is critical. Contact information for both should be easily accessible.
Medicare offers a downloadable guide to Getting Care and Drugs in a Disaster Area. It explains how Medicare beneficiaries have special rights to get out-of-network care if they live in an area where the President has declared a disaster.
The Alzheimer's Association offers programs designed to assist in the return of those who get separated from their caregivers, MedicAlert® + Alzheimer's Association Safe Return®, and that manage a person's location, Comfort Zone® and Comfort Zone Check-In®.
It's important to have access to health records, especially in the case of an emergency. There are now many options for storing personal health records, including online services that make it possible to access records from anywhere in the world. Regardless of how personal health information is stored, make sure there are people other than the primary caregiver who have access to or copies of the person with dementia's medical history, medications, physician information and family contacts.
Disaster situations increase anxiety for everyone impacted however for those with dementia a crisis can increase agitation.
Tips for helping decrease anxiety:
• Reassure the person by holding hands, or offering a shoulder and reassure them that things are going to be fine.
• Find outlets for anxious energy. Take a walk with the person or engage the person in simple tasks.
• Redirect the person’s attention if he or she becomes upset.
• Move the person to a safer or quieter place, if possible. Limit stimulation.
• Make sure the person takes medications as scheduled.
• Try to schedule regular meals and maintain a regular sleep schedule.
• Avoid elaborate or detailed explanations. Provide information using concrete terms. Follow brief explanations with reassurance.
• Be prepared to provide additional assistance with all activities of daily living.
• Pay attention to cues that the person may be overwhelmed (e.g. fidgeting, pacing).
• Remind the person that he or she is in the right place.
During an episode of agitation:
• Approach the person from the front at eye level 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. For example, say, “You’re frightened and want to go home. It’s ok. I’m right here with you.”
• Don’t argue with the person or try to correct. Instead, affirm his or her experience, reassure and try to divert attention. For example, “The noise in this shelter is frightening. Let’s see if we can find a quieter spot. Let’s look at your photo book together.”
For additional support and tips for assisting someone with dementia during a disaster call 800.272.3900