Verna Benner Carson, Katherine Johnson Vanderhorst and Harold G. KoenigCare Giving for Alzheimer’s Disease10.1007/978-1-4939-2407-3_5

5. Help! My Mother Is Lost and I Cannot Find Her!

Verna Benner Carson¹, Katherine Johnson Vanderhorst² and Harold G. Koenig³

(1)

C&V Care Specialists, Inc., Fallston, Maryland, USA

(2)

C&V Care Specialists, Inc., Williamsville, New York, USA

(3)

Dept. of Psychiatry Behavioral Science, Duke University Medical Center, Durham, North Carolina, USA

Verna Benner Carson (Corresponding author)

Email: vcars10@verizon.net

Katherine Johnson Vanderhorst

Email: kvander716@aol.com

Harold G. Koenig

Email: koenig@geri.duke.edu

Keywords

WanderingWalking and getting lostDriving and getting lostSilver alertAlzheimer’s Association’s Safe Return ProgramStrategies to decrease wanderingNeighborhood watchImportance of activities

Wandering is a common behavior that occurs in Alzheimer’s disease (AD)—the Alzheimer’s Association estimates that over half of all those with the disease will wander at one time or another and if the wanderer is not found within 24 h, up to half of individuals who wander will suffer serious injury or death (Alzheimer’s Association 2014). Wandering results from brain damage in the areas of the parietal lobe as well as the hippocampus (see Chap. 2). Wandering involves the need to “keep on the move” (Alzheimer’s Association of Canada 2013).

Regardless of whether or not the caregiver is paid or is a family member, the behavior of wandering “strikes fear” into their hearts. In order for caregivers to experience a sense of competence in the caregiving role, they must be able to institute strategies that keep the cared-for person safe. This chapter provides relatively simple and inexpensive tips for caregivers to limit wandering. For example, an intervention such as placing a black or brown rug held in place with electrical tape in front of all exits of a home is very effective for some with AD. The person with AD loses depth perception and for many the dark rugs will appear as “holes”—the person may be too afraid to cross over the “hole.”

In Chap. 2 we introduced the idea of wandering with a case study of a Virginia man suffering from Alzheimer’s who managed to get on a bus in Virginia and travel to Denver, Colorado. That story had a happy ending because two kind police officers took the time to make sure the gentleman was cared for while they made arrangements to send him safely home. He was a very fortunate man. Not all of the stories about wandering, though, have a happy ending.

How many of those with Alzheimer’s will wander? The statistics are imprecise but the numbers reported by different chapters of the Alzheimer’s Association are about five to six of every ten people with the disease. There are a number of facts that make wandering of even greater concern. A person with Alzheimer’s may not remember his or her address, easily become disoriented in familiar as well as unfamiliar locations, and may not respond to searchers calling his/her name. In fact, the person could be standing in a dark doorway, just feet away from a searcher and fail to identify him/herself to the searcher. One question might be how this behavior fits into the theory of retrogenesis. A story from a mother of a 3-year-old might shed light on this issue:

I was shopping in a K-Mart store and my three year old son Robbie was right alongside of me. I stopped to look closely at some items and I let go of Robbie’s hand. I am not sure how much time elapsed before I realized I was not holding his hand but I believe it was only two or three minutes. When this realization hit me, I immediately called his name; I looked all around and I didn’t see him. I panicked! I had the store manager lock down the store and he called Robbie’s name over the PA system. I think it might only have been about two to three minutes but it seemed like an eternity to me before Robbie came out of the center of a skirt rack and asked whether I was looking for him? I had looked under the skirts but in the center of the rack there was a raised area, just big enough for Robbie to balance on and covered by skirts so I did not see him when I had looked. When he asked if I was looking for him, I had mixed feelings—relief and joy that he was okay but also anger that he had caused me such anguish. He loved to hide from me in this way—and tried to do it multiple times, but the K-mart incident had taught me a valuable lesson.

What does Robbie’s story have to do with the wandering of an older adult with Alzheimer’s? How does this fit in with the theory of retrogenesis? The response or lack of response of the older adult with Alzheimer’s to hearing his/her name called is frequently the same as Robbie’s toddler response—they do not call out, “here I am” or otherwise make themselves known—which is why wandering is such a dangerous behavior. To make matters worse, the person with Alzheimer’s may not remember vital information like his/her name or address and may become disoriented even in familiar places.

Who Is at Risk?

Anyone who is diagnosed with AD and can walk is at risk for wandering . Certainly the risk increases as the dementia progresses but even at stage 4 on the functional assessment staging tool (FAST) scale, people may still be driving (albeit with questionable skill) and can easily become confused about directions. In fact a wake-up call for many families who have noticed a loved one’s repetitive questions and stories occurs when the loved one “gets lost” attempting to drive home from a familiar location. The following is a real life scenario:

Mrs. Johnson goes to the local grocery store where she has shopped for years. However, she becomes confused when leaving the parking lot, turns right instead of left and drives for hours. Her home is only a five minute drive from the grocery store she just left. Finally, she is pulled over by a police officer as she is weaving across the double lines of the highway—80 miles from her home. Fortunately, she has an emergency contact card in her purse with her daughter’s information. The police officer calls the daughter to inform her that her mother is quite disoriented and that they are taking her to the closest hospital for an evaluation. The daughter can no longer tell herself that her mother “has a little memory problem” and the daughter will now be faced with a myriad of decisions regarding what is best for her mother. How can her mother be kept safe? What supports does mom need and who will provide those supports? And of course, must confront her mother and ask her to relinquish the keys to the car.

Sometimes stories like Mrs. Johnson’s often make the national news. Even in the early stages of dementia, a person can become disoriented or confused for a period of time. It is important to plan ahead for this type of situation. The following are warning signs that the loved one is having difficulty getting around safely:

Returns from a regular walk or drive later than usual

Tries to fulfill former obligations, such as going to work

Only gold members can continue reading. Log In or Register to continue