In my last article, I talked about the challenges of Driving with Dementia. As the stages of dementia increase in your loved one, this will become a common issue for many people. One of my readers quickly responded with the following comment:
"Don't tell me how to track someone who is lost. Give me ways to convince them NOT to drive."
I know how hard this decision is to make. I also know that every family is different. Times have changed, and now driving with Alzheimer’s (or any form of memory loss) is now a major issue.
I can remember the scene as if it was yesterday...
Mom received a visit from one of Miami Beach’s finest--a policeman--and came to the house to deliver the news that another motorist noticed mom's erratic driving, reported it, and now mom would need to take a driving test or surrender her license.
My mother was quite the charmer and tried to dissuade the officer with coy laughter and excellent reasoning. She said that she and a “neighbor” weren't getting along, and this police report was retaliation at its finest. Mom even tried to get the name of the person who reported the incident so she could go personally talk to them. We learned mom had not only been swerving, but had cut the person off!
Needless to say, I was personally thrilled that this anonymous Good Samaritan had reported my mother. Even before the stages of dementia had set in, Mom had been a lousy driver. She often took offense at being the brunt of our jokes. I thought my dad (who also didn’t trust mom’s driving skills and would often call me to be his chauffeur) would be as thrilled as I was that the officer had threatened to take away mom's driving license.
The reality was, taking away Mom’s license meant that she would be in the house all day, and that was unacceptable to my father. No matter what I said about mom getting hurt, or both of them getting hurt, or the risk of death to innocent strangers, it all fell on deaf ears.
Dad gave me an ultimatum: Make sure mom passes her driving test or else!
After many heated arguments, I did what most of us do with our parents. I caved in. And so, every day, for two to three hours, I coached my mother through the state's driving exam book. She was not yet diagnosed with Alzheimer's, and we didn't know to be alert for the various stages of dementia. It was a difficult process and I secretly believed mom would flunk the test. After all, she couldn’t even remember what she had for breakfast. There was no way she was going to remember the rules of the road, be able to sit in a car with a stranger and get through the actual road test, right?
So, on the day of the exam, I gladly drove my mom to the testing site and sat inside watching her open the exam. I figured she would give up once she saw the questions and we’d be gone in five minutes.
One hour later, she proudly walked over to the window with her test in hand to be graded. You could have knocked me over with a feather when they said she passed and now would take the driving test.
Whoa! How in God’s name did that happen?!
Well, at least the driving instructor would catch on that she was the worst driver in Dade county and flunk her, right? Even though I didn't know how the stages of dementia were affecting my mother at that time, I trusted the driving test would still be too much for her. With this in mind, I took a deep breath and practiced my condolence speech to her and my dad.
I should have used my time more wisely, because I never got to give that speech. Yep, my mother passed the road test, too.
So, since my Plan A, "Fail the Driving Test" hadn't work, I had to quickly spring into action and put into place:
- Plan B: Hiding the keys
- Plan C: Flatten a tire
- Plan D: Remove a spark plug
- Plan E: Lock the garage door and take the key with me
Each time I was thwarted by my father, as well meaning and determined as he was. It dawned on me that no matter what I did, my dad would have his own agenda and rationale for wanting mom to drive.
Drastic Times Call for Drastic Measures
At that time, I had just given birth to my daughter, Sloane. She was my parents' only granddaughter. Now, it was my turn for an ultimatum.
"Either mom stays off the road, or I will not bring your granddaughter to the house."
Once again I appealed to their reason and the safety of myself, their grandchildren, society. All to no avail.
When dad would call to ask when I was coming over, I would ask if mom was on the road. She usually was from 10-5pm. So my answer would be, "NO!"
I refused to drive into their area of town, unless I knew for a fact that Mom would be safely off the road. I stuck to my guns, which was very hard, and in about three weeks of me coming over, usually past 7pm with very cold, late meals, my dad eventually caved in. Dad finally took the keys away from mom.
My Lesson: In my family, the way to taking mom’s car keys away was through my father's stomach!
Each Family is Different
If you are like me, and have problems with speaking up to your parents. So here are 7 practical solutions you can use for getting your loved one suffering through the stages of dementia off the road more safely:
1. Have the doctor speak to your loved one about medication and driving.
Doctors carry with them a high level of authority. Ask the doctor to explain how medication can affect reaction time, and that your loved one shouldn’t drive for at least one month, until their medication has stabilized.
2. Have the doctor recommend a professional driving evaluation.
Be firm that your loved one mustn't drive until they get evaluated. Make an appointment and stand firm.
3. Have the doctors office fill out a letter to the state.
Each state has a place where you can download a form for your doctor to report impaired driving. In Florida, the form is located at: http://www.flhsmv.gov/forms/72190.pdf
Reporting impaired driving is mandatory in some states.
4. Report the impaired driving yourself.
Reporting impaired driving can be done anonymously, and the state will send a letter to your loved one requesting a driving exam.
5. Disable the Vehicle.
Depending on the loved one suffering through the stages of dementia, you may try my Plan A-E. Just know that each person is different, and you will need to make sure that you are not endangering them or other drivers. My mom was car safety conscious and would check the air pressure daily. Driving on a flat would not have happened in her case, but for others it will. Consult with other members of your family.
6. Have an off-duty police officer come to the home to speak to your loved one.
7. Tell you loved one that the insurance company cancelled their policy and that you are checking around for new quotes.
Some people will stop driving if their license is taken away, others will forget that they don’t have a licence and will drive no matter what.
Depending on the situation, I reccomend a variety of strategies.
Driving was so much simpler in the Bedrock!
What worked for you? Please share or e-mail me. And to Donna, I hope this helps.
Oops, It happened again!
The second I hit Florida after driving back to Miami with the pups in tow, I was greeted not only by palm trees and orange juice at the welcome center, but also by a huge overhead electronic billboard notifying me to be on the lookout for another lost soul.
Silver Alert (http://www.floridasilveralert.com) is for cognitively impaired persons who are lost driving, just like the milk cartons are for lost and missing kids. The only difference is that you're not reading a milk carton while driving 90-plus miles an hour and looking for unmarked state troopers!
And so every few miles, depending on where the billboards are, they flash the make of car and license plate number of the cognitively impaired lost senior.
Florida is a long state, and I saw the same alert in Jacksonville all the way down to Miami. My first thought was OMG they are still missing!!!My second thought was, "Thank God there are no accidents."
As of August 2011 there have been 356 Silver Alerts issued. The total direct recoveries by Silver Alert is 30. In the past few months, most of the alerts have been issued for males. Go figure--they will NEVER stop and ask for directions!
What may start out as an innocent drive to the grocery store, beauty shop, or just a family visit, may turn into an all-point bulletin flashing on roadways and making headlines in newspaper reports hours later.
The reality is, individuals who are cognitively impaired should not be driving and need to be kept off the roads! Family members need to know that even though Silver Alert exists and may provide some peace of mind, the typical driver on today's highways is not going to be able to find your loved one. Today's drivers are operating autopilot, looking for more important things like state troopers, exit signs and reckless drivers. Your loved one is an after thought.
If you got lost in a strange or unfamiliar area, you would simply stop the car and ask for directions, or turn around and go back home.
A person with dementia can’t and won't ask for help. They will just keep on driving until they are out of their neighborhood, county and state!
As a caregiver, we often think that wandering only happens by foot. Nothing could be further from the truth.
When our loved ones drive and get lost, they are wandering. Think about that for a moment. That is why there are so many Silver Alerts on the electronic expressway signs.
So I would like to give you a list of things you can do to ensure your loved one's safety either by foot or by car. In my book, “Alzheimer’s Disease and Other Dementias: The Caregivers Complete Survival Guide” I go into more depth about what to look for, but for now I’m going to touch on the basics.
Here are 6 Dementia Zone Tips to Keep your Loved Ones Safe:
1. Make sure that the person is wearing a Safe Return or Medic Alert bracelet. Get yours at http://www.alz.org/safetycenter/we_can_help_safety_medicalert_safereturn.asp
2. If your loved one carries a cell phone with them, and keeps it turned on, consider buying a cell phone that has a built in GPS. You can use the GPS feature to find your lost loved one, or help keep track of a loved one's whereabouts to make sure they are in a safe place.
3. If your loved one has a favorite jacket, pants or purse, consider putting a small portable GPS device in their coat. You can activate the device at any time to check on your loved one's location.
4. There is a new GPS shoe on the market. Yes, they’re fugly and expensive ($300), but they may help locate your wandering loved one with dementia. I say "may" because I contacted the manufacturer to see if they work when wet (such as in rain puddles) and they haven’t gotten back to me yet. Also, know that at 3am your wanderer will choose their own shoes! However, you may want to look at the GPS Shoe to see if this solution is right for you.
5. When a person with dementia decides to drive, whether they have a license or haven’t driven in 5 years, they may just suddenly decide to take the family car for a spin. Consider having a GPS device installed in the car. Some GPS devices may only work in areas that get a wireless and/or satelite signal, so make sure you know the capabilities of your device before installation.
6. Contact Project Lifesaver, an especially good resource for rural areas. They use small, personalized transmitters that emit a personalized tracking signal. If your loved one goes missing, they can pinpoint their exact location. It makes no difference whether the person is in a high-rise building or in the woods, Project Lifesaver will be able to locate them. Check them out at http://www.projectlifesaver.org/
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Keeping an eye on person’s with dementia is not easy.
Daily, the newspapers are filled with reports of people with dementia who have wandered away from home.
Some people are safely returned and reunited with their caregivers, while others are not so lucky.
As I wrote in the last post, a person with dementia at some point will wander off. Know that a wandering behavior is not intentional or purposely done to upset or scare you.
For a person with dementia, wandering is a purposeful activity.
In the mind of a person with Alzheimer’s, or other form of dementia, they are trying to get somewhere--and their somewhere is a strong memory in their mind.
Wandering is often due to anxiety. The person with dementia is anxious--they want and need to be somewhere, but they can’t remember where.
People with dementia will and have wandered. I’ve had clients wander away from day centers, assisted living facilities, religious services and their own homes. They are reported lost in airports, rest stops, malls and grocery stores. They may board a bus while on a walk or catch a ride with a good Samaritan, or not.
Why am I so passionate about wandering?
I have personally lived through it with my mom and know how frustrating and terrifying wandering can be.
Dad would call me at all hours of the day and night to tell me that mom was “missing,” which was our code for "Houdini has left the building" and for me to come over right away and find her.
And so, I did.
I’d strap in my two young kids into their car seats and drive 20 miles to find my mother, who would either be by the canal in the backyard or pruning trees in the frontyard, at 10 o'clock at night!
I will never forget the time my mother was missing for more than eight hours--off property--only to be chauffered home by a police officer. The Officer had helpfully filed a stolen car report. We found the car the next day, more than six blocks from where my mother “thought” she had parked it!
Mom’s sense of time was gone and so was her judgment.
Here are some Dementia Zone tips to reduce your anxiety and to keep your loved ones from wanderlust and safer in the home:
1. Add additional locks on the doors, either up top or down at the bottom where a person with dementia will not notice them.
2. Make (or buy) a sign that says, "STOP," "Do Not Enter" or "Danger."
3. Place a black or dark colored mat in front of the door. To a person with dementia this will look like a big hole in the ground.
4. To avoid triggers, move the keys, jackets and purses you usually keep at the front door to another location.
5.To alert you that they are leaving, install a motion sensor device or alarm on all doors.
6.Make sure that all doors and windows are securely locked (yes, a person with dementia will try to escape from a bathroom or bedroom window.)
7. Lock and secure all fences and gates.
8. Put up a curtain to disguise the door.
9. Let your neighbors know that your loved one has dementia and to notify you when they see them outside.
10. Change the doorknobs to round handles with childproof grips.
11. Don’t forget the sliding glass doors. It’s inexpensive to put a broomstick in the doorframe to keep them from opening.
12. Secure the perimeter of the home. Put up a pool fence or gate to the lake or canal. A person with dementia will not recognize water or traffic.
Wandering does happen. When you first notice your loved one has gone AWOL and have checked the house, call it in to 911. Do not concern yourself with being embarrassed or causing a false alarm. The longer a person goes missing, the greater the chance of physical harm.
In our next Dementia Zone article we will cover how to keep your loved one safer on outings. Be sure to subscribe to this blog so that you don't miss an article. Until then, take a deep breath and hum along to this Disney sing-a-long:
Last night I had an “emergency” Skpe session I’d like to share with you.
What started out as a lovely outing at the mall had turned into three gut-wrenching, heart-pumping, nerve-wracking hours. My cleint lost her brother in the mall!
As she was telling me about the security search and rescue and how her brother was finally located, she left out
one important detail--how it happened.
Listening to her story, I knew how it happened. She went to the bathroom.
Asking her confirmed it. “I told him to wait” she cried, “Why didn’t he wait?”
“He’s never done this before,” she went on to say....
That’s what I had heard from two other clients earlier today. Maybe it’s the full moon, or a Forest Gump moment. The statistics show that more than 125,000 people with dementia wander away every year.
Before you jump to any conclusions about this caregiver, just let me just say at some point of caring for a person with dementia this will happen to you.
I have had clients wander from home, church, parties, the mall, airports, picnics, weddings and funerals. My mother was a serial wanderer. I never reported her missing because up until recently you had to wait 24 hours to file a missing persons report.
Don’t be fooled into thinking that if a person can’t walk they can’t wander. I had a client who wandered from home in a wheelchair and was picked up on the highway entrance ramp.
Why people wander is a mystery. Finding them alive and unharmed is a gift.
Here are my Dementia Zone tips to keep your loved ones safe:
1. Wandering and dementia go hand in hand
The brain changes and the person becomes confused.
2. 60% of people with dementia will wander
Don’t be fooled into thinking that it won’t happen to you. The 60% are first time wanders and many become repeat offenders.
3. One minute they are fine, the next minute they are gone
A person with dementia will not dress for the elements nor do they care about the weather conditions. They will not recognize unsafe areas such as the woods, neighborhoods or highways.
4. A person who has wandered is scared and confused
Many times, especially outdoors they will hunker down and hide. They may not respond to their given name. Instead of Robert try calling for Bob or Bobby.
5. Wandering poses serious threats
According to the Alzheimer’s Association about 50% of people who wander will suffer serious injury or death if they are not found in 24 hours.
We are all wanders to various degrees. Next time I’ll show you how to keep your free spirited loved one with dementia safer.