DIMENSIONS Autumn 2006

PREPARING FOR THE WORST: CARING FOR DEMENTIA SUFFERERS DURING A PUBLIC DISASTER

by Thomas Orton

Fires, floods, chemical spills, volcanic eruptions. Like death and taxes, disasters have become an inescapable part of life. In recent years, we’ve seen hurricanes, tsunamis and terrorist attacks added to the list. Geologists warn that for those of us living in the Northwest, the threat of a major earthquake – “the big one” – is no longer a matter of “if” but “when.”

Providing comfort and reassurance to people suffering from dementia is already an enormous undertaking. In a disaster situation, the responsibility of the caregiver becomes even more daunting. While it’s impossible to anticipate every possibility, there are a number of things you can do to make yourself feel more secure.

If the person you care for lives in a residential facility, find out from the administrator what the emergency plans are and write them down. Also, let someone at the facility know what you intend to do in an emergency and provide them with a list of alternate phone numbers – of relatives or friends – at which you can be reached.

Preparing for the unthinkable, while caring for a person with dementia at home, begins with practical details such as making sure that all glass objects and hazardous household materials are securely stored.

An emergency survival kit is a must. Besides the basics – drinking water, a battery-powered radio and a fire extinguisher – your kit should include an extra set of medications in a plastic bag, plenty of disposable wipes, a credit card and a supply of cash. Keep a separate kit in the trunk of your car in case the kit in the house becomes unusable. Your car kit should include blankets, a change of clothes and wet weather gear for yourself and the person you care for.

Take the time to write down emergency phone numbers and special instructions. Post the information prominently in the house along with a recent photo of the person in your care. In the event that you are separated, a photo, along with vital statistics and a list of medications, will be especially helpful to emergency workers.

During a disaster, individuals with dementia will likely become more agitated and disoriented than usual. All the usual symptoms – confusion, anxiety, restlessness – may be exaggerated. The individual may also become so overwhelmed that he or she “shuts down” and resists or refuses to cooperate with necessary activities. This means added emotional stress for you as well, especially if the person you care for is a family member, so you will need all of your strength and patience. Remember the basics, like eating regularly and getting as much rest as possible.

The most important thing a caregiver needs to do is to stay calm. The person with dementia will react to whatever emotional signals you send out, so it is important to be cool and collected even if the situation is less than reassuring. Sticking to routines can help, especially with regard to meals, exercise or, if possible, simple chores and watching favorite TV programs.

In the event of an earthquake, storm or flood, the electricity may be cut off, so be sure to have battery-powered lanterns, flashlights and extra batteries on hand. Earthquakes often rupture gas mains, increasing the risk of fire. Though you should keep the gas on if possible, know how to turn off the line to your house. After a quake, check the large appliances in the house – the heating unit, stove and water heater – and turn off the main only if you smell gas.

Plan your escape routes in advance in the event that you must evacuate your home, Make sure you have a clear pathway to doors and windows in each room of your house. Avoid the nightmare of becoming separated by identifying a meeting place for yourself, your relative with dementia, and others who are available to assist you. Draw a map and rehearse your exit with neighbors, other family members, paid caregivers, and anyone else who may help in an emergency.

Leaving your home will almost certainly be traumatic. You may need the person you care for to do unusual things such as climbing into the back of an emergency vehicle or sleeping in a shelter surrounded by strangers. Figure out in advance how best to be encouraging, what words and gestures will give the most comfort.

In the event that you are hurt or incapacitated and unable to continue providing care, make arrangements for your absence before it becomes a reality. Plan for someone to take over your caregiving duties for at least three days.

Most important of all, expect the unexpected. Have a “Plan B.” Even the best strategies have flaws, so make sure there’s a backup in place.

Will you ever have to live through “the big one” or another Hurricane Katrina? Hopefully not. But even if you never experience a public disaster, planning an emergency strategy in advance will give you peace of mind. And chances are, if you rest easier, so will the person you care for.


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