Is it okay to leave a person with Alzheimer’s home alone?

Confused woman at home alone

This is a tricky question. The short answer is it depends. It depends on a lot of things. But if you are asking the question, the answer is probably no.

Use this assessment questionnaire. These issues are difficult to think about, let alone deal with. But if you have a sense of unease when thinking about your care partner’s abilities, it’s time to put safety precautions in place.

  • How far along in the disease is the person? If the person is in the moderate phase of dementia, the phase when they need help with basic daily activities such as bathing and brushing their teeth, it’s not safe to leave him or her home alone.
  • Do they get easily confused?
  • Do they get lost walking around the neighborhood or in the house?
  • Do they follow you throughout the house?
  • Could they make a phone call if they need help or become anxious?
  • Do they still cook, make coffee or use the microwave? Do they forget to turn off the stove or oven? If so, they should not be allowed to cook any longer.
  • Are they able to make themselves something to eat? If not, could they find food that has been prepared for them, or are they able to find a snack?
  • Do they wander?
  • Do they recognize dangerous situations such as fire?
  • Are they susceptible to scam phone calls? Are they apt to provide private information?
  • Can the person engage in enjoyable hobbies or activities such as gardening, knitting, wood work?
  • Can they distinguish between a family, friend, neighbor and stranger if someone comes to the door?
  • Is it easy for them to toilet without assistance?
  • If there were an emergency in the house, could they leave and seek shelter?
  • Is there a possibility the person could damage or destroy your personal property if they got highly agitated?

Keep your care partner safe from wandering

There’s nothing more frightening than discovering that your care partner has wandered out of the house and is nowhere to be found. If the weather is very hot or very cold this could turn into an emergency situation. Or if the person needs a medication at a specific time, it could become a matter of life or death.

Here are some ways to reduce this risk.

Never leave your care partner alone in the car, even for a quick stop.

Hide the car keys. I had a neighbor whose husband took the car keys and drove off into an isolated area. Although the car was found, he was never seen again. It was an unspeakable tragedy.

Camouflage the exterior doors with curtains, a poster, or sign that says, “Stop,” or “Do not enter.

Don’t leave shoes, hats, coats, or keys near the exit doors. All are reminders of leaving home.

Inform your neighbors so if they see your care partner wandering around the neighborhood, they can alert you or the police, or gently guide the person home.

Have your care partner carry a photo ID, and wear a medical bracelet. Put labels inside their coat, hat, etc.,

Project Lifesaver is a program offered by police departments. Some police departments offer wristbands at discounted rates or at no charge. To find out or enroll in Project Lifesaver, contact your local police department and ask if they participate. Call Project Lifesaver International Headquarters at (757) 546-5502 or visit the Project Lifesaver website.

Enroll in the MedicAlert https://www.medicalert.org/ and Alzheimer’s Association’s safe-return program. Read about it here: https://www.alz.org/help-support/caregiving/safety/medicalert-with-24-7-wandering-support. For a fee, participants receive an identification bracelet, necklace or clothing tags and access to 24-hour support in case of emergency. You also might have your loved one wear a GPS or other tracking device.

Read Dr. Laura Struble’s excellent article “How to Minimize Wandering in a Senior with Dementia” in which she says it’s important to first observe the person and try to figure out why your care partner is wandering or trying to leave, what they are trying to achieve, and where they want to go. https://www.agingcare.com/articles/help-a-senior-with-dementia-who-wanders-167541.htm

Safety first is always a good motto. It might take a little work and effort to put these safety measures into place, but it will definitely be worth it for your own peace of mind and for the health and safety of your care partner.

Care for the caregiver

If you are the caregiver of someone at home, it’s vital that you take care of yourself and get out of the house, hopefully, for at least a walk every day. During the coronavirus pandemic, you aren’t doing as much as you normally would outside of the house, but try to take a daily walk.

If you’re depressed, learn about 20 natural remedies that can uplift your mood. https://wordpress.com/block-editor/post/barbracohn.com/5720 Or, 20 energy and stress fixes to use now! https://wordpress.com/block-editor/post/barbracohn.com/4998

If you aren’t able to leave your care partner even for a short walk, it’s time to get respite care. When the time came for my husband to need full-time care, I hired someone to be with him husband twice a week so I could get out of the house. Is there a neighbor who would be willing to come in for 30 to 60 minutes twice a week? This might be tougher during the pandemic. But while the weather is still warm, a care person could take your loved one for an outing, sit on the porch with them, or go for a drive.

Be safe. Be well. Take care.

Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Is your loved one in denial about their Alzheimer’s diagnosis?

After my husband had a heart attack in 1994, a friend told him that he appeared to have one foot in heaven. Morris was more focused on the celestial world and less engaged in his life on earth. He hibernated in his home office, and spent just a handful of hours at his business office each week. He watched too much television, and filled much of his day meditating. His greatest joy was participating in spiritual singing groups.

But I knew something was very wrong. I had an aunt who passed away from Alzheimer’s disease so I was familiar with the symptoms. When Morris started getting lost driving around town, when he departed for a road trip with our son and left behind his suitcase, and when he couldn’t give a friend’s son directions to the high school that Morris had graduated from, I suspected Alzheimer’s.

Morris thought I was ridiculous and refused to see a doctor. It took two more years before he finally agreed. After ruling out metabolic diseases, depression, nutritional deficiencies, and a brain tumor, the diagnosis was quick and clear. Yet, Morris continued to disbelieve that the doctor said he wouldn’t be able to drive in a couple of years.

There’s actually a term for denial of diagnosis. Anosonosia is the medical term for a person who lacks the insight of awareness to understand their own condition. A person with Alzheimer’s can refuse to believe that they have the disease because their brain isn’t fully capable of understanding the illness. Or the person might be in denial because of the stigma attached to having dementia or Alzheimer’s.

How can you help your loved one?

  1. Don’t keep reminding the person of their diagnosis. Instead, be supportive and allow him/her to do as much as they are capable of without taking over for them.
  2. They most likely feel depressed or bewildered or scared, or all of the above. Be a friend and let them know you are there for them.
  3. Listen to their rants, their feelings, their fears. And know that their outbursts of anger are not personal, although that’s difficult. Usually the person closest to the patient is the one that is subjected to the most anger and frustration. Your loved one is scared of how their world is falling apart. You are probably just as scared. Join a support group. The Alzheimer’s Association near you offers support groups for both the person with dementia and for family members. It is a god-send. https://www.alz.org/
  4. Encourage your loved one to do things that will reduce symptoms of the disease. Exercise, socialize (which may be difficult during the pandemic), listen to music, plant a garden, do art projects. There are dozens of ideas to reduce stress for both the patient and the caregiver in my book “Calmer Waters: The Caregiver’s Journey Through Dementia.” https://www.amazon.com/Calmer-Waters-Caregivers-Alzheimers-Dementia/dp/1681570149/ref=sr_1_1?s=books&ie=UTF8&qid=1543875890&sr=1-1&keywords=calmer+waters
  5. Pharmaceuticals for Alzheimer’s help to slow down the progression of the disease. Encourage your loved one to take what the doctor has prescribed.
  6. Although there is no magic bullet, natural supplements also help. Read: “5 Things that Help Dementia that your Doctor Probably Hasn’t Mentioned.” https://wordpress.com/block-editor/post/barbracohn.com/5277
  7. Focus on eating a Mediterranean diet that includes fish, lots of fresh vegetables and fruit, nuts, and healthy fats—olive oil. https://wordpress.com/block-editor/post/barbracohn.com/5170
  8. Help your loved one decrease use of cigarettes and alcohol.
  9. Emphasize a structured routine including getting to bed on time.
  10. Beautiful and simplify the environment with uplifting music and fresh flowers.

Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Activities for people who have Alzheimer’s disease and other dementias

sea stones painted by the children on the beach

During the early stages of Alzheimer’s, your loved one might continue to enjoy their favorite activities. But as the disease progresses, he or she will probably withdraw from activity.

If you’re a caregiver taking care of someone at home, this is when things become challenging. How do you keep your loved one engaged without getting stressed and frustrated?

I hired someone to take my husband out a couple times a week for a drive, walk, movie, ice cream, etc. If you can afford it, and can ensure safety measures during the pandemic, respite care can help ease the boredom of watching TV all day. And it can help you get out of the house to do errands, go to doctor appointments, or just take a walk.

Whether you’re a full-time caregiver or occasionally drop in to visit a friend or loved one with Alzheimer’s, here are some activities to try.

*Fold towels, washcloths and hand towels, socks.

*Sort coins.

*Paint with water.

*Make potholders with a child’s loom.

*Rake leaves.

*Weed flower beds.

*Sort through junk mail, open and tear it up.

*Play bingo.

*Go for a ride.

*Play with Play-Doh https://playdoh.hasbro.com/en-us, clay or Kinetic Sand. https://kineticsand.com/

*Dust and polish the furniture.

*Cut out photos from magazines and make a collage.

*Create an “art gallery” with photos, prints, or original artwork.

*Listen to audio books.

*Watch funny YouTube videos of babies, kittens, puppies, etc.

*Color in coloring books.

*Plant an inside herb garden.

*Lace cards.

*Set up a bird feeder outside the window.

*Set up an aquarium.

*Use rubber stamps to make cards for children in the hospital, etc.

*Look for rocks and then paint them.

*Collect seashells (if you live near a beach), and string them and/or paint them.

Art Therapy

Read about how one caregiver heped her mother make paper paper flowers and find a purpose: https://barbracohn.com/2017/09/26/need-something-to-help-your-loved-one-find-a-purpose-how-one-caregiver-discovered-that-art-therapy-can-be-rewarding-and-stress-reducing-for-herself-and-her-mom/

Here are a few things you can do by yourself and with your care partner.

“Art Exercises for Caregivers” by Meg Carlson, chapter 11 in my book Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia.

  1. Making an Inside/Outside Box

Materials:

  • Boxes-shoe box, tea box, metal tin, etc.
  • Mixed media-crayons, paint, markers, glue, feathers, felt, rocks,

Decorating a box allows the artist to reflect his/her persona or face that is shown to the outside world on the outside of the box. Decorating the inside of the box is an opportunity to express the internal feelings and conflicts that are private or feel too big to find words to express. Use whatever materials that are available to decorate the outside of the box, and then the inside of the box to express these feelings.

Outside Box: How do you experience being around others with your loved one? What do you share with the outside world about your process/how do you share?

Inside Box: What is really going on inside of you each day? What isn’t shared with others that have an impact on you?

What has this process, or your imagery expressed to you? What kinds of responses are you having?

  1. Daily or Weekly Mandalas

A mandala is a circular image. It begins with a circle drawn on a page. It can be any size and any media can be used.

Materials:

  • Paper: Bristol, Watercolor, or mixed media (6×6 is a great size)
  • It is small enough to be done in a brief sitting, and large enough to have room for several images or areas of focus.

Pencils, markers, watercolor, colored pencil, pastels, or crayons are all great.

A version of mandala exists in many spiritual traditions (rose windows in Cathedrals, Navajo and Tibetan sand paintings, Buddhist imagery, etc.) Mandalas can be used to support focusing attention, as a self check-in tool, to express emotions in a contained space (circle), for establishing a sacred space, and to aid in mindfulness and mediation. Carl Jung, through his own art process, came to realize that mandala paintings enabled him to identify dysfunctional emotional patterns and work towards integration and wholeness. 

  1. Color-Texture-Pattern Feelings Portrait

This process is about awareness of how much is going on in each of us at any given moment. It is an opportunity to just GET IT OUT through color, movement, and expression. The imagery is usually abstract. It is the process of expressing that is beneficial here, not the finished product. Feelings are difficult to have, and when they are expressed visually they can be difficult to look at. But that is okay. If you use this process, when you are finished, take a moment to witness it like a loving friend. Then just set it aside. If your image invites a redo or edit, you can come back to it and work with it, even tear it up and re-create it. If not, let it go. The materials will support you to express emotions and that is their purpose sometimes …. to help you create something that is not necessarily pretty, but honest. That is their gift to you.

Materials:

  • Small to medium paper, mixed media paper is sturdy. Taped to surface is best. When you prep ask yourself, What size is my expression today? That will tell you what paper size to use.
  • Pencils, markers, watercolor, colored pencil, pastels, or crayons are all great.
  • This can be done between 5 and 25 minutes. It is simply the process of choosing colors and making textures and patterns that express the layers of feeling present. Let the speed and movement be an extension of your expression. It will be unique every time.
  1. Two Inch Window Drawing

The goal is to work with detail and discernment to create a bird’s eye view. Another way to use this tool is one of magnification, to zoom in to one aspect of something larger; examples could be to feel a single sensation, filling a small (contained) space with just what is magnified. Used as a daily or coping practice it may serve to redirect concentration or focus energy and attention, provide containment while titrating an intense sensation. They take between 1-10 minutes to complete. Think Macro and Micro… what would be most helpful, to step back or lean in?

Materials:

  • Paper: Bristol, watercolor, or mixed media (2×2 or 4×4)
  • Card stock scraps come in several colors, and can usually be found at craft stores.
  • This drawing is small enough to be done in a brief sitting, and can even be a single set of colors.
  1. Process: Journey Drawing

Materials:

  • Paper: Bristol, watercolor, or mixed media (6×6 or larger)
  • Collage materials, or a material you enjoy (fabric, craft papers, natural materials, etc.)
  • Chalk/oil pastels, pencil, watercolor

Where are you in this journey? Emotionally … physically . . .personally . . . socially? Is there stuckness . . . is there movement? What colors, shapes, textures represent where you are right now? What colors feel supportive of your journey or give you strength? What emotions are present for you about your current life, about being a caregiver? Can you think of any supportive guides/helpers that you have met along the way? How has your identity or personality been challenged or changed in this process? Who in your life is accepting these changes, who in your life are having difficulty accepting the changes?

What has this process, or your imagery expressed to you? If you had a chance to respond to it, what kinds of responses are you having? Are you in a different place in your journey than you assumed/thought/hoped? What are the qualities of where you feel you are in your journey as a caregiver? As you have moved through different stages, what has each stage offered you?

Lastly, choose a color that feels strengthening, a color that will help you move into the next stage of your journey. Now create a final piece of you drawing that will offer you strength and power when you look at it.  Be one of the helpers for yourself in this moment of your journey.

6. Process: Breath Drawing

Materials:

  • Oil pastels or chalk pastels
  • Large paper
  • Your breath
    With one color in each hand, draw your breath. Notice the qualities of your in breath (short, stunted, deep, long, interrupted, fast, shallow) and allow your hands and the colors to express it. Same with the exhale. What are the qualities present in your out breath? Move each hand/arm in a circular motion with the expression, notice how the lines change over time. Notice similarities and any shifts. Follow your own breath with soft awareness.

What has this process, or your imagery expressed to you? What kinds of responses are you having?

For more information on activities for people living with Alzheimer’s visit the Alzheimer’s Association’s website: https://www.alz.org/help-support/caregiving/daily-care/activities?gclid=CjwKCAjwzIH7BRAbEiwAoDxxTqQOIQhxq3c2b-k5u12ZU9oZixTf9PAfWpl3X-AGcE2eU9GKGRYxyxoCeRQQAvD_BwE