From "How to Find a Missing Person with Dementia/Searching for people with cognitive disabilities presents special challenges. Can we solve them?" (The New Yorker).
Beta-amyloid and tau proteins often first invade the entorhinal cortex in the medial temporal lobe before assailing the adjoining hippocampus. We use both brain areas to travel through the world: grid cells in the entorhinal cortex help track our positions as we move through space, while the hippocampus is involved in conceptualizing where things are in relation to our bodies.... The mental location of an intended destination—Walmart, say, or a room in one’s home—suddenly disappears, along with the memory of its adjacent landmarks. Wandering is a logical response to this illogical and unsettling experience. A person might walk to escape what suddenly feels like alien territory, perhaps in the hope of figuring out where they’ve been stranded....
Wouldn't you think that GPS devices would completely solve the problem of finding persons with dementia who've wandered off? But, we're told, there are some privacy and autonomy concerns (and also that Medicare doesn't cover phones and smart watches).
पोस्ट्स
४० टिप्पण्या:
My father's family built a cage in their living room to keep my great grandfather from wandering off. He was a large man, and they called him The Giant. At 6'2" he was pretty huge for an Irishman at the turn of the century.
I have a loved one with dementia, but not Alzheimers. And yes, he loses track of where he is both in time and place, and he wants to escape. He needs to go somewhere, and it is very agitating to him that he doesn't know where he wants to go.
We have tried Tile and Air Tags. He has an iPhone.
But people with dementias also misplace things all the time. They hide things. Someone with Alzheimers or other fairly advanced dementias can't be counted on to keep their phone with them, or to operate an Apple Watch.
PROBLEM: And yet a person with Alzheimer’s can’t simply be locked in at home. The loss of dignity and quality of life would be intolerable, and, as many caregivers discover, people with dementia can quite suddenly outmaneuver even those safety measures
SOLUTION: Install that person as President of the USA
Well, you could call the Secret Service. They’ll know where he is.
I almost feel like Althouse was fishing for that kind of comment…
They’re putting this out because our president has it.
Estimates of extinction, endangerment, transgenderism, unhappiness, warming, change, etc. are complementary in a scientific culture.
Shorter New Yorker: Kids defeat childproof locks
Even shorter New Yorker: Convicts escape prison
=XC
This may sound cruel, but we put chips in our cats and dogs.
And Apple has tags that facilitate tracking.
An Apple-like tag in a necklace for people who wouldn't take it off.
A chip for everyone else...
Nursing homes have GPS trackers on the patients. This is not an uncommon solution. Also, they lock the doors to the dementia unit.
If you have lost your ability to reason and take care of yourself, doesn't that mean you are unable to make valid choices and could be a danger to yourself? A locked door is a small price to pay to keep your loved one safe. I think their autonomy is no longer with them.
We purchased a device used to track driving of young drivers in the learning phase. It allowed for geofencing and tracking. It wasn’t expensive. But that only works for vehicles. Cellphones and watches don’t work, because they are typically not kept charged, because that tasks gets forgotten. Unfortunately, once wandering off begins, either you need a full time caregiver or placement in a memory care facility. Otherwise, you are taking chances that are increasingly getting worse.
This is concern trolling.
My experience with memory care units for Alzheimer's has that unit locked down.
Yes, nobody wants to be in the memory care unit. Dad lasted 6 weeks, and left the facility toe's-up!!
The solution is simple. Buy one of these and strap it on:
https://tryfi.com/learn
In 2015 saw a demo by a 14 yr old Asian kid. He created a pair of socks with pressure sensors on the bottom attached to a sending unit.
Put them on grandpa at night. If he got out of bed the socks sent an alert to his parents.
Smart kid. Sure he's at Stanford or MIT by now.
My father had Parkinson's dementia and probably Alzheimers, and in the last year of his life, started to leave the house during the night when my mother and I were asleep. Our solution, suggested by my brother-in-law who had experience of such things with his grandmother, was to place those "chain" locks you see on motel doors at the tops of the doors to the outdoors and the door down into the basement. People with dementia can open dead-bolts and doorknob locks, still, but when faced with a door that can't be opened fully by a lock at the top of the door apparently can't think to look upwards to see the additional lock. It worked for us- but it was us locking him in the house with us while we slept. We didn't ever leave him alone, though- one of us was always in the house with him.
The two times my father got out, I found him the first time sitting on a bench about a quarter mile away- he was going to the hospital he told me at 3 in the morning.
The second time, and last time, it was about 10 F outside, and he snuck out in his underwear, barefoot. I wouldn't have known he was gone if I hadn't gotten up the urinate and looked in the bedroom to find him gone. I drove around the neighborhood for about 10 minutes as my mother called the police, and an officer pulled up in front of me to tell me that another unit had found him about a 1/2 mile away in a cul-de-sac- he was again on his way to the hospital, but no longer knew which street to turn into. I don't know how long he had been out, and he couldn't tell us, but he suffered no physical harm.
gspencer said...
PROBLEM: And yet a person with Alzheimer’s can’t simply be locked in at home. The loss of dignity and quality of life would be intolerable, and, as many caregivers discover, people with dementia can quite suddenly outmaneuver even those safety measures
SOLUTION: Install that person as President of the USA
5/23/23, 11:12 AM
PERFECT!!!!
bracelets/anklets of some kind with GPS built in?
Unless they have Secret Service "protection."
Serious question: why can't we view the approach to the problem of those who are seriously mentally disturbed, yet unrestrained, to the problem of those suffering with other cognitive deficiencies such as dementia, who are restrained and treated against their will?
IOW, why is it OK to let our sister live raving and wandering due to mental illness (or even incapacity due to heavy drug use) but it's completely not OK to let Grandma rave and wander off to sleep under bushes? That societal approach in the first case is described as not interfering with a person's liberty and lifestyle, while the other case is described as unconscionable cruel neglect. Yet neither person is remotely capable of caring for themselves and in both cases it's due to somewhat similar cognitive deficiencies and damage.
Chip them. Like pets.
When I worked with veterans w/dementia their facilities all had door alarms on their fire exits because no locks on fire doors.
This is even smarter. Best security device?
https://fliplok.com/
use TV25 promocode soon!
Canada seems to be heading for a final solution....
But, seriously, could this be why the White House has a fake press room? Let Brandon wander in and answer a few softballs by staff maskarading as reporters.
It's a full and fun filled day.
Unsubstantiated science and dubious estimates pulled from the ether. ChatTNY should focus on the issue, rather than authoritative appeal, with dreams of neglecting/sharing/shifting personal responsibility.
"Michael said...
In 2015 saw a demo by a 14 yr old Asian kid. He created a pair of socks with pressure sensors on the bottom attached to a sending unit.
Put them on grandpa at night. If he got out of bed the socks sent an alert to his parents.
Smart kid. Sure he's at Stanford or MIT by now."
Maybe shares a dorm with this other genius:
Expressing his admiration for a high school student's curiosity about science, President Obama has invited Ahmed Mohamed to the White House.
A tweet from the president reads: "Cool clock, Ahmed. Want to bring it to the White House? We should inspire more kids like you to like science. It's what makes America great."
Ahmed Mohamed, 14, was handcuffed and taken away from his school in Irving, Texas, earlier this week after school officials grew suspicious of a digital clock he had made in a pencil case over the weekend.
We had a neighbor with dementia who would escape and go wandering. Luckily, she grew up in the same neighborhood and the home where she raised her kids was next door to us. (She and her husband had moved around the block when they could no longer do stairs.) So she would wander, show up on her old step, and then I'd send my kids out to talk to her and keep her occupied (she liked to tell them about her kids who "were there ages' and how they should meet) while I called her husband and sun and let them know to come get her and walk her home.
It worked until she broke a hip and kept leaving without her walker--- but for several years it was a fine arrangement. But one that only works where there is community cohesion!
This is how I want to live if I have dementia.
I think the US is behind the curve on this kind of thinking.
Oops! Forgot the link!
https://www.theatlantic.com/health/archive/2014/11/the-dutch-village-where-everyone-has-dementia/382195/#
The psychiatric unit at one of the hospitals where I worked had good security...at the entrance to the main lobby. But there was a self-locking door at the stairwell with a fire door leading to the rear of the building. I was going from one of our offices to another and spotted an aged dementia patient in a wheelchair stuck halfway out the fire door. I came and offered to help her, though she pleaded with me not to take her back into the hospital. I made no promises regarding her plea, but helped her get safely to the sidewalk, then we strolled around to the hospital main entrance, and then to the nursing station for her unit. I explained what happened, and mentioned that they should check the stairwell door. The patient was somewhat disoriented so I'm not sure she knew she was back in the unit, but it all turned out all right.
Our dad had senior dementia, probably not Alzheimer's, but it slowly progressed to the point where he coukdn't live alone. Right around that time, my sister was divorced by her husband of over 20 years, so she volunteered to move in to help care for him. We were in Wisconsin at the time so we couldn't be there except once in a while. Our older sister lived about 20 miles away, married with no kids and many cats, but she wasn't able to help out or do respite care, so for over ten years younger sis bore the responsibility for his care.
In late 2019 he was experiencing 'sundowning' and my sister was at wit's end. I took time to talk Dad through his perceived issues which helped a little, but in November my wife and I came out to southern CA to help for a few months. He had cataract surgery and we had to help him refrain from rubbing his eye.
The first night he had a plastic shield held on with adhesive tape...that went by the wayside before morning, so my idea was to buy a pair of shop goggles to wear at night. That worked for the rest of the week and he had no problems with infection.
Then in March, the lockdowns hit and some of his favorite activities (hot dogs at Costco were #1 on his list) were not available, so we had to get creative. He hated going to the drive-up, but he was perfectly OK if we brought dinner in to his place, so that's how we did it. Anticipating his needs also helped, so instead of waiting for him to tell us he was hungry, we scheduled treat times between meals. As you can imagine, this was a lot like full time work - more than 14 hours a day - but with two of us it was better than having just one of us to do it all.
In January 2021, even though my sister took every precaution, and then some to avoid COVID, they both caught it, and a day short of Dad's 89th birthday he passed in the hospital. She recovered even though she had some comorbidities, and at that time we had just moved to PA ao we weren't there to support her.
That said, I find it hard to believe he would have received better care under a government-funded program. Most likely none of us kids would have been able to do the work for whatever pay it might involve, and absent our sister's divorce, Dad would have had a paid caregiver who might or might not have the training or temprament to help him through his sundowning and other issues.
Just put one of those invisible fence electric shock dog collars on them?
"Just put one of those invisible fence electric shock dog collars on them?"
Probably the greatest kindness, as also for dogs who bark and will get thrown out of apartment buildings. A good cruelly neutral solution.
Some years ago on the sidewalk along a strip mall in Madison on University, an elderly woman approached me. I concluded after awhile that she had dementia and had wandered away, and didn't know where she was or what to do. She was very upset. After some exchanges I decided I should call 911. When I did this (using an old fashioned pay phone), she concluded that I was up to no good, and booked it while I was still on with them.
The headline makes it seem like there's a market for dementia patients..
Team Biden take note.
It is equally challenging to decide at what stage of the dementia a person needs certain privileges taken away. Like driving for example. People don't just go instantly from "normal" to totally demented. There is a prolonged phase where they continually get worse, but it is gradual. They have good days and bad days. Obviously the car keys eventually need to be taken away, but how do you know when that becomes necessary? The person with dementia will rightfully resent the loss of their freedom and independence. They are still sensitive to the loss of control over their own lives and act out in very unpleasant ways towards those who love them and are trying to protect them.
"Just put one of those invisible fence electric shock dog collars on them?"
This is tangential, but only a fool would buy that product (full disclosure: I did 35 years ago). That invisible fence may keep your dog in your yard, but unlike a real fence, it won't stop a feral dog from coming into your yard and tearing Fluffy to pieces after it rapes her. Funny they never mention that in the commercials.
Oh, and my dog? Hambone was a cost-benefit minded creature that realized if he was willing to endure a quick shock or two, he would then be free to roam the world until he felt like coming home. And when he finally did come home, he'd wait outside the fence until I pulled him back into the yard. I guess he felt I wasn't worth getting shocked over. Made me kinda sad.
"The headline makes it seem like there's a market for dementia patients.."
Is the fact that they are never represented in commercials discriminatory?
Tell them, Dutch:
“Nov. 5, 1994
My Fellow Americans,
I have recently been told that I am one of the millions of Americans who will be afflicted with Alzheimer’s Disease.
At the moment I feel just fine. I intend to live the remainder of the years God gives me on this earth doing the things I have always done. I will continue to share life’s journey with my beloved Nancy and my family. I plan to enjoy the great outdoors and stay in touch with my friends and supporters.
Unfortunately, as Alzheimer’s Disease progresses, the family often bears a heavy burden. I only wish there was some way I could spare Nancy from this painful experience. When the time comes I am confident that with your help she will face it with faith and courage.
In closing let me thank you, the American people for giving me the great honor of allowing me to serve as your President. When the Lord calls me home, whenever that may be, I will leave with the greatest love for this country of ours and eternal optimism for its future.
I now begin the journey that will lead me into the sunset of my life. I know that for America there will always be a bright dawn ahead.
Thank you, my friends. May God always bless you.
Sincerely, Ronald Reagan”
I put a battery-powered alarm on the back door several years ago after Dad walked two doors down at 5 am. He never heads to the front door, which has 8 steps and no handrail. Just as well we didn't get his hip replaced in 2018 when it first started hurting when he walked.
Omaha1 said...
It is equally challenging to decide at what stage of the dementia a person needs certain privileges taken away. ....
The Alzheimer Support Forum www.alzconnected.org has posters telling stories about POA's who didn't act soon enough. Apparently, Once the POA knows the diagnosis, they have been held responsible/liable along with the PWD for damages the PWD (person with dementia) caused with a car and the auto insurance was invalidated too. Then the funds for care are gone.....
टिप्पणी पोस्ट करा