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ASK DOCTOR K: Roaming patients can be contained

on April 30, 2013 11:00 AM

DEAR DOCTOR K: My husband has Alzheimer’s disease. Last week he left the house, and it took us hours to find him. How can I prevent him from wandering again?

DEAR READER: One of the most dangerous and distressing symptoms of Alzheimer’s is wandering. It may seem unfathomable that a person might suddenly get up at night to go to the post office, or leave home at any hour for no apparent reason. The inability to control wandering is what often drives families to decide to place a loved one in a nursing home.

However, some simple measures can help to prevent wandering, at least for a time. The Alzheimer’s Association recommends these steps:

• Install slide bolts at the top or bottom of doors.

• Place warning bells on doors.

• Cover doorknobs with childproof knobs.

• Camouflage doors by painting them the same shade as surrounding walls.

• Create a 2-foot black threshold in front of doors with paint or tape. (A rug might do the job, too.) This creates the illusion of a gap or hole that a person with limited visual spatial abilities may be reluctant to cross.

Also, take these additional precautions so you’re prepared if your husband does wander:

• Have a recent, close-up photograph of your husband available, both print and digital.

• Keep a written list of places that he might go, such as church or a favorite restaurant, job site or previous home.

• Post emergency numbers in a handy spot.

• Buy identification jewelry engraved with “memory impaired” and your husband’s name, address and phone number.

A high-tech option uses GPS and cellphone towers to provide an approximate location for a person who might wander. You can request an alert if your husband, who must be wearing the locator device, leaves a specified zone. Or you might tap into the system only in case of emergency.

Why do people with Alzheimer’s disease wander? Where do they think they’re going, and why? Health professionals who work with people who have this disease think that wandering may be prompted by deep-seated memories of work, chores or hobbies, or a longing to return to a former home. Sometimes that’s what people with Alzheimer’s seem to say when they are found wandering. They usually say they are on some kind of mission.

But it’s hard to know. When the brain has been confused by Alzheimer’s disease, does the brain understand what it has decided to do? Could it be that people who are asked why they wander feel they need to give some kind of answer, so they create one?

Someday, medical science is going to figure out how to stop this devastating disease — and then the question of why people wander will be moot. That will be a truly great day.

(Dr. Anthony L. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)

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