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Dr. Joseph Boffa
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Decreased mobility, sight, hearing or cognitive capabilities may limit a person's ability to take the quick action necessary to escape during a fire emergency. People over the age of 65 are twice as likely to suffer injuries or lose their lives in fires compared to the population-at-large, according to the U.S. Fire Administration, part of the Federal Emergency Management Agency (FEMA).
If your elderly loved one has Alzheimer's or dementia, problems with mobility, or is vision or hearing impaired, there are certain precautions that need to be taken in the event of a house fire. These precautions go above and beyond the traditional fire safety guidelines for all families. (LINK)
Here are some fire safety tips for elderly people with special needs, provided by the U.S. Fire Administration and the Federal Emergency Management Agency (FEMA):
If your elderly loved one uses a cane, walker or wheelchair – or is in a cast due to an injury – traditional escape routes may no longer be viable. One-quarter of victims with physical disabilities were unable to act to save themselves during a fire emergency, according to the U.S Fire Administration.
Check all exits to make sure wheelchairs or walkers can get through the doorways. Make any necessary accommodations (such as installation of exit ramps) to facilitate an emergency escape.
A person may be forced to crawl along the floor to avoid smoke. It can be very disorienting to crawl when you are used to walking – especially for those who count steps to locate doors and hallways. Place tactile markers along the baseboard of exit routes to help a visually impaired person feel their way to safety.
Conventional smoke alarms that sound during a fire aren't effective for someone who is hard of hearing.
¨ Many assistive devices are specially designed to alert hearing impaired people of an emergency. These include smoke alarms and appliances that use strobe lights and vibration equipment. Vibrating beds and pillows that are wired to a smoke alarm have been developed to awaken people who are deaf or hard of hearing.
¨ Smoke alarms with a strobe light outside the house can catch the attention of neighbors or others who might pass by.
Alzheimer's or dementia
If your relative has Alzheimer's or dementia, know that even cognitively impaired people oftentimes have an innate understanding that something is wrong during an emergency, and may be more clear-headed than you would imagine.
Practicing escape plans is also vital for all elders.
The following 10-point guide provides easy-to-follow tips that will help family members reduce falls risks for their loved ones with dementia:
1. Arrange for adequate lighting.
Dementia can damage the visual system and cause illusions and misperceptions. Make sure the home has enough lighting in each room to reduce visual difficulties. People with dementia might misinterpret what they see, so reducing dark areas and shadows is vital.
2. Provide visual cues.
People with dementia can have difficulty separating similar colors (such as the same carpet on the stairs and on the floor) and setting objects and their background apart. It is helpful to define the top and bottom of a staircase through the use of contrasting colors.
3. Clear walking paths inside the home.
Those living with dementia can have a hard time recognizing the danger of a loose rug, unsteady footstool or electrical cords stretched across the floor. Removing tripping hazards and keeping pathways clear can help prevent falls.
4. Decrease clutter outside.
Areas outside of the home should be clear of objects (leaves, rocks, etc.) and there should not be dips in walkways or otherwise uneven ground in a senior’s path.
5. Information and reminders in a common place.
Create a single place for any notes or reminders that can easily be accessed and read by a person with dementia. This can be a cork bulletin board or a dry erase board. Using a single location simplifies the process and provides for an organized system, preventing the need for a senior to walk around looking for information.
6. Keep important things by the bed.
A major issue for people living with dementia is confusion at night. Restless nights can leave them tired and unsteady. To help prevent wandering at night, keep important items on a bedside table, including water, a light source, eyeglasses, tissues and the telephone.
7. Consider unmet needs.
A person living with dementia may start to wander as their condition progresses. This may lead them into unsafe areas. Wandering often signifies an unmet need a senior is trying to satisfy. For example, they may be looking for a telephone because they usually called their wife at 5 p.m. Instead of trying to physically stop the wandering, try distracting or redirecting their activity to avoid raising a person’s anxiety or frustration level.
8. Lower noise levels.
As a person living with dementia may have more sensitivity to noise, you should try and decrease the level of white noise and loud sounds around them. If the noise level becomes too much, it can cause anxiety and nervousness – which can make a person with dementia unsteady on their feet.
9. Keep help at hand.
For an older person who is at risk of falling, being able to quickly and easily call for help is vital. Consider various forms of remote care technology, such as a fall alert bracelet or auto detector, which can be used in case of an emergency.
10. Supply safe footwear.
What a person wears on their feet can represent a major fall risk. If a shoe can easily slip off, it can cause them to trip. However, a person living with dementia may struggle with complicated articles of clothing that involve buttons or laces. Shoes with Velcro fastenings are a good solution, making footwear easy to take on and off, but also safely securing it to their feet.
People with Alzheimer’s disease and other forms of dementia can often experience mood swings. These episodes can be trying on their caregivers as they try to help.
“The best thing that a caregiver can do to mitigate mood and behavior changes is to know and understand the individual person — including history, likes and dislikes, favorite foods, music and activities, what soothes them, what upsets them, what time of day they are at their best, and so on,” said Ruth Drew, Director of Family and Information Services for the Alzheimer’s Association. “When you know the person you can organize the day so that you anticipate and avert many problems before they occur. You recognize the signs of distress early and have several methods of dealing with them.”
Some of these methods include filling the day with pleasant experiences in which the person is comfortable and comforted by sights, sounds and tastes they enjoy. This needs to be combined with plenty of “down time” to avoid feelings of boredom and loneliness. Proper management of diet, activity and medications can minimize pain that might also cause mood swings.
“When someone with Alzheimer’s seems upset or withdrawn, first assess for pain or discomfort,” Drewsaid. “Pain in people with Alzheimer’s is under-recognized and under-treated, because they may not tell us in the way we expect. When pain is the problem, rely on your medical team to diagnose and treat the cause. Sometimes the things we interpret as mood swings or challenging behavior can simply be a person’s reaction to uncomfortable clothing, being too hot, too cold, hungry, thirsty, bored or fatigued. Often, if we try to look at the world through the other person’s eyes, we can figure out what’s going on and help to solve it."
Drew reminds caregivers that “all behavior is communication."
Know that sometimes there is only so much a caregiver can do and support for the caregiver and medical intervention for the person with dementia are necessary. The Alzheimer’s Association offers education programs and support groups in local areas, as well as online social media and eLearning sites at www.alz.org, and a 24/7 Helpline at 800-272-3900.
The Ocean State Center for Independent Living
The Ocean State Center for Independent Living is a non-residential , consumer-driven, community-based, cross-disability, non-profit organization. OSCIL was established in 1988 to provide a range of independent living services to enhance, through self-direction, the quality of life for persons with disability and to promote integration into the community. OSCIL is governed by an active Board of Directors comprised largely of persons having disabilities, who play a major role in setting policy and programming.
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