Taken From: a Pacific Medical Training article written by Sarah Gehrke, MSN, RN

Recognize Alzheimer’s Disease

Providing first aid for people with Alzheimer’s can be a challenge, and it’s crucial to remember that no two people are the same. The following tips will help you identify someone with dementia. The person may:

  • Appear disoriented and confused.
  • Appear fearful, agitated, frustrated, angry, or is crying.
  • Have a facial expression that is inappropriate in relation to the circumstances or have a flat affect.
  • Have difficulty with gait and balance, which may be mistaken for intoxication.
  • Reply with inappropriate answers or not respond at all.
  • Not comprehend the situation or be unable to tell you their name, address, or where they are going.
  • Not know the date, time or when they left their home.
  • Have difficulty following directions.
  • Dress inappropriately for the temperature.
  • Be advanced in age (although, dementia can affect those under the age of 65).

Common Situations

  • False Accusations – An individual with Alzheimer’s may call the police station or emergency services to report a burglary, when in fact, the person has lost or misplaced the item.
  • Inappropriate Behavior – Confusion, memory loss, and emotional reactions may produce improper actions, such as taking off their clothes in public. The person with dementia does not understand this is inappropriate behavior.
  • Shoplifting – Confusion and memory loss may cause a person to forget to pay for items in a store or even fail to recognize that it is required to pay for things before leaving the store.
  • Wandering or Getting Lost – People with Alzheimer’s can get lost easily at any time of the day. Assess for signs of dementia when encountering anyone that you suspect is wandering or lost.
  • Fires – A person with dementia may leave the oven on or forget to turn off a burner. Also, it is not uncommon for the individual to mix up the seconds and minutes when using the microwave, thus burning the food in the microwave.
  • Hoarding – Poor judgment can cause a person to neglect themselves and their home, which can lead to safety risks and violation of fire codes. Hoarding may lead to fires, spoiled food, pests, and fall hazards.
  • Abuse and Neglect – Situations of abuse and neglect can be stressful and require a thoughtful response. 
  • Firearms – Firearms are in 60% of households where a person with dementia lives.  Judgment and personality changes can make having a weapon very dangerous for a person with dementia and others living in the home.

Medical and Disaster Emergencies

During an evacuation, it is essential to keep the person with dementia calm. To do so:

  • Avoid restraint or physical force.
  • Be imaginative when communicating rather than rely on reality.
  • Provide specific one-on-one guidance by using simple words.
  • Attempt to relocate the person to a quiet place.
  • Use distraction by giving the person a simple task.
  • Ensure the person is observed at all times.

Communication Strategies

The further the disease progresses, the less a person will be able to express or understand what is said.

Remember that communication can be both verbal and nonverbal. Your body language, tone, and volume of your voice can be just as important as your words.

  • Identify yourself and establish eye contact. Let the person know you are there to help.
  • Speak slow and present one idea at a time.
  • Establish a caring atmosphere. If you are approaching an individual who is upset or emotional, your composure may help to calm the individual. A sense of humor may help to diffuse a stressful situation.
  • Move the person to a quieter area to decrease distractions. Activity may make it difficult for a person with dementia to concentrate.
  • Ask closed-ended questions that require simple answers, such as “yes” or “no.” “Do you know this street?” is easier to answer than “Where do you live?” Attempt to limit reality checks.
  • Use actions to back up your words. If possible, demonstrate what you need the person to do by using non-verbal communication, such as point to the chair if you are asking the person to sit down. You may need to sit down next to them.
  • Listen carefully to what the person is trying to say. You may not understand all of the spoken words, but you may recognize emotions, such as fear or anger. You can acknowledge the person’s feelings by saying, “You seem upset.”
  • Watch for nonverbal signs. The person may not be able to express themselves adequately with words. Rubbing a body part may indicate pain. Tugging on or attempting to remove clothing may be a sign the person needs the restroom.
  • Repeat and rephrase responses. If it is difficult to understand the person, try to repeat or rephrase what is said to ensure you understood correctly.

Additional Resources

For suggestions on home safety, one-on-one consultations about behaviors and safety tools to keep in place during an emergency please call 512-241-0420 or email [email protected]. Our 24/7 helpline is also available anytime for assistance or just to speak with someone who cares.

First Responder Access and Functional Training Series – video series designed to educate first responders on the various sensitivities related to those with Alzheimer’s. https://www.youtube.com/watch?v=fPx-UP7hjW8&feature=youtu.be

The Healthy Brain Initiative – resources for the public health community to embrace a multifaceted approach to cognitive health. https://www.cdc.gov/aging/healthybrain/index.htm