Dementia: safety and independence

March 25, 2019

Everyone with a memory loss condition deserves the opportunity to stay engaged in life for as long as possible. Early in the disease, your loved one will continue to do many things quite well. Your challenge is to balance respect for your relative’s independence with the need to ensure safety. All this while preserving a trusting relationship.

In the beginning, just keep an eye on things. Encourage engagement and support self-esteem. Over time, you may need to provide some assistance. Not to do things “for” him or her, but “with.” As abilities decline, suggest alternative approaches. And when you notice risky and unwise decisions, transition into taking over. Respectfully.

Managing mail and doing calculations can become confusing early on. Watch for unopened bills, an unbalanced checkbook, utility shut-off notices, or difficulty calculating the tip at a restaurant. Offer to “make life easier” by putting bills on autopay. At tax time, suggest doing it together. Or that you take it on, as he or she has “done that chore long enough.” Poor judgment may leave your relative open to scams. Look for odd purchases or erratic spending. Work with your loved one’s financial advisors to talk about money management options. Eventually, if you have power of attorney, you may need to activate that.

If your loved one is still driving, be the passenger frequently to check his or her capability. Dementia affects reaction time, spatial judgment, and decision making under pressure. Typical problems include

  • not following right-of-way rules, for example at stop signs or when making a left turn.
  • getting flustered at intersections or stopping midstreet when feeling uncertain.

You might suggest driving simpler routes and when traffic is less busy. Or facilitate rides from friends, public transit, etc. Eventually, call the doctor and ask for a driving evaluation.

Is your loved one in the early stages of dementia?
Such a delicate balance! We can help. We at Iowa City Hospice see families struggle with the natural temptation to protect their loved one by taking over, only to be met with anger and resistance. As the Iowa City, Muscatine and Cedar Rapids experts in family caregiving, we can help you navigate the need for safety AND independence. Give us a call at 1-800-897-3052, toll-free.