Social Work Services Assist Claire - Step 6

By Anne M. Foerg, Director of Social Work

After George was found safe at a local hospital, the Wanderer’s Safety Program referred Claire to speak with a member of the social work team. Claire needed support following this traumatic experience and guidance as to what could be done to prevent it from happening again. When our social worker connected with Claire, she shared the story of what happened, a common one for those caring for people with dementia in the middle stage. George usually woke early in the morning, a habit acquired from his career as a mail carrier. Claire tried to wake at the same time, or even earlier, to prepare her husband’s breakfast and often remind him that he no longer worked. But this time she woke to find that he was already gone. George was found, but Claire was understandably shaken by the experience. She spoke of how overwhelmed she had become as George’s functioning declined, barely able to carve out a minute to herself, as he often followed her around the house.George also often wanted to go out, and Claire spent a significant amount of time arguing with him about the fact that it was no longer safe for him to do so alone.

As Claire was wrestling with her guilt about what happened, our social worker assured her that no one can care for a person with dementia every day, all day, without some relief. Not only was Claire entitled to her sleep, she also needed time to herself, to relax and participate in activities that restored her, both physically and emotionally. Thankfully, George had been found safe and the social worker explained that Claire could now focus on crafting a plan to help her husband and herself.

Our social worker initially guided Claire in thinking about how to prevent George from wandering again. They discussed tactics such as removing cues that might prompt him to go outside, such as the presence of shoes and coats by the door. The social worker also introduced Claire to items such as door chimes and alarmed door mats that would alert her if George tried to go out, and confounding door locks, safety devices designed so that a person with dementia would not be able to use them.

Understanding why the wandering or “exit seeking” might have occurred in the first place was also an important part of preventing it. Wandering behavior often signals that a person with dementia needs something to do. A proud mail carrier for the U.S. Postal Service, George was used to rising early for his job. He loved being outside and active during the day, and his busyness continued when he returned home in the evenings, often socializing with friends and neighbors. The social worker explained that George’s disease did not change his need for meaningful engagement and social activity. It may have been why he was often trying to leave their apartment or following his wife. He was looking for something to do, but he could no longer initiate an activity for himself.

The social worker suggested that Claire explore George’s participation in a social adult day program, a structured, activity-based socialization opportunity for people with dementia. This would keep him engaged with others and provide respite for Claire to take care of her own needs. In addition to identifying such programs near the couple’s home, the social worker counseled Claire about managing the cost, as she expressed concern given the couple’s fixed income. The social worker introduced Claire to the concept of Medicaid, the only form of public health insurance that pays for this type of long-term care, and how George may become eligible for it in order to cover the cost of the day care, as well as home care.

This was a lot of information for Claire to process and she wanted to discuss it further with her children. Claire arranged for her son to stay with George while Claire and her daughter met with the social worker to discuss these issues and to begin making a long-term plan.Claire’s children had been eager for her to have help with their father’s care, as their full-time jobs made it difficult for them to do more. Meeting with the social worker allowed them to develop a plan for care and divvy up the tasks necessary to implement the plan. Their daughter agreed to set up a consultation with an elder law attorney to begin the process of planning for Medicaid, while Claire would make appointments to visit the local adult day programs in order to find the one that would be the best fit for George. Claire expressed a huge sense of relief at finally seeing a light at the end of what had become a very dark tunnel.

George and Claire’s Journey continues on the next page...

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