February 17, 2009

Wondering about Wanderers?

Suppose your grandmother wanders out of the house in the middle of the night. What can you do for some peace of mind to keep them safe?

One option is a MedicAlert + Safe Return bracelet. Here's some information:
  • Enroll in program: 1.888.572.8566
  • Report a wandering incident: Call 911 first. Then call 1.800.625.3780. 

  • MedicAlert + Safe Return enrollment package

    For $49.95, with a $25 annual renewal fee, the enrollment kit includes:

    * MedicAlert Identification bracelet or pendant
    * Wallet card
    * "6 Steps to a Safe Return" magnet
    * Personal Health Record Summary
    * Alzheimer's Association brochure

    What are some important considerations for dementia?
    Here's a few mnemonics that might be helpful:
    Remember the reversible causes of DEMENTIA
    Drug intoxication
    Metabolic (hypothyroidism, order TSH!)
    Emotions (screen for depression!)
    Nutrition (Vit B1/B12... order B12!)
    Tumor/Trauma/"Tension"-Normal Pressure Hydrocephalus
    Infection (neurosyphilis, consider RPR!)
    Anemia/Atherosclerosis (order CBC!)

    I'm very fond of important mnemonics that help me quickly recall things at the bedside, especially if they can be easily detected and treated before it progresses into something much more permanent.

    GOMERS go to ground - The Fat Man, House of God. (Elderly people have a tendency to fall.)
    There's a ton of mnemonics on falling. IHATEFALLING, CATASTROPHE*... those are too long but you can google them at your leisure.
    GMA MOVES is more to my liking.
    Gait impairment
    Multiple Meds-Polypharmacy
    Alcohol and drug use
    Medical illness (PNA, MI, anemia, hyponatremia)
    Orthostatic/postprandial hypotension
    Visual Impairment
    Environmental hazards (poor lighting, stairs, rugs, uneven floors)
    Syncope, vertigo, presyncope, or disequilibrium

    See my post on the Mini Mental Status Exam (ORArL 321 RWD!)
    Medical Mnemonics.com
    Fall Prevention checklists: Patient Handouts

    [edit] * The CATASTROPHE mnemonic is not available on the AAFP article so I've tracked it down for you.
    Functional hx after a fall in the elderly
    Alcohol (including w/drawal)
    Tx (meds & compliance)
    Affect (depression, lack of initiative)
    Teetering (dizziness)
    Recent illness/hospitalization
    Ocular problems
    Pain w/ mobility
    Environmental hazards

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