People with AD may lose taste sensitivity. As their judgment declines, they also may place dangerous or inappropriate things in their mouth.

If possible, keep a spare set of dentures. If the person keeps removing dentures, check for correct fit. Keep all condiments such as salt, sugar, or spices away from easy access if you see the person with AD using excess amounts. Too much salt, sugar, or spice can be irritating to the stomach or cause other health problems. Remove or lock up medicine cabinet items such as toothpaste, perfume, lotions, shampoos, rubbing alcohol, or soap, which may look and smell like edible items to the person with AD. Consider a childproof latch on the refrigerator, if necessary. Keep the poison control number by the telephone. Keep a bottle of Ipecac (vomit inducing) available but use only with instructions from poison control or 911. Keep pet litter boxes inaccessible to the person with AD. Do not store pet food in the refrigerator. Learn the Heimlich maneuver or other techniques to use in case of choking. Check with your local Red Cross for more information and instruction.

Hearing

People with AD may have normal hearing, but they may lose their ability to interpret what they hear accurately. This may result in confusion or over-stimulation.

Avoid excessive noise in the home such as having the stereo and the TV on at the same time. Be sensitive to the amount of noise going on outside, and close windows or doors, if necessary. Avoid large gatherings of people in the home if the person with AD shows signs of agitation or distress in crowds. Check hearing aid batteries and functioning frequently.

Driving

Driving is a complex activity that demands quick reactions, alert senses, and split-second decision-making. For a person with AD, driving becomes increasingly more difficult. Memory loss, impaired judgment, disorientation, impaired visual and spatial perception, slow reaction time, diminished attention span, inability to recognize cues such as stop signs and traffic lights can make driving particularly hazardous.

People with AD who continue to drive can be a danger to themselves, their passengers, and the community at large. As the disease progresses, they lose driving skills and must stop driving. Unfortunately, people with AD often cannot recognize when they should no longer drive. This is a tremendous safety concern. It is extremely important to have the impaired person's driving abilities carefully evaluated.

Warning Signs of Unsafe Driving

Often, it is the caregiver, a family member, neighbor, or friend who becomes aware of the safety hazards. If a person with AD experiences one of more of the following problems, it may be time to limit or stop driving.

Does the person with AD: get lost while driving in a familiar location? fail to observe traffic signals? drive at an inappropriate speed? become angry, frustrated, or confused while driving? make slow or poor decisions?

Please do not wait for an accident to happen. Take action immediately!

Explaining to the person with AD that he or she can no longer drive can be extremely difficult. Loss of driving privileges may represent a tremendous loss of independence, freedom, and identity. It is a significant concern for the person with AD and the caregiver. The issue of not driving may produce anger, denial, and grief in the person with AD, as well as guilt and anxiety in the caregiver. Family and concerned professionals need to be both sensitive and firm. Above all, they should be persistent and consistent.

The doctor of a person with AD can assist the family with the task of restricting driving. Talk with the doctor about your concerns. Most people will listen to their doctor. Ask the doctor to advise the person with AD to reduce his or her driving, go for a driving evaluation or test, or stop driving altogether. An increasing number of States have laws requiring physicians to report AD and related disorders to the Department of Motor Vehicles. The Department of Motor Vehicles then is responsible for retesting the at-risk driver. Testing should occur regularly, at least yearly.

When dementia impairs driving and the person with AD continues to insist on driving, a number of different approaches may be necessary. Work as a team with family, friends, and professionals and use a single, simple explanation for the loss of driving ability such as: "You have a memory problem, and it is no longer safe to drive." "You cannot drive because you are on medication." or "The doctor has prescribed that you no longer drive."

Have the doctor write on a prescription pad DO NOT DRIVE. Ask the doctor to write to the Department of Motor Vehicles or Department of Public Safety saying this person should no longer drive. Show the letter to the person with AD as evidence.

Offer to drive. Walk when possible, and make these outings special events. Use public transportation or any special transportation provided by community organizations. Ask about senior discounts or transportation coupons. The person with AD should not take public transportation unsupervised.

Park the car at a friend's home. Hide the car keys. Exchange car keys with a set of unusable keys. Some people with AD are in the habit of carrying keys. Place a large note under the car hood requesting that any mechanic call you before doing work requested by the person with AD.

Have a mechanic install a "kill switch" or alarm system that disengages the fuel line to prevent the car from starting. Consider selling the car and putting aside the money saved from insurance, repairs, and gasoline for taxi funds. Do not leave a person with AD alone in a parked car.

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Tags: Alzheimer's Disease, Hearing

About the Author

NIA, one of the 27 Institutes and Centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.