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First Line: Firefighters must understand how to deal with dementia

September brings the winds of change and for many parents it is a time of celebration. Kids are back in school, no more worrying about how to entertain them or keep them busy.

For the sandwich generation, those of us raising kids and taking care of elderly parents, it can bring on different emotions, especially if you have a parent with Alzheimer’s or dementia. I encourage you to think about our aging population, one of our high-risk groups when it comes to fire safety, an even higher risk when dementia or Alzheimer’s is involved.

The number of Canadians with dementia is rising sharply. There are more than half a million Canadians living with dementia plus about 25,000 new cases diagnosed every year. By 2031 that number is expected to rise to 937,000, an increase of 66 per cent.

At aged 69, my mother was diagnosed with vascular dementia/Alzheimer’s disease. Dementia is progressive, which means the symptoms will gradually get worse as more brain cells become damaged and eventually die. It was a frightening time for all of us and it required a lot of planning and research to help figure out the day-to-day living and, more importantly, future caregiving and support.

My mom wanted to continue leading an active, meaningful life and we wanted her to be safe. Since she lived with us, it meant telling neighbours about the diagnosis, planning meal deliveries, cold snacks, and lying to her about blown fuses when we turned off the breaker for the stove and microwave oven when the kids were in school and we were at work. It meant hiding the curling iron so that it could only be used when we were at home.

With the lying came lots of guilt. This past June at the National Fire Protection Association (NFPA) conference, my guilt was put to rest when I heard the term “therapeutic fiblets”, which is telling a lie for the greater good. Therapeutic fiblets are often used to answer the question “What’s the kindest, most loving thing I can do for my parent/partner in this moment?” These lies allowed us to keep mom safe and allowed her to keep her dignity.

If you take the time to get a better understanding of this disease you will be in a better position to communicate and assist people with dementia in your community. The Alzheimer Society of Canada reports that people with dementia are often able to maintain their usual level of abilities for some time but will eventually experience changes in all aspects of their life. Their mental abilities, emotions and moods, behaviours and physical abilities are all affected. They may not remember something they have just done. They may be uncoordinated and appear to be intoxicated. They may not recognize when their behaviour is wrong or inappropriate.

A person with dementia may experience symptoms, including memory loss that affects day-to-day abilities. This can put them at a greater risk of having a fire, as they lose the insight to realize when they are in danger.

Some of the common fire risks are: not knowing what to do when the smoke alarm sounds, leaving a pot on the stove or forgetting to turn off the oven, mixing up the seconds and the minutes when using a microwave causing items to burn, and hoarding; the individual may excessively accumulate material possessions of dubious value and quality. This hoarding can cause a fire hazard from the accumulation of combustibles, piles toppling onto persons or pathways through home.

In my home we dealt with each of the above. We installed smoke alarms that were connected to our smart phones so we would know if they were activated. We disabled the oven/microwave and hid curling irons. When my mom went to the Alzheimer’s day program we cleaned her room of her “collections” and added fresh flowers and clean bed linen as a distraction. It worked for us, until it didn’t and then she moved to a care facility. We chose her care facility with her fire-safety in mind. It is a fully-sprinklered building with well-trained, caring staff on duty 24 hours a day.

A person with dementia will lose the ability to communicate. The further the disease progresses, the less they will be able to express themselves or understand what is being said. Often, when they do communicate, it is driven by emotions. As a first responder, it is important that you know your body language, tone and volume of your voice can be just as important as the words you use.

The Alzheimer Society Canada has fantastic resources. Here are a just a few of the strategies on their website. I found them helpful when approaching and communicating with a person with dementia.

• Identify yourself. As you approach, state your name and why you are there. You may have to repeat this information.
• Establish a calm, caring atmosphere.
• Keep in mind that your uniform may make the person with dementia feel anxious. Your uniform may also trigger a memory from their past, such as experiences of war or trauma.
• Establish and maintain eye contact.
• Speak slowly and clearly. Present one idea at a time.
• Simple questions which can be answered by “yes” or “no” may be more successful than open-ended questions.
• If you need the person to do something, demonstrate it by using non-verbal communication whenever possible.
• Listen actively and carefully to what the person is trying to say. Respond to the emotional tone of the statement.
• Repeat/rephrase responses.

Fire departments are constantly evolving and taking on new challenges. Our service is about protecting and caring for our residents. We have to step up our understanding of dementia and Alzheimer’s to better care for and protect our most vulnerable.

Samantha Hoffmann has been in the fire safety field for more than 25 years. She is the public fire and life-safety officer for Barrie Fire & Emergency Service in Ontario. In 2014, Samantha was named Public Fire and Life Safety Educator of the Year by the National Fire Protection Association – the second Canadian and first Ontario educator to receive the award since its inception. Email Samantha at Samantha.hoffmann@barrie.ca and follow her on Twitter @shoffmannpflso