Supporting a person with dementia in a crisis

People with dementia rely heavily on what is familiar: known faces, fixed routines, usual rooms and objects. These things are like handrails that guide them through the day. In a crisis, many of these handrails disappear at once – it is noisy and hectic, the surroundings are unfamiliar and the people around them are stressed. Fear and confusion can then increase sharply, and some people try to walk away.

Preparedness starts right there. It brings along as much that is familiar as possible and makes sure strangers – emergency services, staff in a shelter – quickly learn what the person needs. The less the companion has to explain in the moment, the more attention is left for the person themselves.

Every case of dementia progresses differently, and what fits today may no longer fit in a year. So the plan is discussed and adjusted regularly with the care service and the doctor. Medical and nursing questions always belong with these professionals.

The personal profile is a single page with name, diagnosis, medication list, allergies, communication tips, what calms and what upsets, the relatives' contact details and a recent photo. The photo is especially important: if the person goes missing, police and rescue services need a picture that matches how they look today. A photo from ten years ago helps little.

Identification on the body helps if the person is found alone: name and emergency contact in the jacket pocket, on clothing or on a bracelet. Which solution fits depends on what the person accepts and does not take off. Whether technical aids such as locating devices make sense and are permitted is something to clarify with the care service or an advice centre.

The go bag holds medication for several days, aids such as glasses, hearing aid and walking aid, continence supplies, a change of clothes and a familiar item, such as a blanket or a photo album. How to keep a supply of medication is something to discuss with the doctor's practice or pharmacy.

Speak calmly, in short sentences, and give one piece of information at a time. “Now we put the jacket on.” Pause. “Now we walk to the car together.” Long explanations of why something is happening tend to overwhelm. Do not contradict or argue if the person misunderstands something – gently redirect instead.

Do not rush, even if time is pressing. Pressure usually causes resistance and costs more time in the end. Lead the person by the hand, stay close and do not leave them alone in unfamiliar surroundings. These are exactly the moments when people with dementia are most likely to get lost.

In a shelter, hand the profile to the staff and ask for a quiet spot, ideally away from the entrance and through-routes. Keep usual routines as far as possible: mealtimes, bedtimes, small rituals. Even if you stay at home, for example during a power cut, torches on walkways (no candles) and secured doors help.

If a person with dementia has gone missing, call the local emergency number at once (112 in the EU) and have the recent photo ready. Many relatives hesitate because they hope to find the person themselves straight away. But time is decisive here, and emergency services can deploy far more people and resources for a search. Getting help is not overreacting.

Clarify early with the care service, the family doctor and, where available, local authorities whether support is offered during evacuations. Such services differ greatly from place to place. For someone who lives in a care home, the home's emergency plans apply – ask there what they look like.

Decide on a companion and a deputy whom the person knows and trusts. Involve neighbours too, so someone is there if you happen not to be. Legal questions such as powers of attorney or guardianship are a separate topic; there are advice services for that.

Family carers are also under great pressure in a crisis. A well-thought-out plan relieves them because not everything has to be kept in their head. It is fine to ask for help – from neighbours, friends, care services or advice centres.

Ready.gov gives family carers guidance on emergency preparedness, for example on medication supplies, identification and familiar items. How to support older people emotionally in crises is covered by a separate entry in the psychology world.