Senior & mobility-limited · Cognitive
When the person cannot understand the plan.
An estimated six million Americans live with dementia. Most depend on family caregivers in the community. Developing and executing an emergency plan is extremely challenging when the person you are protecting cannot understand safety instructions or the logic behind a relocation.
The preparedness planA guide for the caregiver
Dementia changes almost everything.
This guide is written for the person managing the situation, not the person with dementia. It addresses the specific challenges that cognitive impairment creates during an emergency and the preparations that make those challenges manageable rather than overwhelming.
The Alzheimer's Association notes that natural disasters can be particularly upsetting and confusing for people with dementia. Change of location combined with unfamiliar noises and activities may cause increased stress and confusion. The strategies that work for a cognitively healthy older adult may not work here, and the caregiver needs a different set of tools.
The National Alzheimer's and Dementia Resource Center has published an Emergency Preparedness Toolkit specifically for people living with dementia and their caregivers, emphasizing that plans must be tailored to the individual's cognitive abilities and behavioral patterns.
What dementia changes in an emergency
- May resist leaving a familiar environment
- May forget safety instructions within minutes
- May wander away if left unattended even briefly
- May become frightened or agitated by unfamiliar surroundings
- May forget to take medication or refuse it from an unfamiliar person
- May be unable to communicate needs or describe symptoms
- May become unable to operate familiar equipment
- May require continence supplies that are not in a standard emergency kit
The first rule
Do not leave the person alone.
The Alzheimer's Association states this directly: do not leave the person with dementia alone during an emergency. It only takes a few minutes for a person with dementia to wander away, creating a far more dangerous situation than the original emergency. Do not count on the person to stay in one place while you go to get help.
This single rule shapes the entire emergency plan. It means you cannot leave to get the car, get supplies, check on a neighbor, or talk to first responders without either taking the person with you or having someone else stay with them. It means the backup caregiver plan is not optional for a dementia household. It means evacuation must be planned so that the person is never unattended at any point in the process.
If you must leave for even a moment, another responsible person must be present. Plan for this in advance. Identify the specific people who can be called for exactly this purpose.
The preparedness plan
Prepare for the person they are today.
Dementia is progressive. The plan you write today may not match the person's capabilities six months from now. Review and update the plan at least every three months, and immediately after any significant change in cognitive function, medication, or daily routine.
Wandering prevention and identification
The Alzheimer's Association recommends enrolling the person in the MedicAlert + Alzheimer's Association Safe Return program, which provides a medical ID bracelet or pendant and a 24/7 emergency response line. If the person wanders or becomes separated during an emergency, anyone who finds them can call the number on the ID.
- Place identification labels inside garments
- Keep a recent photograph of the person readily accessible
- Keep an article of the person's worn clothing in a sealed plastic bag (this helps search dogs if the person goes missing)
- If the person uses a GPS tracking device, keep it charged and confirm it is working
Source: Alzheimer's Association, "Preparing for Emergencies" and "Disaster Preparedness." Accessed August 2026.
Medication management during disruptions
Medication compliance is one of the hardest challenges in dementia care, and it becomes harder during a disruption. The person may refuse medication from an unfamiliar caregiver, may not remember taking it, or may take it twice if the routine is disrupted. Some dementia medications have narrow therapeutic windows where missed doses or double doses create real risk.
- Pre-sort medications into a daily pill organizer with AM and PM compartments
- Note which medications the person will accept from a familiar person and which require a specific approach
- Include this information in the backup caregiver document
- See Medication Preparedness for the complete medication list and storage guide
Evacuation with dementia
The Alzheimer's Association advises: if the need to evacuate is likely, do not delay. Leave as early as possible to minimize long delays in traffic. Move to a safe place that has been designated in advance. This guidance aligns directly with the leave-early framework, which is even more important for dementia households.
- Choose destinations where the person has been before, if possible, to reduce confusion from unfamiliar surroundings
- Bring familiar objects: a favorite blanket, a photo, a familiar pillow. These comfort items help reduce agitation in unfamiliar settings
- If the person resists leaving, use calm, simple, short sentences. Do not argue or explain the danger at length. "We need to go now. I'm right here with you" may work better than explaining why
- Be prepared for agitation during travel. Music, a familiar voice, and a calm presence in the back seat can help
Supplies specific to dementia care
In addition to the standard emergency supplies, a dementia household emergency kit should include:
- Continence supplies (incontinence briefs, wipes, disposable underpads) for at least 7 days
- Comfort items the person responds to (a specific blanket, a stuffed animal, a photo album, familiar music on a charged device)
- Extra clothing in case of incontinence or confusion about dressing
- Easy-to-eat foods that do not require utensils or complex preparation
- A written description of the person's behavioral patterns, triggers, and what calms them, for anyone who might need to help
If you are relocated or displaced
The Alzheimer's Association notes that extra care and attention must be given when a person with dementia is displaced to an alternative living arrangement. Unfamiliar surroundings can dramatically increase confusion, anxiety, and wandering behavior.
- If conditions are noisy or chaotic, try to find a quieter place within the shelter or host home
- Maintain as much of the normal routine as possible: mealtimes, bedtime, medication times
- Alert shelter staff or hosts that the person has dementia and may wander, especially at night
- Keep the person's familiar objects within reach
Source: Alzheimer's Association, "Disaster Preparedness from the Alzheimer's Association." Accessed August 2026.
Managing the moment
Your calm is their calm.
The Alzheimer's Association advises caregivers to do their best to remain calm during an emergency, as this helps establish a positive tone for the person with dementia. A person with cognitive impairment reads emotional signals even when they cannot process the words being said. If you are panicked, they will be panicked. If you are steady, they are more likely to cooperate.
This is easier said than done during an actual emergency. The preparation you do in advance is what makes it possible. When the evacuation bag is already packed, the destination is already confirmed, the driver is already called, and the medication is already sorted, you can focus on the person instead of the logistics. That is the purpose of every other guide in this section: to move the logistics out of the crisis and into the preparation.
If you need help during a disaster, the Alzheimer's Association operates a 24/7 helpline at 800-272-3900. They can provide guidance, connect you with local resources, and help problem-solve in real time.
Plan for the worst case
If you become separated.
The goal is to never be separated. But the Alzheimer's Association advises planning for the possibility because the unexpected can happen. If the person wanders away during an evacuation, during a shelter stay, or because the caregiver is suddenly incapacitated, the following preparations determine how quickly they are found and returned safely.
Identification on the person
- MedicAlert + Safe Return bracelet or pendant (worn at all times)
- Name and emergency contact sewn or ironed into every garment
- A card in their pocket with their name, your name, and your phone number (they may not remember any of this)
- A GPS tracking device if wandering is a known behavior
Information you carry
- A recent photograph on your phone and a printed copy in your bag
- A physical description: height, weight, hair color, distinguishing features
- An article of the person's worn clothing in a sealed bag (for search dogs)
- The Safe Return program number and the person's enrollment ID
This week
Five steps for dementia households.
Enroll in MedicAlert + Safe Return. Make sure the person wears the ID at all times, including at night.
Time: 15 minutes online
Write the behavioral section of the backup caregiver plan: what calms them, what escalates distress, and what a replacement caregiver should expect.
Time: 30 minutes
Pack a dementia-specific addition to your emergency kit: 7 days of continence supplies, comfort items, easy-to-eat food, extra clothing.
Time: 20 minutes
Place identification labels in every garment. Put a card in every pocket with the person's name, your name, and your phone number.
Time: 30 minutes
Confirm your evacuation destination can handle dementia-specific needs: a quiet room, door locks, someone who understands the behavior. Save the Alzheimer's Association helpline: 800-272-3900.
Time: 10 minutes
Connected guides
Related sections worth knowing.
Senior & Mobility-Limited Hub
Back to the full section.
Creating a Backup Caregiver Plan
The behavioral section of the backup plan is especially important for dementia households.
When to Stay and When to Evacuate
The leave-early framework is even more important when the person you are evacuating cannot understand what is happening.