Month: January 2020

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Mandatory-Physician-Reporting States & Drivers’ Licensing

Does Your State Have Mandatory-Reporting Laws?

Within the United States and Canada there are laws that require a physician to report a patients with neurological or cognitive disorders to a licensing agency, as those patients may be a danger behind the wheel of a vehicle.

This type of reporting is not mandatory across the entire United States.  Currently, there are only six (6) states that mandate a physician to report on a patient’s ability to operate a motor vehicle. These six states include:

  • California
  • Delaware
  • Nevada
  • New Jersey
  • Oregon
  • Pennsylvania

Not all mandatory states direct their reporting law toward those who are afflicted with Alzheimer’s Disease or, indeed, any sort of dementia whatsoever. Below are some specifics around each mandatory state and what is defined in their law.

If you want to see and hear me present the material, feel free to watch the YouTube video that I prepared, here:

California

The state of California is the first that I will discuss. It’s a prime example of a state in which (a.) there is mandatory reporting, and (b.) that reporting is at least partially concerned with Alzheimer’s Disease expressly.

The California Legislative Information website (leginfo.legislatures.ca.gov) references chapter 3 – Disorders Characterized by Lapses of Consciousness [103900-103990].

103900 states: “Every physician and surgeon shall report immediately to the local health officer in writing, the name, date of birth, and address of every patient at least 14 years of age or older whom the physician and surgeon has diagnosed as having a case of a disorder characterized by lapses of consciousness.”

This law specifically includes Alzheimer’s Disease as a disorder that involves the requisite “lapses of consciousness.”

For additional information, see the entry on California – “What does California State Law say about Driving with Alzheimer’s?” – in my “50-State Guide to the Laws on Driving With MCI and Alzheimer’s.”

Delaware

In Delaware, the focus is on conditions that are characterized by “losses of consciousness.” In this respect, Delaware’s statutory language is similar to the “lapses of consciousness” verbiage present under California law.

Title 24 of the Delaware Code Online – Professions and Occupations Chapter 17, Medical Practice Act states: “Every physician attending or treating persons who are subject to losses of consciousness due to disease of the central nervous system shall report within 1 week to the Division of Motor Vehicles the names, ages and addresses of all such persons unless such person’s infirmity is under sufficient control to permit the person to operate a motor vehicle with safety to person and property.”

Again, for further reading, scroll down to “Delaware’s entry, HERE.

Nevada

Nevada is a good example of a state in which, while there is mandatory-physician reporting, it is not directed towards cognitive impairments such as dementia (of which, as we know, Alzheimer’s Disease is the most common variety). (On two ways of understanding the difference between Alzheimer’s Disease and dementia, see my YouTube video, HERE.)

According to the Bradley, Drendel & Jeanney law firm: “…Nevada laws can regulate the driving rights of individuals with epilepsy. In fact, doctors in our state are required to report epileptic seizures to the state’s Department of Motor Vehicles…”

You might be picking up on a recurring theme, here, but… for additional information, click down to “What does Nevada State Law say about Driving with Alzheimer’s?” in my 50-State Guide, HERE.

New Jersey

The New Jersey Academy of Ophthalmology, states, “NJ Law (N.J.S.A. 39:3-10.4) requires all physicians to report patients to the Motor Vehicle Commission within 24 hours after determining that a patient experiences any of the following:  Recurrent convulsive seizures, recurrent period of unconsciousness or impairment, or loss of motor coordination due to conditions such as, but not limited to epilepsy in any of its forms which persist or recur despite medical treatment.”

Even so, New Jersey appears to be one of those states in which physicians could potentially be held liable, legally, if they don’t report potentially dangerous drivers.

While New Jersey law has established an elective reporting system for drivers with vision deficiencies and mandatory process for reporting specific neurological dysfunctions, there is no statute that protects a physician from liability if they have failed to report a patient that may cause injuries to a third party due to a condition known by the physician.

Given this, you might think that a New Jersey doctor will err on the side of reporting. And, I may be inclined to agree.

For more info, where do you think I’ll send you? My state guide, of course! Find it, HERE.

Oregon

The Oregon Driver & Motor Vehicle Services states: “Most medical professionals are required to report drivers who can no longer drive due to impairment.”

It is required of medical professionals to report on a patient’s impairment, even if that patient has agreed to give up driving.

The Oregon Secretary of State website similarly states: “…mandatory reporting by physicians and health care providers of those persons with severe and uncontrollable cognitive or functional impairments affecting a person’s ability to safely operate a motor vehicle.”

Cognitive impairments as specified in Oregon include: attention, judgement and problem solving, reaction time, planning and sequencing, impulsivity, visuospatial, memory and/or loss of consciousness or control.

Intuitively, this list is expansive enough to range over various cognitive impairments like dementia and Alzheimer’s Disease, even if they are not singled out for special or explicit attention.

See: “What does Oregon State Law say about Driving with Alzheimer’s?” which is a subsection of my longer, and more comprehensive (but certainly not exhaustive) reference, elsewhere on this website.

Pennsylvania

According to Schemery Zicolello Law Firm, the Pennsylvania Medical-Reporting Law requires health care personnel to report to the Pennsylvania Department of Transportation the full name, date of birth and address of every person over 15 years of age that is diagnosed as having a disorder or disability that could impair his/her ability to drive.  In the list of reportable medical conditions, the attorneys specifically call out dementia.

That’s good enough for me.

If you want a bit more detail, scroll down to “Pennsylvania,” on my article, HERE.

Utah

Utah was mentioned in an article by National Center for Biotechnology Information (NCBI) as a reporting state. However, in the Fact Sheet for Patients and Families provided for Utah drivers, the indication for mandatory reporting by physicians is not present.

The document does state that the patient is expected to report and disclose their impairments to the department of motor vehicles.

So… I don’t find that Utah is actually a mandatory-reporting state.

For more, see: https://alzheimersproof.com/u-s-laws-on-driving-with-mci-and-alzheimers-disease/.

Concluding Remarks

Bear in mind that just because a state does not have mandatory-reporting laws, it should not be assumed that physicians won’t report anyway.

In the first place, a doctor might believe that it is his or her ethical duty to report a potentially dangerous driver – regardless of whether state law strictly requires that he or she do so.

Additionally, the physician’s other professional entanglements – for instance, his or her affiliation with a medical group or his or her professional-liability insurance – might have stricter requirements governing action steps in relevant cases.

Additional Information Or Resources

Over the course of several months, I compiled an article as a reference to U.S. Laws on Driving with MCI and Alzheimer’s Disease which provides a guide on all 50 states and their associated laws.

Another of my references is the post Canadian Laws on Driving with MCI and Alzheimer’s Disease which outlines comparable laws specified within the Canadian provinces.

You might also want to consult the National Highway and Traffic Safety Administration at their website: https://www.nhtsa.gov.

Moreover, in the Physician’s Guide to Assessing and Counseling Older Drivers, Chapter 7, Legal and Ethical Responsibilities of the Physician, some important key terms are defined.  Here are a few highlights.

Mandatory Medical Reporting Law States:  In some states, physicians are required to report patients who have specific medical conditions (e.g., epilepsy, dementia) to their state Department of Motor Vehicles (DMV).  These states generally provide specific guidelines and forms that can be obtained through the DMV.

Physician Reporting Law States: Other states require physicians to report ‘unsafe’ drivers to their state DMV, with varying guidelines for defining ‘unsafe.’  The physician may need to provide (a) the patient’s diagnosis and (b) any evidence of a functional impairment that can affect driving (e.g. Results of neurological testing) to prove that the patient is an unsafe driver.

Physician Liability States:  Case law illustrates situations in which the physician was held liable for civil damages caused by his/her patient’s car crash when there was a clear failure to report an at-risk driver to the DMV prior to the incident.

On the NHTSA’s website, a survey of medical review practices can be found that indicate while all 51 jurisdictions accept reports of potentially unsafe drivers from physicians, only 6 jurisdictions require physicians to report drivers to the motor vehicle agency.

Another helpful article on NHTSA’s website is ‘Current Screening and Assessment Practices’.  This article summarizes the legal requirements in each of the six mandatory reporting states.

Another helpful resource is the National Center for Biotechnology Information, the website for which can be found, here: https://www.ncbi.nlm.nih.gov.

National Library of Medicine, National Institutes of Health contains an article within the Journal of General Internal Medicine (abbreviated “J Gen Intern Med”).  Of interest is an article titled “Reporting by Physicians of Impaired Drivers and Potentially Impaired Drivers,” which mentions that virtually all states have established policies for the identification of drivers with physical or mental impairments, however, the reporting is voluntary with the exception of specific states.[1]

Additional references on AlzheimersProof.com include:

“Is it Legal to Drive with Alzheimer’s Disease?”

This is a resource regarding the legalities of driving with Alzheimer’s or another cognitive disorder.  This is not legal advice, simply research and research leads presented in a comprehensive article to assist in locating additional sources for further information. You can find additional information and important aspects specific to your state within my 50-State legal guide, HERE.

“Are Drivers with Alzheimer’s more Dangerous than Others?”

The above article, also on my website, goes into a discussion about a number of factors that may impact a person’s ability to drive, given their cognitive or mental state. This not only addresses that Alzheimer’s Disease occurs in stages (for more on which, see HERE), but also addresses some concerns around other cognitive impairments.

“Is it Safe to Drive with Alzheimer’s?”

I also have an article – and a companion video (see my YouTube channel, HERE) – talking specifically about considerations of driving safety, apart from an explicit discussion on any legal requirements.

“Disabling Devices – Car”

Now, if it gets to the point where you have to actually restrict your loved one’s access to the vehicle (and I sympathize with you if this happens), then you might find something of use in the above resource.

“How do you Alzheimer’s Proof a Car?”

The final piece that I’ll note, here, is a general article that I did on the question of how to “Alzheimer’s Proof” a car. Recall that Alzheimer’s Proofing is akin, in this context, to baby proofing or childproofing. For more on this, see HERE.

Disclaimer

Please note – this article should not be treated as providing legal or medical advice, but purely as a reference that provides general information in regards to the laws that require a physician contact a licensing bureau in regards to a patient’s ability to operate a vehicle. This post is given as-is; I do not warrant that the information is accurate or complete. But I provide the information in good faith and I believe, to the best of my knowledge, that it is reliable.

Notes:

[1] As noted in the main text, the article’s list of states includes Utah, while in other references, Utah is not mentioned as a mandatory state.

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Warning Signs of an Unsafe Driver: Alzheimer’s Dementia

Alzheimer’s Disease is a progressive, neuro-degenerative illness that presents itself in stages. While there is some debate over the precise number of stages (for more on which, see my ARTICLE or companion VIDEO), for present purposes, we can say that there are three: early, middle and late. Because cognitive degradation is just what it is to have some form of dementia, the fact is, at some point, an Alzheimer’s sufferer will become unsafe behind the wheel of a car.

In the early stage of Alzheimer’s, memory impairments may be mild affording a person the ability to safely drive. A larger concern occurs during the transition from the early to middle stage of the illness.

During the middle stage of Alzheimer’s, memory impairments may become more severe. You or your loved one may be doing fine one day, but have a lapse in memory or judgement, causing challenges the next day. These lapses, or deterioration in memory, can make a person with Alzheimer’s more of a danger to themselves or others, especially when driving.

By the time a person reaches the late stage of Alzheimer’s, he or she will have lost so many abilities (including language, mobility, responsiveness, etc.) that driving will be virtually inconceivable. Generally, by that time, the level of physical disability alone makes operating a motor vehicle practically impossible.

But before that threshold is reached, it may be somewhat difficult to identify the precise time at which a person becomes an unsafe (or at least unreliable) driver. Here is a breakdown of some early signs or symptoms that may indicate it is no longer safe for a person with this illness to operate a vehicle.

(These signs may be noticed by the person themselves, a loved one, vehicle caretaker or an outside party such as a neighbor, physician, police officer, etc. Additionally, it is important to assess behaviors and signs relative to a person’s “baseline.” In this context, a baseline is the starting point for comparison. It’s basically the way a person acted or the degree of functionality they possessed for most of their adult life – at a point when they were obviously not impaired in the relevant sense.[1])

Emotional Changes

A person with a mild demeanor may become more aggressive, hostile, or otherwise difficult. These changes in behavior could potentially be due to a mood disorder or other neurological problem. However, these behavioral changes can also occur in a person with Alzheimer’s Disease or some other form of dementia.

If you notice that you or a loved one becomes unable to control anger or depression, becoming so overcome with emotional fits or episodes, it may be an indicator of Alzheimer’s or some other serious condition. Whatever the cause, these emotional changes will increase the dangers and risks of being behind the wheel of a car.

  • Anger – Your loved one may become agitated or irate with little or no apparent provocation, or beyond what a normally functioning person would think of as justified or reasonable.
  • Anticipation – In this case, the pathological component may be another outgrowth of memory loss. If you loved one seems or professes to expect or hope for an imagined or past event, it may be a sign of worsening dementia.
  • Disgust – An Alzheimer’s patient may have difficulty masking emotions and might display naked aversion, distaste, loathing, revulsion, etc. even in inappropriate contexts or directed toward things that they previously felt fondly toward.
  • Fear – On a low level, this might result in an increasing level of anxiety. It could be apparent through spoken language, but it may only become apparent to people who notice subtler signs or body language (e.g., in facial expression or posture) or habit (such as hand wringing or nail biting). Alternatively, fear may manifest in more extreme ways, for instance, through indications of a pathologically paranoid or suspicious turn of mind.
  • Joy – We all like to see our loved ones content and happy. But, in some cases, the level of jubilation or excitement may exceed what is appropriate to or warranted for the occasion. For instance, your loved one may not exercise due restraint. Alternatively, it may appear strike you as inappropriate in the sense that he or she seems to be taking pleasure in something that ought to elicit a different emotional reaction.
  • Sadness – A dementia-afflicted people might suffer from apathy or depression, or from some other related sort of unrelenting melancholy. They may tend to brood or become removed or withdrawn from family or other social circles.
  • Surprise – Look for evidence or amazement or bewilderment that seem out of place. Astonishment or shock could be a result of affected judgment or reasoning. But it also could be a function of increasing forgetfulness and impaired memory.
  • Trust – This may be related to fear and paranoia in the sense that your loved one may begin to suspect family members of plotting against them. Contrariwise, it might be expressed in an inappropriate or unwise willingness to follow or receive instructions from strangers.

Memory Changes

Some Alzheimer’s-afflicted individuals may have issues with short-term memory loss but are able to remember things that occurred further back in time. Vehicle operations can be broken up into “before,” “during” and “after” categories to determine if memory changes impact or undercut safe driving. Here’s what I mean.

Before Getting Into the Vehicle, Ask…

  • Do you or your loved one have an issue finding the keys?
  • Is it consistently a challenge to remember where the vehicle is parked? Or…
  • Is it hard to recall which vehicle belongs to you?

Everyone misplaces things from time to time. Obviously, when it is sporadic, this is not necessarily an indicator of Alzheimer’s Disease or some other form of cognitive impairment or dementia. However, the issue occurs when this becomes more of a pathological condition where memory loss is more frequent than normal, or when its occurrence undermines safety.

While Inside of the Vehicle, Ask…

  • Do you or your loved one have trouble remembering which pedal is the accelerator and which is the brake?
  • Is there confusion on what traffic signs or signals are indicating?
  • Do you or your loved one regularly forget where you are going, or how to get there?
  • Beyond the perceptual diminishment that often accompanies normal aging, cognitive impairments may erode sensory faculties. Does the driver have reduced sensory-processing capabilities? (See further below.)
  • Do the A/C or radio controls confuse you or distract you from the road?

A person with this illness may not understand signs to where they inadvertently drive through a construction zone. They may also forget where they are going or how to get where they are going, even if the route is familiar.

After Exiting the Vehicle, Ask…

  • Are there dents or scratches that cannot be accounted for?
  • Is parking haphazard or erratic?
  • Are items forgotten inside the car inadvertently?
  • Are keys routinely left in the vehicle?
  • Is the car left running unintentionally?
  • Have you or your loved one begun to receive mailed traffic citations? Or…
  • Is the driver being pulled over more frequently than before?

A person afflicted with this some form of dementia or other cognitive difficulty may not remember how a particular dent or scrape appeared on the vehicle.

All these items are warning signs or indicators that something else may be going on beyond normal forgetfulness.

Motor-Skill Changes

Cognitive disabilities are only half of the picture, though. Driving also places physical demands on a person. Therefore, various physical impairments can also undermine safe-driving abilities.

Similarly to the previous category, these changes can also be evaluated by looking at requirements that impose themselves before, during, and after using a vehicle.

Before Getting Into the Vehicle, for Example…

  • Changes in motor skills or reductions in physical strength may hinder a person from doing something as simple as opening or closing a vehicle door.
  • You or your love done may struggle with opening or closing the hatch or trunk.
  • It may become difficult or practically impossible properly open or close the hood of a vehicle.

It is true that memory may come into play here as well. And there’s little question but that forgetting how to do these minor tasks may be an indicator of Alzheimer’s.

But diminished motor skills can be serious problems on their own. And, when determining a person’s driving fitness, physical abilities need to be assessed alongside cognitive ones.

While Inside of the Vehicle, for Example…

  • A person with diminished motor abilities may have difficulty turning the wheel.
  • He or she may have trouble physically depressing the pedals or shifting gears.
  • Someone might find it physically taxing to keep the car in the correct lane.
  • Parking the vehicle may begin challenging, especially if the individual has limited abilities to turn their body or head.
  • Sensory impairments such as hearing or vision loss can also undercut the ability to safely operate a car or truck.

After Exiting the Vehicle, for Example…

  • Do you or your loved one have difficulties just physically getting in and out of the house, opening entry or garage doors, carrying groceries, and so on?

Of course, people often drive in order to assist them with the functional activities of life – such as shopping. While general impairments may not specifically speak to the question of safety behind the wheel, they do speak to the issue of whether driving is beneficial or necessary. If you or your loved one can no longer perform or engage in other life activities – like shopping – then it may be that driving is no longer helpful. This suggests that it may pose a risk that outweighs any potential benefit.

Additionally, the loss of non-driving-specific abilities indicates a general physical decline any may suggest either that driving-related abilities may soon erode or that further cognitive impairment is on the horizon.[2]

Clearly, being unable to physically control a vehicle, while not an Alzheimer’s-specific problem, may be an indicator that you or your loved one can no longer reliably or safely operate a vehicle.

Perceptual Difficulties

The normal aging process can cause perceptual difficulties. However, Alzheimer’s can exacerbate these issues.

Perceptual difficulties may impact visual-spatial abilities such as being able to judge distance or peripheral vision. Being spooked by shadows or not noticing cars or pedestrians next to you may be a result of diminished perception.

There may also be an inability to see traffic signs, signals, or other drivers (for example, people braking in front of them or merging into the same lane).

Perceptual difficulties may also include a decreasing ability to hear sirens or horns. This poses an obvious danger – especially, though not exclusively, if it is coupled with memory impairments. Forgetting what emergency-vehicle sounds indicate or require in terms of courses of action can lead to accident, injury, or death.

Reasoning Changes

A deviation from a normal route may cause confusion for a person with Alzheimer’s, as they may not be able to react or think through an alternate route. They may also have issues navigating around accidents or construction sites.

A person with this disease, or some other form of cognitive impairment or dementia, may have a reduced reaction time that, in turn, undermines their ability to react to unexpected changes within their route. These include such things as closed roads and bridges, etc., which could potentially lead to accident, and certainly engender confusion.

Deviations and detours can also result in you or your loved one becoming lost.

Concluding Remarks

As difficult as this can be for the afflicted individual, there will come a point where having them behind the wheel of a car or truck will become more of a danger than a benefit.

For more information, please see my companion YouTube video, HERE.

Postscript

In addition to these safety considerations, there may also be legal implications and potential liabilities in regards to a person driving with Alzheimer’s Disease.

While I am not a lawyer or legal expert, I do have several, relevant resources available on AlzheimersProof.com.

For instance, I have:

Additional Resources

Notes:

[1] Of course, some persons may have lifelong afflictions or disabilities. These will have to be factored in as well. Doing so is beyond the scope of this article. Consult a healthcare or medical professional for personal evaluations or recommendations.

[2] See, e.g., Salynn Boyles, “1st Signs of Dementia May Be Physical,” WebMD, May 22, 2006, <https://www.webmd.com/alzheimers/news/20060522/1st-signs-of-dementia-may-be-physical>.

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Reduce Elopement/Wandering: ‘Defender’ Lock for Alzheimer’s

This one simple device may reduce 'elopement' risk

One of the major challenges in caring for someone who has Alzheimer’s Disease, or some other form of dementia, is that they are often prone to “elopement.” Of course, in the context of long-term care, elopement has nothing to do with illicit or surreptitious marriage. It has to do with a cognitively impaired person leaving the safety of the care environment without supervision.

This problem can be extremely vexing for the caregiver and perilous for the Alzheimer’s sufferer. I know this firsthand. On one memorable occasion, my dad was returned to his home by a police officer after he had been found wandering along a busy road in our city. During a snowstorm.

However, I was able to hinder my dad from wandering with an ingenious little gadget. In this article, I’m going to explain how to install that device – a door blocker called the “Defender.”[1] I have installed several of these blockers: one in an apartment, and a couple of them in a townhouse. I absolutely love these products. And I think that you might, too.

Introduction

What’s the Function of the ‘Defender’?

Knowing your loved one can open doors and leave the care environment without you or a caretaker in tow – or even realizing your charge is gone – is a terrifying proposition. Memory and reasoning deficits raise the possibility that he or she could become disoriented and lost, or even injured or worse.

From the perspective of long-term home care, then, the main benefit of these locks is to prevent your loved one from eloping. The devices are inexpensive, and the contemplated modification may be performed relatively easily.

This sort of change is part of what I mean by “Alzheimer’s proofing” your home environment. (This is a concept that I describe more fully HERE.) Under this way of using the phrase, it is a close cousin to childproofing a house as expectant parents would do in preparation for the arrival of a newborn.

Devices Double as Theft Deterrents

These door blockers can deter Alzheimer’s sufferers, or other cognitively disabled persons, from opening exit doors, leaving the care environment, and potentially putting themselves in harm’s way.

But it is worth noting that this particular use – keeping someone inside the house – is a bit of a departure from the product’s stated purpose.

This style of door lock has been designed and marketed as a security device and theft deterrent. When properly installed on an entrance door, the lock helps to prevent forcible entry into a house. It essentially fortifies the door so that even if a thief has jimmied it, or defeated its deadbolt and locking mechanisms, the door blocker will enable the door to remain in a closed position.

So, beyond the standpoint of Alzheimer’s proofing, it will add another layer of security to your home.

Can Your Alzheimer’s-Afflicted Loved One Defeat the Blocker?

As stated, the Defender is intended to be set into a locked position inside the home in order to reduce the probability of forcible entry should an intruder attempt to gain access to the interior of your house.

Given this, it has been designed to be locked and unlocked by normal-functioning adults. Therefore, it is possible for a cognitively impaired person to operate the latch. However, to do so he or she would have to have a number of cognitive and physical abilities. A rough-and-ready enumeration of these might look the following.

Cognitive Abilities Plausibly Needed to Defeat the Blocker:

  • The ability to notice the device
  • The capability to identify its function
  • The capacity to understand or the resourcefulness to determine the correct way to unlock it once
  • The motor skill and dexterity required to execute the unlocking action
  • The memory power to remember how to defeat it on subsequent encounters

I’m certainly no medical or psychological expert. But, the likelihood that a cognitively impaired individual would possess this collection of abilities seems to me to be somewhat low. More guardedly, I suppose that I would venture the opinion that the probability is low at least once your loved is sufficiently advanced in his or her dementia to be a serious elopement risk.

Often, if it is positioned high enough on the door – or if it is camouflaged – your loved one may not even recognize that the door blocker has been installed. Of course, this is because Alzheimer’s tends to diminish perception. In the case of my dad, for instance, I don’t believe he noticed that the thing was even there.

Additionally, a high-up position might hinder the door-opening ability of a senior adult in general – quite apart from any dementia – for example if he or she has joint or mobility issues.

Moreover, the door blocker requires an additional motion, outside of those used to open doors in the usual way, that may frustrate a person with a cognitive deficit and prevent them from eloping from the home.

WARNING!

I should, however, inject an important word of caution.

These door blockers may hinder your and your loved one’s abilities to exit the house in the event of a fire or other emergency. If you’re going to use these products as a deterrent to help prevent elopement of a loved one from the residence, you may want to ensure the blocker is activated only during the time periods where your loved one is at the highest risk of vacating the premises without you noticing.

Of course, from a theft-deterrence perspective, it is appealing to have the latch activated throughout the night or during whatever intervals occupants of the house wish to lower the likelihood of intrusion.[2]

Disclaimer:

I cannot advise you as to the appropriateness of any particular course of action for your application. Furthermore, I cannot be sure, and do not warrant, that the device will be effective for you – for any purpose whatsoever. This information is presented as-is, for general or entertainment purposes only. Whatever use you put this information to is entirely your own responsibility. No one at or affiliated or associated with AlzheimersProof.com assumes any liability for how you may implement or not implement any of the ideas described in on this website or in any companion videos.

Be aware of where and under what circumstances you are installing these blockers. The upshot is that I am certainly not guaranteeing that these devices or installation methods will be successful or safe for your individual or family situation.

I can only state that these blockers were a tremendous help for me and my family when caring for my Alzheimer’s-afflicted dad.

My Installation Procedure

‘Unboxing’ & Collecting Required Tools

'Defender' Install Sheet
‘Defender’ Installation Instructions

Upon opening the Defender’s packaging, you will find several items. These include:

  • The door blocker device itself;
  • Instructions;
  • 3 large wood screws;
  • 4 smaller metal screws;

Tools

The main tools needed include:

  • A drill (this could be theoretically be corded or cordless; mine was the latter)
  • 1/8-inch drill bit
  • Philip’s screwdriver

Optional (& Possibly Necessary) Tools

  • Wood chisel (if there is insufficient space in between the door and door jamb to accommodate the blocker)
  • Hammer (to use the chisel, if one is needed)
  • Center Punch (to tap a small “pilot” for the drill bit)
  • Tape Measure (to assist in positioning the blocker on the door with respect to the other locking hardware – such as doorknobs and deadbolts)

Safety Equipment

  • Safety goggles

Positioning the Blocker

You may want to begin by determining where you want to place the Defender door blocker. The instructions suggest that it be installed at least 6 inches above the door handle and deadbolt.

As suggested above, it may be beneficial to install this blocker a bit higher than this. In fact, there is an “L-shaped” area on the door within which the manufacturer recommends placing the Defender.

'L'-Shaped Area
Inverted ‘L’-Shaped Install Location

While determining where to install the blocker, place the blocker in the locked position. While in this fully closed position, slide the plate between the door frame and door with the black pad against the door.

This will allow you to get a good look at everything, and to reposition the blocker is desired or necessary.

**Be mindful of any electrical outlets nearby as there may be wiring within the walls near where you may be drilling. Additionally, look at surrounding door hardware, molding, key hooks, or other things that might interfere with your ability to operate the blocker and allow it to swing fully from locked to unlocked positions, and back again.

Actual Installation Steps

Step One

Once you have determined where you want to place the door blocker, use a pencil to mark the placement of the center screw within the door frame.

Step Two

Use your drill and 1/8-inch drill bit to make a hole where the center screw will be placed.

Step Three

Place the door blocker plate back against the door frame, allowing the recently drilled hole drilled to be visible in the center-hole of the plate.

Step Four

Drive the center screw into the door frame allowing the blocker plate to be provisionally positioned.  The center hole is oval shaped and allows for the back-and-forth movement of the device in order to ensure that it is tight enough against the door to perform its function, but not so tight that it prevents you from latching and unlatching it.

Step Five

Test for the appropriate and desired fit. Before fully securing the door blocker, close the door and test the blocker in the locked position to ensure the placement is optimal. If the lock is difficult to engage or disengage, the placement of the plate may need to be adjusted slightly for proper operation of the device. In this case, you would simply loosen (but not remove) the center screw, move the blocker, and re-tighten the screw.

Step Six

Once the positioning has been established, ensure that the center screw is fully tightened – but not over-torqued. (You don’t want to strip the head or threads.)

Screw assortment
Longer Wood Screws & Shorter Metal Screws

Then, drive in the remaining three (3) screws – large screws for a wooden door frame; small screws for metal – into the remaining holes present on the door blocker plate to firmly secure the blocker.

Congratulations!

Your Defender door blocker has now been successfully installed!

Open & Closed
‘Defender’ in Position

If you need an additional assist, or a bit more in the way of visual aids, never fear. For a demonstration of the operation of the lock, or for a video tutorial on the installation procedure, please view my companion YouTube video: Alzheimer’s Elopement & Access Control: Install the Defender Door Lock.

Thank you for reading! I wish you all the best trying to deal with elopement risk.

Notes:

[1] The “Defender” appears to me to be an off-brand version of a different door blocker known as the “Door Guardian.” I also have the Door Guardian and will walk through its – nearly identical – installation procedure in a subsequent post.

[2] Note that there is no “key” and that the device is not designed to be unlocked from the outside. It is supposed to be activated and deactivated from within the area being secured.