Inside the Home
Whether your loved one is in the early stages of dementia and is able to live alone, or if you have become the caregiver inside your own home, home safety is key to the protection of their life.
Even if your loved one is still able to manage themselves at home, you want to prepare for the future. Inside the home safety is a good starting point by looking at the living space through the eyes and mind of the loved one with dementia.
Remember, people with dementia have difficulty with cognitive functions such as understanding and remembering instructions, and as dementia advances, their ability to interpret the world around them and make sound decisions also decline. As you create a home environment safe for your loved one with dementia, focus on the key obstacles that your loved one may struggle with such as depth perception, and physical difficulties such as loss of strength, balance, and coordination.
Room by Room Home Safety
Look for areas in the home that may lead to misinterpretation or confusion in a person with dementia which ultimately can become safety hazards.
One of the best places to start is the walls and flooring. Walls that are painted in neutral colors, with no bold designs or wallpaper, and those that contrast with the floor creates an area with definition, which can help with depth perception, as well as balance and coordination.
Evaluate and look for:
- Clutter may include treasures that add comfort and reminders of fond memories for the person with dementia, however, clutter may also lead to accidents. Ask yourself, if the treasured items were knocked over, would your loved one with dementia be able to maneuver around the mess on the floor, or would their lack of coordination and depth perception lead them to stumble and fall?
Is there a clear path for your loved on to walk through without the danger of bumping into extra objects or furniture?
Is the clutter a fire hazard? Piles of old books, newspapers, or magazines can be of interest to many of us, but in the wrong hands, and in the wrong place, it becomes a fire hazard.
If your loved one is in the early stages of dementia, consider including them in the decluttering decisions. What do you keep and what do you get rid of (or store away)? Being a part of the decluttering process minimizes confusion for the person with dementia and it promotes a therapeutic sense of independence.
- Floors that are in good repair are integral to the coordination of a person with dementia. Uneven floors or areas with rugs may cause a person with dementia to misinterpret where the floor begins or ends, which may cause them to stumble or fall. To avoid tripping hazards, it is best to avoid the use of throw rugs at all. Always use non-skid waxes and cleaners on the flooring. Textured flooring or carpet provides more grip for the feet.
- Stairways should be marked at both the top and the bottom with reflective tape. Ensure handrails are provided, as well as light switches at both ends. If possible, stairs should be carpeted or have grip strips.
- Smoke alarms and carbon monoxide detectors should be installed near the kitchen and all sleeping areas. Batteries in each detector should be checked frequently. Ensure your loved one understands what to do if a detector does go off.
- Mirrors or glass doors can lead to confusion or may look like an open door. Place stickers on glass doors and mirrors to ensure the glass is visible. Avoid the use of decorative mirrors on the walls.
- Lighting should be strong but without glare. Ensure lights are arranged in a way that avoids shadowing which can lead to confusion in people with dementia. Install motion-sensing lights throughout the home which help with night safety and provide additional light on days with dim natural light.
Remember: The level of safety measures required for people with dementia depends upon the stage of dementia your loved one is in. If they are still living on their own, consider each of these measures as ways you can improve safety within their home today, and help plan safety as their dementia progresses.
Kitchens are one of the most dangerous rooms for people with dementia.
Carefully assess each of these kitchen areas:
- Install safety knobs and automatic shut off switches on the stove. With a gas range, install a safety shut off valve that the person with dementia cannot accidentally turn on.
- Consider disconnecting the garbage disposal.
- Install drain traps to catch anything that may end up in the plumbing.
- Install a motion-sensing night light.
- Clear the kitchen of dangerous and toxic chemicals.
- Install childproof locks on cabinets that contain glass or breakable items.
- Place cleaning products, matches, knives, scissors, and small appliances under lock and key. Consider moving these objects to a designated locked storage area away from the kitchen.
- Clear out junk drawers as these lead to confusion and can be a safety hazard for the person with dementia.
- Store medications and prescriptions in a locked cabinet.
Persons with advanced dementia should not be left in a bathroom alone, however, steps can be taken that help with balance and coordination.
- Remove the lock from the bathroom door to prevent being locked inside.
- To prevent slipping on wet floors, consider using washable wall-to-wall carpeting. Try to avoid the use of throw rugs, but if you find them necessary, secure the rugs with double-sided tape.
- Place non-skid adhesive strips, decals, or non-slip mats in the tub and shower.
- Consider purchasing foam rubber faucet covers in the tub to prevent injury if your loved one should fall.
- Install a raised toilet seat with handrails or grab bars beside the toilet.
- Install grab bars in the tub or shower.
- Consider installing a faucet that emits both hot and cold water to avoid burns and set the water temperature at no great than 120°F to avoid scalding.
- Install a motion-sensing night light.
- Remove all electrical devices from the bathroom.
- Remove all medications and cleaning products from the bathroom and lock them in a cabinet or designated storage area elsewhere.
People get out of bed during the night for various reasons—to use the bathroom, hunger, thirst, restlessness, and pain. Help your loved one with dementia safely maneuver their way out of bed:
- Consider a night light which allows enough light for safety, but not so much that it leaves shadowing effects on the walls or inhibits sleep.
- Remove the bedroom door lock to prevent being locked inside the room.
- Use a monitoring device in later stages of dementia to ensure you hear when your loved one needs assistance.
- Remove portable space heaters. Ensure fans cannot be knocked or tripped over, and that objects cannot be pushed into the blades.
- Avoid electric blankets and mattress covers to avoid burns, but if you do use them, ensure the person with dementia does not have access to the controls.
- If the person is prone to falling out of bed, consider placing thick mats next to the bend to cushion falls—but know that mats or rugs can lead to tripping and falling.
- Consider bed railings, or hospital beds, for people prone to falling out of bed, however, be aware of the serious and life-threatening entrapment or entanglement safety risks outlined by the U.S. Food and Drug Administration.
Safety in the laundry room rests on the stage of dementia your loved one is in.
If the person with dementia can operate the washer and dryer on their own, ensure the products that they use are safety and coordination friendly, such as the use of laundry detergent pods or dryer sheets. Remember, though, that people in later stages of dementia may try to eat items that come in small packages, including laundry detergent pods. Remove dangerous caustic chemicals, such as chlorine bleach, from the laundry room altogether.
If the person with dementia is living with you and unable to take care of themselves, keep the door to the laundry room locked. If this is not possible, lock all laundry products in a cabinet. Remove knobs from both the washer and dryer and ensure washer and dryer lids remain closed and latched.
Exterior Doors and Windows
For the person with dementia who can safely take care of themselves at home, working locks need to be installed on all the exterior doors and windows. This measure is more to keep intruders out than to keep your loved one in.
For you, the caregiver who lives with a person in an advanced stage of dementia, you must take extra precaution to ensure your loved one cannot wander out of the house. Install deadbolt locks either high or low on the doors to ensure it is difficult for the person to walk out. Also, consider installing alarms that notify you when an exterior door or window has opened.
Always get in the habit of keeping an extra door key on you to ensure you’re not locked out of your own home. It never hurts to keep an extra set of keys either hidden or given to a close family member or friend for easy access.
There’s Much More to Home Safety
There is much more to home safety than evaluating room to room.
The development of an emergency plan for both you and your loved one sits at the top of the priority list, as well as a review of the home safety areas that are outside of the living area of your home, such as the basement, garage/storage areas, as well as vehicle safety.
Over the next few months, we will be continuing our series on home safety for dementia care. If you are a caregiver and would like to talk about the best options for the future, give us a call at 512-399-5080. We can help you through every step of the way.