Safety at Home
By: the Alzheimer's Association
Adapting the home to support the person with dementia ®
When caring for a person with dementia, having a safe and supportive home is an important concern. As Alzheimer’s disease progresses, the abilities of a person with dementia will change. But a caregiver can adapt the home to support these changes with some creativity, flexibility and problem solving.
Changes that can affect safety include:
Forgetting how to use household appliances
Sense of time and place
Getting lost on one’s own street; being unable to recognize or find areas in the home
Becoming easily confused, suspicious or fearful
Having trouble with balance; depending upon a walker or wheelchair to get around
Experiencing changes in vision, hearing, sensitivity to temperatures or depth perception
Focus on adapting rather than teaching
Avoid trying to re-teach the person about safety. Instead, identify possible risks and take precautions.
Simplify the activities
Most accidents, especially in the area of personal care, occur when the person is rushed. Break up activities into simple, step-by-step tasks, allowing the person plenty of time to get tasks done. Give extra help with tasks that have become hard to do.
Support the person’s needs
Try not to create a home that feels too restrictive. The home should encourage independence, social interaction and meaningful activities.
Be realistic about what you can do
You can’t prevent every problem. Rely on your common sense while paying close attention to objects or activities that could be dangerous.
Providing a safe place to live
After you have identified potential safety problems, take these steps to modify your home.
Limit access to potentially dangerous places. The person with dementia may be at risk if he or she can reach certain areas of the home or the outdoors.
Put dangerous areas out of reach:
Lock or disguise hazardous area
Cover doors and locks with a painted mural or cloth
Use “Dutch” (half ) doors, swinging doors or folding doors to hide entrances to the kitchen, stairwell, workroom and storage area
Install locks out of sight
Place dead bolts either high or low on exterior doors to make it difficult for the person to wander out of the house
Keep an extra set of keys hidden near the door for easy access
Remove locks in bathrooms or bedrooms so the person cannot get locked inside
Use special safety devices
Child-proof locks and door knobs can help limit access to storage areas for knives, appliances and equipment, as well as cleaning fluids and other poisonous products.
Use automatic shut-off devices for appliances like irons, toaster ovens and coffeemakers.
Adapt to changes in the person’s sight
As the disease progresses, changes in vision may make it difficult for the person to distinguish colors and understand what is being seen.
To adapt to vision limitations:
Diffuse bright light
Reduce glare by removing or covering mirrors and glass tops or highly polished furniture.
Block bright sunlight by covering windows with blinds, shades or sheer draperies. Avoid using bare light bulbs or clear “decorator” bulbs without shades. Reducing glare may help to ease agitation for the person with dementia.
Create an even level of lighting
Add extra lighting in entries, outside landings, areas between rooms, stairways and bathrooms. Changes in levels of light can be disorienting to a person with dementia. Use different colors Place contrasting colored rugs in front of doors or steps to help the person anticipate staircases and room entrances. But avoid using a dark-colored rug because it may appear to be a “hole.” Put colored stickers on glass doors and large windows so the person doesn’t think they’re open. Install special lighting Use night lights in hallways, bedrooms and bathrooms to prevent accidents and reduce disorientation – especially if the person could potentially wander. Illuminated light switches and light timers in these areas can also assist the person at night.
Beware of dangerous objects and substances
Even the most basic appliance or household object can become dangerous for the person with dementia. To reduce risk of injury: Limit use of certain appliances and equipment Water and electricity create a dangerous combination. Remove from the bathroom electrical appliances, such as electric razors or hair dryers, to reduce the risk of electrical shock. In the kitchen, put away potentially dangerous appliances like mixers and utensils such as knives.
Consider removing the knobs from stove burners. You may also install a hidden gas valve or circuit breaker so the person cannot turn on the stove. Secure grills, lawn mowers, power tools and guns. The person may not recall how to safely use these items. Supervise smoking and the use of alcohol Keep an eye on the person during any use of cigarettes, cigars or pipes. He or she may not realize the dangers related to smoking.
Monitor the use of alcohol. It can have many negative effects, especially when mixed with medication. Be aware of items mistaken for food. People with dementia have been known to eat items such as small rocks, dirt, plants, flowers and flower bulbs. Take precaution by removing toxic plants and decorative fruits (wax, plastic, etc.) that the person may think are real. Also, remove vitamins, prescription drugs, sugar substitutes and seasonings from the kitchen table and counters.
Secure household chemicals Keep cleaning supplies, like laundry detergent and dishwashing soap, and other dangerous liquids in a safe place so the person cannot mistakenly drink them. Keep the refrigerator safe A person with dementia may be unable to tell the difference between fresh and rotten food.
Clean out the refrigerator regularly, throwing out any old food. Keep foods that are safe to eat in the front of the refrigerator at eye level where the person can easily see them. Keep walking areas clear
Reduce the chance of injury and create safe walking areas by removing objects such as magazine racks, coffee tables and floor lamps. Keep floors and other surfaces clutter-free.
Avoid injury during daily activities
Most accidents in the home occur during daily activities such as eating, bathing and using the restroom. Take special precautions at these times.
To reduce risk of injury:
Watch temperatures As the disease progresses, the person may become less aware of temperature. To avoid burns, consider setting hot water heaters at no more than 120 degrees. Install automatic-mixing or anti-scalding devices in the faucets. Meanwhile, help the person mix hot and cold water, and always turn off the hot water first when finished. Check food temperatures before serving to make sure food is not too hot or too cold to eat.
Install walk-in showers and grab bars in the shower or tub and at the edge of the vanity to allow the person to move around safely and independently. Shower seats and commode chairs are also helpful if the person has limited ability to get around. Add textured stickers to slippery surfaces. Apply adhesives to keep throw rugs and carpeting in place – or remove rugs completely. Place padding on any of the sharp edges of counters and bathroom fixtures.
A person with dementia may have trouble properly using prescription and over-the-counter medications. He or she may forget to take them or take too much. Consider using a locked pill dispenser that works on a self-timer if the person can understand its use. Install locks to limit access to any cabinets containing medications.
Creating a supportive home
Make sure your home supports the person’s changing needs, which is just as important as safety. Encourage independent movement Eliminate hazardous objects, and limit access to dangerous areas like stairwells, kitchens and outside doors. Move furniture or other obstructions to create more space for wheelchairs or walkers. Involve the person in daily activities Have the person participate in preparing meals, rinsing dishes, folding clothes, raking leaves and other activities that you supervise. These activities can enhance self-esteem and make the person feel more valued around the home.
Adapt surroundings to encourage activities
In key locations, place scrapbooks, photo albums or old magazines that help the person reminisce. Encourage conversation about them. Play a favorite kind of music to prompt dancing, clapping or other kinds of exercise. Keep noise level low – loud, distracting sounds could upset the person.
Provide access to the outdoors
Encourage the person to enjoy supervised outdoor activities like gardening or walking. A backyard with a fence allows the person to go safely outside on his or her own. If going outdoors is not an option, consider indoor activities in a room filled with windows or an enclosed porch or balcony.
Be prepared for emergencies
Keep a list of emergency phone numbers and addresses for local police and fire departments, hospitals and poison control helplines. Check fire extinguishers and smoke alarms often. Regularly conduct fire drills.
Did you know?
The presence of a weapon in the home of a person with dementia may lead to unexpected danger. Dementia can cause a person to mistakenly believe that a familiar caregiver is an intruder.