Dementia: Safety in the Home
Dementia is the name given to the broad range of symptoms resulting from illnesses that cause degenerative intellectual functioning.
The onset and symptoms present differently in each situation. Side effects range from confusion, memory loss and disorientation, to the reduced ability to finish thoughts or follow directions. For some people, their dementia may also be combined with decreased mobility, loss of balance and problems with coordination.
As the disease progresses, the person may struggle to perform familiar tasks, remember recent events, or understand and recognise potential problems and solutions.
For those living with a person with dementia it can be a confusing and scary time. However, there are some simple ideas that can help make the home a safer and user-friendlier environment.
Arranging the Home Environment
Providing an uncluttered home environment not only eliminates tripping hazards, but it also removes potential distractions that may add to a person’s confusion and disorientation. For example, to a person with dementia, a dark mat before a door may look like a hole in the floor. Similarly, patterned flooring may be mistaken for steps.
Suggestions for arranging the home environment include:
- Remove loose rugs and mats, seal up carpet edges and provide non-slip flooring.
Provide a well-lit environment during both day and night, as people with dementia may not have the insight to look for light switches. It may be helpful to install a path of night-lights between the bedroom and the toilet.
Remove potentially disorientating visible barriers, such as closed doors.
Provide pictures/labels around the home to identify rooms and cupboards (eg a picture of a toilet seat on the toilet door, a photo of each family member on their bedroom doors, labels or pictures on clothing drawers).
Do not hide important items (eg make sure the toilet paper is clearly visible without the need to search it out).
- Remove or lock up potential hazards (eg medication and anything that could be mistaken for food or drink)
Remove items that have the potential to cause disaster/injury if mismanaged (eg hot water bottles, electric blankets, hair straighteners, bar radiator heaters, sharp knives)
- Remove the locks from the toilet and bathroom doors to avoid anyone becoming locked inside.
It can be difficult for people with dementia to gauge how hot or cold they are. For this reason, it is important to monitor the temperature in the home. In winter, instal a timed heater that switches on in the morning and off at night. In summer, do the same with an air conditioner.
If you are concerned about the person wandering, consider putting extra locks on either the upper or lower parts of the door. These are harder to see because they are not in the direct line of sight.
Make the bathroom environment safer with grab rails, slip-resistant flooring/mats and equipment such as shower chairs and toilet seat raisers.
Install electrical safety switches, gas leak detectors and smoke alarms.
- If possible look at setting the hot water system to a ‘safe’ temperature. Alternatives, although slightly more expensive, include tempering valves and thermostatic mixing valves.
- Place bells or chimes on doors and gates to let you know if someone is arriving or leaving.
Create a safer garden environment by removing overhanging branches, cluttered pathways and hazardous substances in garages.
An occupational therapist can give you a home safety assessment, which will help you make decisions about: grab rails around the home, modifying/eliminating steps, creating shower alcoves, installing hand-held shower hoses and setting the correct height for furniture.
Safety Equipment, Tips and Gadgets
It is impossible to have a completely risk-free environment and it is a fact of life that minor incidents can, and probably will, occur. The following are some examples of gadgets and ideas that can help promote a safer home environment:
- Isolation valves on gas stoves and heaters that turn the equipment off after a designated period of time.
- ‘Access proof’ your home by installing magnetic cabinet locks, stove guards, oven locks, tap covers and cupboard latches.
- If keeping track of time and appointments is a problem, consider a talking watch that speaks the time and has an alarm function that can verbalise a pre-recorded message. Other handy ideas include easy-to-read electronic clocks and calendars with automatic day, date and time.
- In order to keep track of medication consider using pillboxes. Some pillboxes also have a system that locks the pillbox against opening until a pre programmed time. When the pre-programmed time arrives, the pillbox unlocks and sounds an audible reminder.
If falling is a concern, hip protectors may provide some protection against injury.
- It is often important to introduce new ideas or equipment during the early stages of dementia because during the later stages it becomes harder to introduce new skills or ask the person to adjust to new ideas and ways of doing things.
WanderingWandering can be a common concern. Some simple ideas to easy the worry include:
- Visit neighbours and shops in the local area to explain the situation and provide a contact phone number in case of need.
- Avoid having items lying about which may trigger the idea of wandering (eg handbag, coat or keys).
- Ensure the person with dementia is wearing a personal identification bracelet and has identification and a list of emergency contact numbers in their wallet or purse.
- If there is a concern that the person may become locked inside the house during an emergency, consider making the garden secure (rather than the house) so they can leave the house and have a safe, familiar environment in which to wait.
Consider installing movement detection devices such as:
LOCAL RESOURSES FOR WANDERING