Safety around the home becomes an issue for people with Alzheimer’s disease and other dementias, especially as the disease progresses. Persons with dementia may become disoriented, confused, be limited in their coordination and mobility, as well as be forgetful, all contributing to the possibility of safety issues. As caregivers of persons with dementia, taking preventive steps in the home is important to avoid falls and other accidents, as well as to prevent your loved one from wandering off. In the late stage of dementia, other physical safety concerns develop. This includes the ability to safely lift and move your loved one and the prevention of bedsores due to lack of mobility.
Make note of the following suggestions and safety tips to keep your loved one with dementia safe and healthy in the home:
Older people are more susceptible to cold temperatures. Potentially dangerous drops in body temperature, known as hypothermia, may occur in response to not being kept warm enough. People with Alzheimer’s may not realize how cold they are and may not take appropriate steps to stay warm. Hypothermia can happen even when the temperature is not below freezing, so the temperature in the home of your loved one with dementia should be set around 70 degrees.
As a person with dementia’s coordination decreases, it is important that your loved one be able to move about the house safely. Make sure that rooms and hallways have non-slip walking surfaces and have sufficient lighting. Consider placing nightlights in the bedroom, bathroom, and hallways if your loved one walks around at night. Also, make sure that there is a clear pathway through rooms and hallways. This means that furniture, cords, or clutter should not obstruct the walkway. This includes floor rugs, as they can easily be tripped over. If there are stairs in the home, consider installing handrails, as well as safety strips on the steps.
Bathroom floors can be notoriously slippery when wet. Place non-skid strips on the floor, the bathtub and / or shower. The addition of shower chairs, handheld showers, toilet seat risers, and grab bars in the shower and by the toilet make the bathroom a much safer place for persons with dementia who are lacking in mobility and balance. Please note, depending on the stage of dementia, it may not be safe to leave your loved one unattended in the bathroom.
It is important that dangerous items or complicated appliances be placed out of the reach of loved ones who might confuse their use or purpose. Consider automatic shut-off devices for appliances, such as ovens and toasters, or storing smaller appliances when they are not in use. In addition, stovetop knobs can be removed and stove burners covered up. Disabling garbage disposals is also a good safety measure.
Child-proofing devices or locks on cabinets may be needed to safeguard cleaning supplies and chemicals, scissors, kitchen knives, matches, and other potentially harmful items or substances. Medications should also be kept in a safe place, as persons with dementia may not remember taking their medication and take an extra dose, or even a couple of extra doses. Click here for information about monitoring medications for persons with dementia. Car keys are another item that should be well safeguarded. Read Dementia Related Driving Problems to learn of the dangers of a person with dementia driving, particularly as the disease progresses.
If you don’t already have smoke detectors and carbon monoxide detectors in the home, make sure to install them. If they are battery operated, make sure the batteries are working. Fire extinguishers should also be equipped in the home. Be aware that persons with moderate to severe dementia are unlikely to be aware of what the alarm sounds indicate.
Locks are an easy way to prevent your loved one from opening windows or doors and wandering, which is unfortunately common in persons with dementia. Outside windows and doors should have locks installed in out of sight places near the top or bottom of the doorframe. If wandering is a big problem, installing alarms on doors and windows is another option. In addition, locks should be removed from bathroom doors or other rooms in the house where loved ones could inadvertently trap themselves inside.
Medical alert bracelets or a simple card in your loved one’s wallet or purse stating he or she has dementia is another important safety measure that should be taken. The individual’s address, your name, and your phone number should also be included. More on preventing wandering.
It is approximated that 40 – 60% of persons with dementia have firearms in their homes. Safety tips for homes with guns include making sure the firearm is unloaded and locked away when not in use and keeping the ammunition stored in a different location than the firearm itself. If you wish to get rid of the weapon or to learn more about firearm safety, talk to your local police or sheriff’s office.
If someone else will be staying with your loved one while you are absent, be sure that this person is aware of your loved one’s needs and abilities. If possible, have this person visit beforehand when you can be present to assure that the visitor is comfortable around your loved one and that your loved one is comfortable with him or her.
As your loved one’s dementia advances to the late stages of dementia, new concerns arise.
Lifting your loved one will eventually become necessary in the later stages of dementia. If your loved one is no longer able to move independently, it is important to use proper techniques to avoid injury to both him or her and yourself. Consult with a health care professional about proper ways to lift and turn your loved one.
Moving your loved one’s limbs and joints when he or she no longer moves independently is important to prevent joints from “freezing” up. Consult with a physical therapist or nurse to learn how to slowly move the arms and legs two to three times per day and other ways to maintain range of motion.
Once your loved one is confined to a chair or a bed for long periods of time, pressure sores, also called “bedsores”, become a potential concern. These sores are usually caused due to the individual remaining in the same position for long lengths of time.
Changing your loved one’s position a minimum of every two hours can help reduce the risk of bedsores. Also, use pillows or pads to protect bony areas and make sure to keep your loved one’s body properly aligned. Consult with a health care expert to learn what is needed for your loved one’s degree of mobility. For example, special mattresses and special types of bandages may be needed. It is important to treat pressure sores early and seek medical care if they do not heal.
Hospice is care and support for terminally ill patients. As the dementia progresses to the final stage, you may wonder when it is appropriate to transfer your loved one to hospice care. Medicare offers guidelines on when they consider it the appropriate time for people to be covered for hospice care. For example, a doctor must certify that the individual has less than six months to live. Investigate ahead of time what hospice care options are available in your community and what you will need to do should the need arise.