Adapting your home to make it safe for your loved one with dementia is one of the most important things you will do, creating a safe place for your love one and eliminating some of the worries you may feel…
Safety is one of the biggest worries when caring for your loved one with dementia – especially as the condition progresses. Each situation is different and requires different precautions. Often there is a balance to be struck between protecting the person and their right to independence. However, it is important, where possible, to involve them in any decisions you make. Also bear in mind that precautions need to be constantly revisited. What is currently safe may not be in a few months’ time. Here are some of the risks to think about with strategies to consider.
There are a number of reasons why your loved one may decide to walk out the door and go wandering at odd times, including the middle of the night. These may include:
- Having been used to an active life, they are brimming with energy
- Waking up in the night to go to the bathroom and then thinking it is time to get up
- Restlessness caused by pain, social contact, medications or stimulants such as coffee
- Wanting to be somewhere else. For example, where they lived 40 years earlier
- A way of relieving physical and emotional tension.
Remember, if the person feels agitated or wakes up in the night and wants to go out they may not remember that it is not safe, an appropriate time or that they may be putting themselves in danger. Their time sense has gone. To give yourself piece of mind and help keep the person safe, consider the following:
- Installing an alarm or chime system on outside doors that will alert you when someone goes out
- Making sure your loved always carries some kind of identification. This might be a medical bracelet or necklace. Have it inscribed with their name, address, your phone number and the words ‘Memory impaired’. If they are found wandering the finder will be able to get in contact with you. Identification kept in handbags or wallets can get lost or become separated from the person.
- Using electronic ‘tracking’ devices that can locate someone if they have got lost.
- Keeping doors locked. This may mean using a deadbolt or a second lock or bar placed high up so your loved one cannot reach it. Bear in mind that this could cause him or her to become angry as they have been used to coming and going freely. There is also the danger of them not being able to get out in the event of fire.
- Keeping a recent photograph of them available so that if they do go missing you can give it to the police to help.
- Letting your neighbours know that he or she goes wandering so that they can keep an eye out for the person.
- Ensuring your loved one has plenty of exercise and stimulation during the day. Or, if they want to go out during the night, consider doing your shopping with them at an all-night supermarket.
Kitchens can be highly dangerous places. Here are some suggestions to help minimise the risks. What is appropriate will differ depending on the circumstances.
- Switch cookers off at the main control.
- Have an appropriate fire extinguisher and fire blanket.
- Remove any appliances that are not needed.
- Put labels on appliances to show what they do. Pictures are good for this.
- Remove any items that might be dangerous, such as sharp knives.
- Use battery operated lighters to light gas and dispose of all matches.
- Obtain removable knobs for the cooker so they can’t be turned on, or have cut-out mechanisms fitted
- Use kettles and other appliances that switch off automatically.
The risk of falls increase with age. Your loved one may have had a stroke, have balance difficulties, some visual impairment or other factors which affect them. Reduce the risk of falls by:
- Checking the home regularly for possible hazards. This might include removing rugs, objects left in hallways, corridors or on floors in rooms such as plant pots or low furniture that obstruct pathways, and mending loose or torn carpets.
- Making sure your loved one exercises regularly. This can help maintain both strength and balance.
- Keeping objects they may want to use within easy reach.
- Avoiding doing things in a rush. Many falls occur when people are rushing.
- Making sure lighting is good. The person may have reduced ability to detect movement or to clearly distinguish between objects and their background or have other visual problems.
- Leaving a light on in the bathroom, landing or hall during the night in case your loved one needs to get up.
- Get rid of clutter: boxes, piles of magazines or newspapers.
Medications and other hazardous items
There may be many things around the home that may cause harm. Inspect the house, garage and any sheds and remove or lock up items that could cause harm such as:
- All medications, both prescribed and bought, such as aspirins or cough mixtures.
- Dangerous products such as paint thinners, paint, cleaning fluids, petrol cans and bleach.
- Any tools or implements which might be harmful, such as scissors, sharp tools, knives, etc.
- Lotions, shampoos, perfumes. (These can look appetising.)
Other things to consider are:
- Turning down shower and water temperature so that burning cannot occur.
- Immobilise any cars or other vehicles and make sure the keys are not available. (Essential if the person is used to driving)
- Lock any bicycles so they cannot be used. (Essential if the person has been using a bicycle)
- Labelling hot water taps as hot and cold. Some modern designs may not be recognised as taps.
- Having smoke and carbon monoxide alarms in or near the kitchen, in bedrooms and any other rooms that may have gas fires.
- Using childproof plugs for electricity outlets.
- Adding a strong handrail on the stairs.
- Using colourful signs and pictures to label rooms bathroom, kitchen, study, lounge and bedroom. Putting pictures of whose bedroom it is on the door.
- Putting a gate on the stairs if they present a hazard because of balance or other physical difficulties.
Marking the edge of steps with brightly coloured tape to make them more visible
The above gives a general indication of what might present a danger to your loved one. Do keep in mind that each home varies and will present different hazards. Also, familiarity may make you overlook some things which could present danger in the near future. It is better to take precautions and avoid something happening, than waiting and finding out that it could have been avoided. Contact your local fire services, they usually provide home safety visits and advise on how to make the home safe as well as about fire precautions. Also, contact your local authority, an occupational therapist will advise on adaptations for the home to make it safe, such as when the person is getting in and out of the bath. They will provide you with information about how to get them and whether or not you might qualify to receive funding for recommended alterations. It is well worth arranging a visit.
This article was written for Carewatch by Robin Dynes. Robin also wrote our Activity guides for people with dementia to help carers enrich the lives of those they support.
Robin has worked in the National Health Service, Social Services and Adult Education for over 30 years as a counsellor and trainer. His main role has been to develop innovative services to meet the needs of older people and others who are vulnerable.