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This Caring Home  

Dementia Friendly Home Safety

A dementia-friendly home can ease safety challenges and help make caregiving less stressful and more rewarding. In this article, we’ll explore key design elements and technologies that can help enhance home safety and quality of life — for you and the person you care for.

Keys to Success

Accepting change can be challenging to anyone, but especially for people with dementia. To help reduce challenging behaviors when making changes, keep in mind that:

  1. Each person and environment is unique; no one solution will work in all situations.
  2. The person’s needs change over time — what works today may not tomorrow.
  3. Whenever you make a change, observe how the person responds and switch course if needed.
Cooking and Household Safety

The use of cooking appliances when the person’s memory or judgment is impaired is a top home-safety concern. There are a few ways to enhance safety, depending on remaining abilities. In the early stages, large reminder signs and cooking timers with a loud, long ring may help remind the person that food is cooking on the stove. Devices can be installed on electric stoves that turn the stove off after a set period of time if the person forgets. Toaster ovens are available that automatically turn off after a set amount of time (usually 30 minutes) and some electric teakettles automatically turn off after the water boils. Microwaves are available with one button cooking.

Keep in mind that not everyone will be able to use a new appliance or learn a new way of cooking, no matter how minor. Regardless of strategy, you’ll need to frequently assess the person’s cooking skills and judgment. For example, do they still know which cookware is safe to use, or, do they put plastic containers on burners or metal containers in the microwave?

Off Limits

It is not always clear if a person can safely engage in an activity. Balancing risk and freedom is an ongoing challenge. At some point, you may need to make certain appliances or household items like knives or cleaning supplies off limits. Keep in mind that people react very differently when access is denied. Some may simply walk away if they can no longer turn the stove on (after removal of the knobs) or open a newly locked cabinet door. But others may become so frustrated that they attempt to remove the lock or, worse yet, the door. Here are a few things to do for a more positive outcome:

  • Don’t leave the person alone until you know they are comfortable with the change.
  • Make sure to have snacks available and alternative activities for the person to engage in. This redirects the person’s attention and provides structure in the person’s day, essential for well-being.
  • Instead of locking a cabinet, try placing the item out of view in the same room (like a teakettle on an upper shelf in the back) or move it to another room. However, he or she may become upset when they notice the item missing, so have a creative strategy in place if needed.
  • If you need to lock a cabinet, keep some cupboards/drawers unlocked with safe items for the person to rummage through.
Falls

Persons with dementia fall up to three times more often than individuals without cognitive impairments. In addition to age-related vision and mobility changes, dementia brings its own unique set of challenges that increase fall risk. For example, it is not uncommon for a person to forget they can no longer walk safely and get out of a bed or a chair by themselves, or walk unaided.

To help reduce falls, here are five things to consider:

  • Boost the lighting, especially at night. Use easy-on-the-eyes blue or green LED nightlights or motion-activated nightlights.
  • Use bright colors to overcome dementiarelated problems with depth perception. For example, paint a two inch strip of bright paint on step edges or place a rose colored towel on a white bath chair.
  • Be bathing safe. Use a bath mat inside the tub and a bath chair; a swiveling, sliding seat to ease transfers can be helpful if the person can no longer slide across the chair. Install grab bars into the walls (no suction cup grab bars, as they can fall off). Use low pile floor mats with non-skid backing (no rugs that can “bunch up”).
  • Use motion detectors or chair, bed, or floor pads with chime alerts so you can be alerted when the person is getting up from a bed or chair.
  • Remove doorsills, area carpets, and clutter from walkways. Store items in baskets or plastic crates if removal causes distress.
Burns

Memory aids like red electrical waterproof tape wrapped around the hot water faucet can visually signal which handle to turn when the person forgets. Anti-scald valves prevent scalding by either 1. reducing the hot water to a trickle (screw on device) or 2. premixing the water to a safe temperature before it flows out of the pipe (requires plumber).

Wandering

Leaving home and not being able to find the way back is a serious problem, especially since it happens so unpredictably. To alert you that he or she is attempting to leave home, try a door monitoring device that sounds a remote chime in the rooms you are likely to be in. When needed, install sliding locks high or low on the door (they’re often not noticed). Be sure to talk to the Association’s staff about their programs that assist in the timely return of persons who become lost, including their Medic Alert Safe Return program and their new Comfort Zone GPS Management System.

It can be difficult at times being a caregiver to a person with dementia. But there are many proactive steps you can take to create a dementia-friendly home that eases caregiver stress and promotes more positive outcomes. Providing for the safety of your relative with dementia is an on-going challenge, and changes over time as the disease progresses. You can keep learning by staying in touch with the NYC Chapter, attending education meetings, and learning from others in a support group.

Research Study

If you are a family caregiver and are interested in participating in a research study to test the efficacy of our new Web site, ThisCaringHome.org, please email Ms. Bakker for more information at rob2013@med.cornell.edu.

ThisCaringHome.org is a Project of Weill Cornell Medical College.

Visit : www.thiscaringhome.org for more helpful tips on home safety, special concerns, products and more.

Alzheimer's Association

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