Maintaining a Safe, Dementia-Friendly Environment

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The home is an important place for everyone. For the person with dementia, a familiar environment can help her connect with the past and maintain a sense of who she is. However, some practical changes may need to be made to keep the home "dementia-friendly."

When modifying your home environment, keep it familiar, striking a balance between safety and independence. Too many restrictions can make it difficult for her to take part in daily activities, and can seriously affect her self-esteem. 

Keep in mind some of the changes that occur with dementia: decreased balance and reaction time; visual-perceptual problems; physical limitations that make it more difficult to walk; memory; judgment; and insight. Also keep in mind that you are more likely to be tired, and feel under pressure, making it more difficult for you to anticipate risk and prevent accidents. 

Adapt the task to the person's current abilities. For example, a person who enjoyed wood-working may no longer be able to use power tools but may still be able to nail, sand and paint in the workroom. Be aware of changes as they happen and re-evaluate the need to make further changes to adapt to his abilities.

Some areas of a home may have more risks than others. Pay extra attention in the garage, work room, basement and outdoor areas. 

Take a few minutes to complete the following checklist on home safety. Keep in mind that, as the disease progresses, you may need to update your responses.

Home safety checklist

✓  Do I need to store the scatter rugs and secure the carpet to prevent falls? 
✓  Are the stairways safe for the person I am caring for? 
✓  Is the person with Alzheimer's disease able to use the electrical appliances in the kitchen and bathroom safely?
✓  Should the hot water heater temperature be lowered? 
✓  Are there any medications, cleaning substances or gardening chemicals that should be locked away?
✓  Do I need to be there when the person with Alzheimer's disease has a cigarette or should I hide the lighter and matches?
✓  Should I lock some of the doors or do I need to change where on the doors the locks are? 
✓  Should I consider installing some safety equipment in the bathroom (e.g., grab bars, elevated toilet seat, non-slip mat)? 
✓  Does the lighting sufficiently eliminate shadows that may cause confusion? 
✓  Are there items that confuse the person with Alzheimer's disease (e.g., pictures, mirrors)? 

This information is taken from the Alzheimer Journey, Module 2: On the Road. You can get a copy from your local Alzheimer Society.

Safety tips

  • Make sure to keep fire extinguishers, smoke detectors and carbon monoxide detectors in the house and test them regularly to make sure they are working.
     
  • Lock any hazard areas or cover the doors or locks so that they are disguised. Place locks either high or low on doors to make them less obvious.
     
  • Remove locks in bathrooms or bedrooms so he cannot get locked inside. 
     
  • Use child-proof locks and doorknob covers on drawers and cupboards that have dangerous materials inside, such as knives, cleaning liquids and appliances.
     
  • Consider registering the person with the disease with our MedicAlert® Safely Home® program to assist emergency responders to identify the person who is lost and bring the family back together. 
     
  • Use appliances that have an automatic shut-off feature, and keep appliances away from sinks and other sources of water. 
     
  • If you are concerned about the person using the stove, install a hidden gas valve or circuit breaker that prevents it from being turned on. Or consider removing the knobs from the burners. 
     
  • Store dangerous tools, such as grills, lawn mowers, any power tools, knives and firearms, in a secure place.
     
  • Remove any toxic plants or decorative fruits that she might mistakenly try to eat.
     
  • Remove any medications or other substances from open areas such as the kitchen table and counters. This might include vitamins, prescription drugs, or even sugar, sugar substitutes or seasonings. Keep medications in a locked area.
     
  • Supervise him when using tobacco or alcohol as both may have harmful side effects and may interact with certain drugs. Always supervise him when smoking as he may forget a burning cigarette and start a fire.
     
  • Check the temperature of water and food, as she may have difficulty telling the difference. This applies to water temperature in a bath, for example, and the temperature of hot food.
     
  • Install safety equipment in the bathroom, such as grab bars, to prevent falls.
     
  • Add non-slip stickers to slippery surfaces such as tile floors and loose rugs. Or remove rugs completely.
     
  • Use contrasting colours to make steps and transitions (e.g. the beginning of a staircase) easier to see. Avoid dark rugs as they may appear to be a hole.
     
  • Use good lighting at entries, outside landings, between rooms, on stairways and in bathrooms.
     
  • Keep emergency numbers by the phone for quick access.
     
  • Remember that symbols lose meaning (skull, crossbones, “toxic”, “poison”, etc.)
     
  • Consult an occupational therapist for advice on safety, and adapting the home to make it as safe and accommodating as possible.

For further details on keeping your home safe, see the publication, Home Safety for People with Alzheimer’s Disease on the website for U.S. National Institutes of Health, National Institute on Aging at http://www.nia.nih.gov/Alzheimers/Publications/homesafety.htm