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Home Safety Guide for Alzheimer’s and Dementia Care
Alzheimer’s and dementia are the foremost cause of disabilities later in life. 1 in 10 Americans over the age of 65 has Alzheimer’s, and worldwide, nearly 50 million people have dementia with an estimated increase of 10 million new cases every year. Alzheimer’s disease is the most common form of dementia. Roughly 60-70% of all cases of dementia are attributed to Alzheimer’s disease.
The symptoms of dementia syndrome and Alzheimer’s disease are usually progressive and affect cognitive functions such as:
- The ability to calculate.
- Lowered learning capacity.
A diagnosis of dementia and/or Alzheimer’s can feel overwhelming for both the individual as well as the family and caretakers. Dementia and Alzheimer’s also affects every individual differently, but most experience the three stages of signs and symptoms.
The first stage includes:
- General forgetfulness.
- Losing track of time.
- Becoming lost in once-familiar places.
The second stage includes:
- More severe forgetfulness, including forgetting peoples’ names or recent events.
- Becoming lost at home.
- Having difficulty communicating.
- Needing support or assistance with personal care.
- Behavioral changes.
- Wandering or repeating the same questions.
The third stage includes:
- Lack of awareness of time and place.
- Difficulty with recognition, or forgetting close relatives and family.
- Requiring assistance for self-care.
- Mobility difficulty and feeling off-balance.
- Behavioral changes which may include anger or aggression.
While there is no available cure for Alzheimer’s or dementia, there are certain steps that can be taken to ensure a safe living situation for someone who lives with the symptoms of the disease.
How Alzheimer’s and Dementia Affect Safety
Because symptoms of Alzheimer’s disease and dementia syndrome can affect an individual’s cognitive abilities, there are some safety risks associated with the various symptoms. This may include:
- Memory and judgment: Fire or electrical hazards from forgetting how to use an appliance, or forgetting to turn it off after use. Forgetting to take medications, or taking too many doses of medication.
- Thinking and orientation: Feelings of confusion or feeling lost in familiar places, including the neighborhood and their own home.
- Comprehension and language: Difficulty expressing needs or understanding tasks. Not recognizing family, friends, or caretakers.
- The ability to calculate and lowered learning capacity: Difficulty remembering healthcare appointments, managing spending, or how to call for assistance in case of an emergency
- Changes in behavior: Becoming easily confused, or displaying suspicion, fear, anger, or aggression towards caretakers. Loss of interest in regular activities that support a healthy lifestyle, including exercising or socialization.
- Lowered physical abilities: Loss of mobility or balance which can lead to trip and fall hazards.
- Changes in senses: Loss of ability to recognize temperature differences for food or water which can result in burns or undercooked food. Loss or change of hearing or vision. Loss of depth perception, which can lead to tripping and falling.
While these symptoms can result in various safety hazards around the home, there are many solutions and changes that can be made to the individual’s home to ensure safety and security. However, in doing so, it is important to consider and support the person’s individual needs. Changes to the home should not result in feelings of restriction. The best solutions are ones that create a safe space while encouraging feelings of independence and opportunity for social interaction.
How to Create an Alzheimer’s and Dementia-Safe Home
Creating an Alzheimer’s- and dementia-safe home will include looking for common safety hazards around the home, as well as some senior and accessibility focused changes. Caretakers and family members that are assisting the individual with Alzheimer’s or dementia may also make gradual changes to the home to align with the stages of the symptoms of the individual and to meet their individual needs. Choosing to make gradual changes rather than drastic changes can soften the experience, and provide feelings of comfort and independence to the individual.
Some family members or caretakers may also choose to install a home security system. This may allow for non-invasive monitoring of the individual and can alert you if they leave the house or forget to close doors and windows in the home. Some security systems can also connect to fire alarms or carbon monoxide detectors to alert the caretaker in the case of an emergency. An individual with Alzheimer’s or dementia may not be able to hear or comprehend an alarm.
The following sections will provide specific insight into safety precautions for each designated area of the home, but you may also consider the following general advice:
- Be discreet about security measures you put in place to ensure that you are aware and supportive of the individual’s feelings of independence and overall emotional wellbeing.
- Eliminate clutter around the house without removing sentimental objects. Overcluttering may cause too much stimulation for a person with Alzheimer’s or dementia.
- Offer a small selection of choices for items such as clothing, or food that is manageable for them to make decisions on their own.
- Include a small selection of hobbies, music, or easy access to television to create a more enriching space.
- Use bright light bulbs and motion detector lights throughout the house so it is easier to see.
- Provide access to nature and natural light to improve the mood.
- Create an open floor plan by removing large obstacles or decor to create space for the person to walk around unhindered.
- Focus on positivity. Many individuals with Alzheimer’s or dementia worry that they are a burden on their family or caretakers. Be sure to provide access to a phone they are comfortable using, encourage focusing on positive memories, play relaxing music, and schedule regular visits from friends and family.
- Display emergency contacts and your personal contact information near all telephones and in visible spaces.
- Install security locks on all outside facing doors and windows.
- Avoid tripping hazards like extension or electrical cords, or throw rugs.
- Install hand-rails on all stairways.
- Remove all dangerous objects such as guns, weapons, power tools, or machinery.
- Create an emergency plan and have a list of contact information for local police, fire departments, medical care and hospitals, and poison control helplines.
- Set water heaters to 120 degrees Fahrenheit or lower to prevent accidental burns.
- Ensure that all entry areas are well lit.
- Consider installing motion sensor lights for entryways.
- Check that door locks work well but are easily opened in case of an emergency.
- Keep a spare key in case the person accidentally locks themself out of the house.
- Check that any stairs to the entryway are in good repair and install handrails for stability.
- Post a “No Solicitors” sign by the front door.
- Remove entryway rugs to prevent tripping hazards.
- Avoid and remove clutter from the space to create a less stimulating and easier-to-navigate environment.
- Mark glass doors and windows or glass furniture with a decal or masking tape.
- Wrap or tape cloth around sharp edges of furniture or cabinets to soften any impacts from falling or running into sharp edges.
- Tape off, cover, or close existent fireplaces or wood-burning stoves. People with Alzheimer’s or dementia should not be left alone with a fire.
- Clear all rugs and electrical cords from walkways to reduce tripping hazards.
- Remove matches or lighters to reduce possible house fires.
- Keep small items or devices that could be confusing out of sight, this may include remote controls or sound systems. Instead, mark and label buttons on devices with tape and instructions for use, until no longer needed.
- Use night lights, easy to reach and turn on lamps, or motion detector lights.
- Use monitoring devices such as child monitors to alert you to any sounds that indicate a fall or cry for help.
- Remove rugs, cords, and other tripping hazards from walkways.
- Remove portable fans or space heaters that could fall or have objects placed in the blades or heating element.
- Be cautious of the use of electric heating items such as blankets, sheets, or pads. These items can cause burns and fires.
- Provide easy access to mobility aids including grab bars or walkers.
- Understand the risks and best practices for using hospital beds.
- Consider using pads or mats next to the bed in case the individual falls from bed, or slips when getting in and out of bed. This should only be done if these items do not pose a tripping hazard.
- Ensure that there is a clear path to the bathroom.
- Use childproof latches on cabinets and drawers that contain easily breakable, fragile, sharp, or other dangerous items. This may include scissors, knives, or matches.
- Lock up household cleaning products and remove any flammable liquids.
- Remove, disconnect, or install safety measures for dangerous appliances. This may include putting safety knobs or automatic shut-off switches on stoves, unplugging the garbage disposal, or discarding any appliances that no longer work properly.
- Remove any food-like decor so that it cannot be mistaken for something edible and consumed.
- Store medications in a secure place.
- Remove any rugs or tripping hazards.
- Use a night light.
- Install a drain trap that will catch any items put down the sink drain.
- Regularly check the fridge and other foods to ensure it is not rancid or out-of-date.
- Address slippery surfaces by placing non-slip strips on the floor and a non-skid shower mat in the bathtub. Decorative rugs and trip hazards should be removed.
- Install a shower seat and a hand-held shower head to make personal hygiene and bathing practices easier, and to reduce the chance of slip and fall hazards from standing fatigue.
- Install a faucet cover that can reduce impact and injury from a fall in the bathtub.
- Install grab bars or a safety frame near the toilet and bathtub to assist the individual with sitting, getting up, and getting in and out of the shower.
- Consider installing a raised toilet to make sitting and getting up from toileting easier.
- Set the water heater to a maximum temperature of 120 degrees Fahrenheit to avoid accidental burns.
- Consider installing a single faucet in the shower and sink that mixes hot and cold water rather than having two distinct temperature knobs to better regulate water temperatures.
- Lock up all bathroom cleaning products and potentially dangerous items such as razors, small electrical appliances, and medications.
- Remove door locks from the bathroom door so the individual does not accidentally lock themselves in the bathroom.
- Install drain traps that can catch small items from going down the drain.
- Use a night light.
- Cover or close off electrical outlets to avoid accidental electrocution or shock.
- If the individual uses an electric razor to shave, have them shave in a different room to avoid potential water contact with the electric razor.
- Lock and secure all laundry products and detergents which can be fatal if accidentally consumed.
- Remove large knobs from the washer and dryer to keep the individual from tampering with or accidentally starting the machine.
- Add latches or childproofing devices to the doors and/or lids of the washer and dryer to prevent the individual from placing objects in them.
- If possible, it might be best to completely lock and secure the laundry room to prevent entry.
Garages and Basements
- Depending on the stage and symptoms of the individual, you may consider locking access to the garage and basement.
- Lock and secure all potentially dangerous items such as chemicals, fertilizers, gasoline, cleaning supplies, machinery, equipment, etc., into appropriate storage containers.
- Lock and secure all motor vehicles and bicycles to reduce the potential for the individual to consider leaving and get lost or have an accident or fall.
- If you do not restrict access to a basement or garage, make sure to clear all walkways of trip hazards and clutter, and install handrails for walking up and down stairs.
- Keep all walkways and entrances clear and free of debris and de-iced to prevent slips and falls.
- Install handrails and guardrails near any steps or staircases. Trim, prune, and keep plant growth away from walkways.
- Lock and secure any pool or body of water and restrict access unless the individual is being closely supervised.
- Remove, hide, or secure any grills or fuel sources.
- If possible, place a small bench or table by entrances to hold parcels or bags while unlocking the door.
- If possible, place easy access to outdoor seating with support rails so the individual can easily and safely sit outside when desired.
- Ensure that outdoor lighting is adequate and consider adding motion detector lights in outdoor areas.
- Consider placing a “No Soliciting” sign on the fence or walkway to the entrance of the home.
Creating and ensuring a safe living space for a family member or loved one with Alzheimer’s or dementia is of the utmost importance for not only keeping them safe, but also in creating a comfortable living arrangement. You may have questions regarding the process of making modifications, installations, and accommodations to your residence or the residence of the individual.
Additionally, there may come a time when downsizing your loved one’s home or selling the home of the individual may be necessary to ensure a safe living situation for the individual. The following sections will address these questions and provide further insight into when these changes are necessary, as well as guidance on how to make these decisions.
DIY or Hiring Contractors
There are many options for safety installations and accommodations to create a safer environment for a person with Alzheimer’s or dementia. Many of these projects are manageable, but some may require more expertise. If you are questioning whether you can DIY or if you should hire a contractor you should consider the following:
- Consider your skills and experience to determine your ability to correctly make an installation that will not fail at a crucial time, such as a handrail becoming dislodged during a fall.
- Look to see if you have the correct tools to accomplish the project.
- Be aware of your bandwidth. Some DIY projects may take longer than expected. Also, if you are waiting until you have free time to implement a serious safety installation, you may consider outsourcing to a contractor that can promptly make a safe installation.
- Consider the risks associated with DIY projects. Changing a lightbulb for better lighting in a living space is an easy task, but rewiring a room for better lighting is no small feat and should be contracted out. Hiring certified contractors for some tasks such as wiring and electrical installation may not only be a good idea, but may also be a legal requirement in some states.
Downsizing to a New Home
There may come a time where downsizing the living space of the individual with Alzheimer’s or dementia can provide a safer and more manageable living situation. If you can no longer guarantee the safety of an individual in their current residence, you may need to prepare them to downsize.
The first step you must take is to plan for the new home and anticipate their individual needs. Some individuals may not need living assistance and only need a more manageable living situation. However, others may need further considerations and assistance from a memory care or assisted living home.
If you plan to buy a downsized home for the individual, there are many simple and easy home search options online. If you are looking for a specific location consider searching for the local area listings. For instance, residents of the Carolinas may utilize city-specific real estate search systems — searching for Charleston homes or Myrtle Beach homes and real estate values in South Carolina, or looking for Wilmington homes on the market in North Carolina, to navigate the appropriate local market precisely.
These types of listings can provide you a survey of the local real estate and changes in pricing within a specific community. If you have not previously owned a home, you may also need to consider researching some basic information and steps to buy a home.
If you are contemplating the option of placing the individual in a quality memory care facility, you may want to consider the following tips:
- Begin your search using trusted sources. Seek advice from medical care providers who can point you to trustworthy services.
- Consider the location of the assisted living facility.
- Visit the facility and interview the staff and relatives of residents to ensure that it is a good fit.
- Evaluate the quality of care that they can provide and ensure that it meets the individual’s needs.
- Consider the cost of the facility and your long term plans to make sure that it is an affordable option.
When downsizing the home of a person with Alzheimer’s or dementia, it is important to consider the following actions:
- Prepare to store items. There may be sentimental items that the individual is not ready to get rid of. Trying to force a person with Alzheimer’s or dementia to get rid of items that they are not ready to can cause agitation, stress, and anger. It is important to incorporate the individual in the process so that you can meet their physical and emotional needs as you begin to make the transition to the new home.
- If there are items of sentimental value that cannot be kept, you can take pictures of the belongings and put them in an album that the person can revisit and reminisce over at their leisure.
- If the individual experiences a great amount of stress from moving or is in a later stage of their symptoms and are experiencing confusion, create a distraction plan. Plan a special outing for the individual during the removal of items, or during the move to alleviate the stress of the situation.
- Once you have sorted through the items, consider hiring a professional mover. This can help you with your distraction plan. While the movers are doing their job, you can spend time with your loved one.
Selling Your Parents’ Home
If you have concluded that it is best to downsize the living situation of a family member or person in your care that has Alzheimer’s or dementia, you may need to navigate selling the home that they own. If you are a first-time home seller, you may need to research the process of selling a home to ensure that the home is appraised and sold correctly.
You may also need to look into whether you have a right to sell the property, as the homeowner is the only person that can transfer the house to a buyer. You may need to begin the process of appointing a power of attorney or guardianship of the individual so that you can sell the house to provide the individual with the care they need. The process of becoming a guardian or gaining power of attorney may be lengthy, but the many steps you may have to take are necessary to ensure that you are not taking advantage of the individual with Alzheimer’s or dementia.
The following list includes additional resources for those caretaking for an individual with Alzheimer’s or dementia:
- You can call the Alzheimer’s Association helpline 24/7 at 800-272-3900. The helpline offers confidential consultations for crisis and decision-making assistance, as well as basic information, or information about local services. The hotline accommodates more than 200 languages.
- The Alzheimer’s Association also offers care training and resources for caretakers and family members to better understand the symptoms and individual needs of the person with Alzheimer’s or dementia.
- The Alzheimer’s Association also offers resources for ethics and care issues for a variety of topics, including but not limited to dementia-related behaviors, driving and dementia, end-of-life care, feeding issues, respect for autonomy, and right to treatment.
- There are many difficult situations for families as the symptoms of Alzheimer’s and dementia progress. There are resources for resolving family conflict in ways specific to the needs of Alzheimer’s and dementia.
- The NIA Alzheimer’s and Related Dementias Education and Referral Center (ADEAR) can provide resources for diagnosis, treatment, patient care, caregiver needs, long-term care, research, and clinical trials.
- The Eldercare Locator can help caregivers find essential information as well as local and community resources for care for those living with Alzheimer’s or dementia.
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