Home safety and Alzheimer’s

People with Alzheimer’s can live in their homes, as long as safety measures are in place. As Alzheimer’s progresses, a person’s abilities change. But with some creativity and problem solving, you can adapt the home environment to support these changes.

Alzheimer’s disease causes a number of changes in the brain and body that may affect safety. Depending on the stage of the disease, these can include:
Judgment: forgetting how to use household appliances
Sense of time and place: getting lost on one’s own street; being unable to recognize or find familiar areas in the home
Behavior: becoming easily confused, suspicious or fearful
Physical ability: having trouble with balance; depending upon a walker or wheelchair to get around
Senses: experiencing changes in vision, hearing, sensitivity to temperatures or depth perception

Assess your home:
Look at your home through the eyes of a person with dementia. What objects could injure the person? Identify possible areas of danger. Is it easy to get outside or to other dangerous areas like the kitchen, garage or basement?
• Lock or disguise hazardous areas.
Cover doors and locks with a painted mural or cloth. Use “Dutch” (half) doors, swinging doors or folding doors to hide entrances to the kitchen, stairwell, workroom and storage areas.

Home Safety Checklist
Be prepared for emergencies;
• Keep a list of emergency phone numbers and address for local police and fire departments, hospitals and poison control help lines.

• Make sure safety devices are in working order.

• Have working fire extinguishers, smoke detectors and carbon monoxide detectors.

• Install locks out of sight

• Place deadbolts either high or low on exterior doors to make it difficult for the person to wander out of the house. Keep an extra set of keys hidden near the door for easy access. Remove locks in bathrooms or bedrooms so the person cannot get locked inside.

• Keep walkways well-lit.
Add extra lights to entries, doorways, stairways, areas between rooms, and bathrooms.
Use night lights in hallways, bedrooms and bathrooms to prevent accidents and reduce disorientation

• Remove and disable guns or other weapons.
The presence of a weapon in the home of a person with dementia may lead to unexpected danger. Dementia can cause a person to mistakenly believe that a familiar caregiver is an intruder

• Place medications in a locked drawer or cabinet.
To help ensure that medications are taken safely, use a pill box organizer or keep a daily list and check off each medication as it is taken.

• Remove tripping hazards.
Keep floors and other surfaces clutter-free. Remove objects such as magazine racks, coffee tables and floor lamps

• Watch the temperature of water and food.
It may be difficult for the person with dementia to tell the difference between hot and cold. Set water temperature at 120 degrees or less to prevent scalding

• Support the person’s needs.
Try not to create a home that feels too restrictive. The home should encourage independence and social interaction. Clear areas for activities.

Driving: Decisions for a Person with Alzheimer’s disease

Making the decision that a person with Alzheimer’s is no longer safe to drive is difficult, and it needs to be communicated carefully and sensitively. Even though the person may be upset by the loss of independence, safety must be the priority.

  • Look for clues that safe driving is no longer possible, including getting lost in familiar places, driving too fast or too slow, disregarding traffic signs, or getting angry or confused.
  • Be sensitive to the person’s feelings about losing the ability to drive, but be firm in your request that he or she no longer do so. Be consistent—don’t allow the person to drive on “good days” but forbid it on “bad days.”
  • Ask the doctor to help. The person may view the doctor as an authority and be willing to stop driving. The doctor also can contact the Department of Motor Vehicles and request that the person be re-evaluated.
  • If necessary, take the car keys. If just having keys is important to the person, substitute a different set of keys.
  • If all else fails, disable the car or move it to a location where the person cannot see it or gain access to it.
  • Ask family or friends to drive the person or find out about services that help people with disabilities get around their community

Sleep Problems for Caregivers and a Person with Alzheimer’s disease

For the exhausted caregiver, sleep can’t come too soon. For many people with Alzheimer’s disease, however, the approach of nighttime may be a difficult time. Many people with Alzheimer’s become restless, agitated, and irritable around dinnertime, often referred to as “sundowning” syndrome. Getting the person to go to bed and stay there may require some advance planning.

  • Encourage exercise during the day and limit daytime napping, but make sure that the person gets adequate rest during the day because fatigue can increase the likelihood of late afternoon restlessness.
  • Try to schedule physically demanding activities earlier in the day. For example, bathing could be done in the morning, or the largest family meal could be served at midday.
  • Set a quiet, peaceful tone in the evening to encourage sleep. Keep the lights dim, eliminate loud noises, and even play soothing music if the person seems to enjoy it.
  • Try to keep bedtime at a similar time each evening. Developing a bedtime routine may help.
  • Limit caffeine.
  • Use night-lights in the bedroom, hall, and bathroom if the darkness is frightening or disorienting.
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