Robin Schiltz, C.D.S.
When older adults are diagnosed with Alzheimer’s disease, it is hard for both the patient and family members to accept.
There are a lot of questions in regard to the patient’s mental status, prognosis, medical care, and what caregivers should expect as the disease progresses.
If the loved one wishes to live at home, it can become a dangerous place for someone with reduced cognitive abilities.
Caregivers must learn about potential hazards and dangerous situations for their family member to make the home safe.
How do you keep Alzheimer’s patients safe at home?
To keep Alzheimer’s patients safe at home, ensure a clutter-free environment to prevent falls. Install safety locks on doors and windows to prevent wandering. Label rooms and items for easy identification. Regularly check on them for any signs of distress or confusion. Use alarms or monitoring systems for added security. It’s also crucial to maintain a routine to provide structure and familiarity.
Caregiving can be a daunting task for the spouses and adult children of a person with a dementia diagnosis.
In the later stages of the disease, providing care transitions from doing simple things to having potential dangers pop up around every corner.
If you have had any friends or acquaintances who cared for someone with Alzheimer’s disease in the past, it can be helpful to reach out to them now. Keeping in touch with them as you move through the phases of the disease will also be invaluable for both advice and support.
In addition, there are several steps you can take to provide a safe home for your loved one with Alzheimer’s, which we will be sharing with you in this article.
A note of caution: There may come a time when care for someone with dementia at home is unsustainable. It’s important to know when someone with dementia or Alzheimer’s is ready for 24-hour care.
Alzheimer’s Home Safety Checklist
The first thing dementia caregivers should prepare is a checklist for the patient’s personal care and safety.
This should not be done on your own. Instead, get a professional, such as the patient’s doctor, an occupational therapist, or a social worker, to help you create the list.
There may be things you are not aware of that should be added to it.
You will also want to do some research online to gather the information that will help with putting the home safety checklist together.
It is a good idea to start with the Alzheimer’s Association.
Their website contains a wealth of information for the patient and their family members on in-home care and information about the items the patient should or shouldn’t have in their homes.
*NOTE – The Alzheimer’s Association has a hotline that is available 24 hours a day, seven days a week. It is staffed by professionals who routinely work with Alzheimer’s patients and who can advise you on your home safety checklist, as well as with answering any questions you may have.
After talking with the Alzheimer’s Association, you still will likely want to gather additional information online.
There are many websites that have checklists and articles on home care that can help caregivers put home safety checklists together:
- The Alzheimer’s Organization has an entire In-Home Care page of information for patients and caregivers about items that would be needed to prepare the home for the patient.
- Alzheimer.net Blog has an article on the topic, called Home Safety Checklist for Alzheimer’s and Dementia
- The National Institute on Aging also has information and a Home Safety Checklist for Alzheimer’s Disease
Once you have your checklist assembled, you will want to have a family meeting to go over the checklist.
This important step helps family members better understand what you will be up against and lets them see where or when they may be able to help with patient care.
Home Modifications For Alzheimer’s Patients
The caregiver will have to prepare the home for the Alzheimer’s patient in the same way they would prepare a house for toddlers.
You certainly should never treat a patient like a toddler, but many of the methods of childproofing a home will prove helpful for helping Alzheimer’s patients be safe as well.
Generally speaking, people with dementia may have difficulty with:
- Mobility, such as walking, standing, and stair climbing
- Cognitive abilities, such as recognizing familiar people or objects
- Memory, especially short-term memory
- Perception of space and distance
With these safety concerns in mind, you can consider the different types of home modifications that are needed for a person with dementia.
I would recommend speaking to an Occupational Therapist or Senior Home Safety Specialist to get a full assessment of your home.
Using Sticky Note Reminders
For older adults in the early stages of Alzheimer’s the use of sticky note reminders throughout the house can be really beneficial in providing cues about safety. Place these notes near the kitchen, bathroom, and other hazardous areas to remind your loved one of potential hazards and how to avoid them.
But this method will not work any longer if the person has advanced Alzheimer’s disease, because they may no longer be able to recognize the written words. In this case, you will need to rely on other methods, like supervision and security measures, to keep your loved one safe.
Prevent Falls
The first thing in home modification is to prevent or reduce the risk of falls.
The house could be made fall-proof by cleaning up clutter and removing or securing throw rugs, extension cords, and small furniture pieces or items that would be easy to trip over.
Install smoke detectors and carbon monoxide detectors throughout the home, if not already in place.
Ensure there is good lighting in all rooms of the home so the patient doesn’t trip over something in dim light.
About Glass Doors
To keep someone with Alzheimer’s safe around glass doors, consider applying safety decals or stickers at eye level to make the glass more visible.
Use tempered glass doors which are safer as they shatter into small, harmless pieces if broken. Install door alarms to alert you if the patient attempts to leave. Regular supervision is also important to ensure safety.
Secure Dangerous Items
Next, make a plan to go room by room and secure items the patient could hurt themselves with accidentally, such as bookcases that could be pulled over on top of them.
Lock up any firearms in the home or remove them.
Remove any extra chairs that could actually add to the clutter.
Place child-proof outlet covers over unused outlets to prevent electric shock and child-proof cabinet latches to lock up chemicals like dishwasher soap and cleaning supplies.
About Electrical Appliances
To keep someone with Alzheimer’s safe around electrical appliances, unplug appliances when not in use and use safety covers on outlets. Install appliance locks on ovens and refrigerators.
Keep cords out of sight to prevent tripping or unplugging. Regularly supervise the individual when they are around these appliances and provide clear instructions about their safe use.
I know that I’m repeating a lot the issue of “supervision” but it’s so very important and in my experience as an Occupational Therapist, I have noticed that many family members tend to underestimate or overlook this key factor.
Use A Monitoring System
A baby monitor with two-way audio, like this Infant Optics DXR-8 Video Baby Monitor, or a similar monitoring system is a great investment for the caregiver.
Good monitors like the one we have linked to come with cameras that can tilt or can pan 360 degrees.
A baby monitor should be placed in every room, along with motion detectors and door sensors with alarms to keep the patient from leaving the house.
Bathroom Safety
Bathrooms should have non-slip mats on the floor and in the bathtub or shower (read more about non-slip mats in our article).
A panic button (like the emergency alert devices from Life Alert) should be placed in the shower in case of slip and fall.
Install grab bars in the shower and toilet areas. (Read our article on how to do this.)
If there’s a medicine cabinet in the bathroom, it needs to be locked.
Bedroom Safety
To keep a bedroom safe for someone with Alzheimer’s, remove clutter and ensure clear pathways to prevent falls. Use night lights for visibility and consider a bed with side rails to prevent rolling out.
Keep necessary items within easy reach and label drawers for easier identification. Install door and window alarms for added security. Regularly check for any potential hazards like loose rugs or cords.
Kitchen Safety
For the kitchen area, all sharp objects must be placed in a locked cabinet or drawer.
Place a camera in the kitchen so you can monitor the room if you are in another area of the house.
You don’t want to be caught off guard if the patient tries to cook and starts a fire.
Put locking knob covers on the stove knobs. These safety knobs keep the person from being able to turn on the stove burners.
The cabinets where cleaning supplies are kept should be locked with a child-proof cabinet latch, and any mats in the kitchen need to be either removed entirely or be non-slip.
One of the areas that many family members forget to secure is the garbage disposal.
To keep an Alzheimer’s patient safe from a garbage disposal, consider installing a safety switch or a lock-out tag that requires a key or code to operate. This prevents them from accidentally turning it on. Regular supervision during kitchen activities is also crucial.
Locks
Because persons with dementia tend to wander, one of the most important safety features is door locks and window locks.
All doors in the house must have locks, especially front doors and those that lead to the basement, closets or attic.
Any keys to the doors or the car need to be put away where the patient can’t get hold of them
Garage Safety
One type of door that isn’t thought of much but should be considered are car doors.
They need to be locked when not in use and the car keys are hidden away, especially in the summer, because the patient could get into a hot car and become trapped. In a hot car, death can occur in minutes.
This same advice applies to old, unused household appliances. If a non-working refrigerator or freezer is in the garage – it must be removed
Also, relocate any chemicals or other hazardous materials (for example: coolant for the car or pesticides) to a locking cabinet.
Get rid of (or lock up) power tools.
Do the same for any sharp yard utensils and equipment, like clippers to trim bushes, trowels or spades, chainsaws, and screwdrivers.
Again, look at the garage as if you are trying to make it safe for a toddler – think about what they might get into, and then secure that item to keep your loved one with Alzheimer’s safe.
Keep Medications Secure
Home safety modification involves medications.
Install a locking medicine cabinet or put the medicines away in a locking box.
This goes for all medications, including over-the-counter medicines, such as aspirin or Tylenol, in order to guard against overdoses or the patient taking the wrong medications.
If your loved one is in the early stages of Alzheimer’s, they may feel they can take their prescriptions without a problem.
If you want to allow them some freedom, you can let them do this, but stay in the room and watch what they do to make sure they’re taking the medications correctly.
For Alzheimer’s patients who are in more advanced stages of the disease, the caregiver needs to take over the job of giving out the prescriptions.
Be sure to hand them their medications pill by pill – don’t just give them the entire bottle.
Water Temperature
Ensuring the water temperature is not too hot or cold in the home of someone with Alzheimer’s is crucial because they may have diminished sensitivity to temperature or difficulty adjusting water controls.
Extremely hot water can cause burns, while very cold water can lead to hypothermia. Moreover, maintaining a comfortable water temperature contributes to their overall comfort and well-being.
To ensure the water temperature in your home is safe and comfortable for your loved one with Alzheimer’s, you should check on the water heater. Make sure that the hot water heater is set to 120°F or lower.
This will make sure that no scalding occurs when bathing or washing hands. Additionally, setting this temperature can help prevent any instances of hypothermia due to very cold water.
Secure The Home Outside As Well
Finally, the house needs to be secured outside.
Garages and storage sheds need to be locked when no one is using them.
If a car is parked outside, it must be locked as well.
All objects such as water hoses, potted plants, and toys need to be cleared from driveways, porches, decks, walkways and steps to prevent falls.
All dangerous yard work devices (the lawn mower, hedge trimmers, weed whacker, etc) should be locked away so the patient doesn’t get hurt while trying to use them.
Alzheimer’s Temperature Sensitivity
Patients with Alzheimer’s disease are very sensitive to changes in temperature.
This is due to the effects that very hot and cold weather have on the body’s ability to regulate itself.
For this reason, you will want to be sure their home environment isn’t too warm or too cold.
According to an article in the About Memory website, when people with Alzheimer’s are in conditions where their body temperature drops, it causes their symptoms to get worse.
This means they need to stay warm in winter, so check to be sure they are properly dressed for the weather if they go outside.
Warm up the car and run the heater before the patient gets in it.
Also be careful of using a portable heater inside or of making a fire in the fireplace, as the patient may get burned.
In situations where Alzheimer’s patients are exposed to hot weather, greater effort needs to be made to keep the person cool.
Alzheimer’s temperature sensitivity occurs, in part, because older people’s bodies cannot regulate heat and cold as fast as when they were young.
Too much heat could cause heat stress, according to an article on the Bright Focus website and, among other things, overheating could alter the effectiveness of medications.
Thus, you should limit the patient’s time outdoors, especially in the summer.
Another good tip for the caregiver to know is, when going on trips with the patient, you should prepare in advance for times when your loved one suddenly feels cold or hot.
While you might not understand why the person feels uncomfortable, it must be taken seriously to keep them from feeling anxious and becoming agitated.
As a caregiver, you can make the patient’s outing more pleasant by getting their favorite sweater or a comfortable jacket in the winter, or cool light clothing that they could change into if they feel too warm in the summer.
This may not happen often, but it’s good to stay on top of things by packing these items, just in case.
Mirrors and Alzheimer’s
In caring for your loved one at home, you should learn about the complications they suffer as the disease progresses.
One of these difficulties has to do with mirrors.
If you haven’t been warned about mirrors before, then you should know that any mirrors in the house might cause the person to become angry or afraid.
As they lose memories, the patient might not recognize their own reflection, so they may think they are looking at an intruder.
To illustrate, a neighbor of my parents had dementia and would get very angry when his wife turned on the television.
He was certain that the character on the TV was actually in the room with them and he would become quite agitated.
This is the same principle that applies to mirrors!
Be watchful because the patient may start swinging at the “intruder” and then get hurt by breaking the mirror.
If the mirrors in the home are causing negative emotions and possible violence, the solution is to cover them up or remove them to a closet that you can keep locked.
If the bathroom medicine cabinet has a mirror, you can cover it up with adhesive wallpaper.
Similarly, there are specific paints that can be found in art supply stores that can be brushed onto a glass mirror to cover it up.
They can be removed with a straight-edge razor blade if the patient moves out of the home in the future.
Alzheimer’s Locks
Alzheimer’s locks are portable locks that caregivers can use to add a lock to a door that doesn’t already have a lock.
I’m talking about modern closet doors, old screen doors, or any other lockless door.
These locks add extra security to keep the patient from wandering away from the house or getting into things that could harm them.
These locks can be purchased online or from hardware stores or a locksmith.
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