There are almost six million patients suffering from Alzheimer’s and dementia in the United States. Many of these patients remain in the familiar environment of their homes. In such cases, home safety becomes a constant concern for their families and an additional challenge when caring for a loved one.

Below are some tips for caregivers on how to best create a reassuring environment for the patient and help the patient take care of him or herself. The diagnosis of dementia affects the entire family, and self-care is a must for burdened caretakers.

• • The initial and difficult step is acceptance by the patient and the family. Accepting a dementia diagnosis can be difficult for everyone involved and will evoke many emotions. emotions. Both parties should listen to each other’s concerns. Family members should engage the patient as much as possible to keep the environment as natural as possible. Acceptance of the diagnosis makes this easier for all.
  • The home should be checked for hazards that might affect the patient. We have a room-by-room list of possible problems below. It may be an excellent idea for the caregiver to invite a professional caregiver into the home for an official “inspection” for everyone’s peace of mind.
  • Before the dementia situation progresses, everyone will benefit from appropriate planning. The family should ensure that important documents such as a living will and health care powers of attorney are in place. This will assist beloved family members to work with the medical team to provide needed health care.

The patient will require obvious care. Less obvious, but equally as important, is the caretaker’s need for self-care. Caretakers require time off, and other family members should be available to provide adequate breaks. If none is available, a professional can provide the needed assistance. This helps prevent caregiver burnout and enables the patient to receive better and more focused treatment.

General Home Safety Principles

1. The Importance of Maintaining Familiar Routines for Alzheimer’s Patients

Most dementia patients and their caregivers are not prepared for the daily challenges of in-home health care. A consistent daily routine is important for both. Dementia, with its accompanying loss of memory, can fill the patient with anxiety. With a comfortable and familiar daily schedule, he or she can feel more at ease with daily life. The less stress there is for the patient, the calmer the day is for the caretaker.

A daily routine can consist of grooming habits, choosing clothes and foods, and customary activities and hobbies, such as grocery shopping or a walk in the park. The caretaker can elevate the patient’s daily experience by arranging for favorite music and television shows. Dementia patients may forget what day it is, but the odds are they will start dancing to their favorite tune.

2. Remove Unnecessary Clutter While Keeping Essential Items Easily Accessible

Clutter can be interesting. For some, it will evoke memories. For anyone suffering from dementia, memories are a good thing as well as a burden and reminder of a hazy past. Paperwork, such as bills, piles up and becomes lost.

Downsizing the clutter helps keep the household reasonably sane. Photographs are a treasure, as are a few familiar trinkets. Keep special items in a designated bureau. The lack of clutter helps maintain a safer living environment with fewer falls and mishaps. And it will ensure precious memories won’t get lost or accidentally tossed out.

3. Secure Potentially Dangerous Items While Maintaining a Warm, Homelike Atmosphere

The caretaker should be aware of potentially dangerous items in a home inhabited by a dementia patient:

• • Install locks or latches on cabinets that contain dangerous or breakable things.
  • To avoid burning, keep the water heater at 120 degrees and label all faucets hot or cold.
  • Test smoke alarms and gas detectors regularly.

4. Use clear labels and visual cues to help with navigation and identification

Patients with dementia may become easily confused and will benefit from visual clues  The caretaker can label drawers with pictures or photos of underwear, shirts, gloves, socks, etc. This will help the patient find what he or she is looking for. Kitchen cabinets can be similarly labeled with pictures of canned goods, cups, plates, seasonings, coffee, etc.

Create a Safe Home for Dementia Patients

Even a familiar home environment can become confusing for someone suffering from dementia. It is a good idea to assess hazards in each room, preferably with a professional caregiver.

1. Kitchen Safety Modifications

• • Arrange for items that are used every day to be within easy reach.
  • Store sharp objects and potentially harmful cleaning supplies in locked cabinets
  • Use appliances with simple, straightforward controls and automatic shut-off capability
  • Place pantry items within easy reach
  • Remove and lock up any vitamins

2. Bathroom Safety Essentials

• • Consider providing a walk-in shower with non-slip mats
  • Install bars within the shower and by the toilet
  • Ensure that the “hot” water setting is not scaling
  • Lock up any medication in a separate area
  • Label items that can be confused, such as shampoo or lotion bottles

3. Bedroom Adaptations

• • Ensure clear pathways between the bed and bathroom
  • Install motion-sensor night lights for added safety
  • Make sure the bedding is familiar; it can help if the patient picks his or her own items
  • A phone should be kept within reach of the bed. If possible, a second phone can be placed in the bathroom
  • Lower the height of the bed if the patient has difficulties climbing in and out
  • It is not a good idea to leave the patient alone and unmonitored with an electric blanket or an electric heater. Beat the cold with additional blankets
  • Ensure that items in the closet are within easy reach – hangers may be too high. Many items can be kept in a see-through clear container instead

4. Living Area Safety Features

• • Ensure that all furniture is strong and secure. A disabled dementia patient may grasp a chair for safety, but that chair may tilt and cause the patient to tumble if it is not strong enough.
  • Ensure that there are no obstacles around the living area and its entrances.
  • “Baby proof” electrical outlets
  • Chairs should be at a height that makes it easy to sit and stand. Flimsy chairs can tilt.
  • Ensure that bookcases, televisions, and other large pieces of furniture are secured.

5. Secure Other Spaces

• • Secure locks should be installed at all doors and windows, along with an alarm system
  • Create safe, enclosed outdoor spaces for enjoying nature
  • Ensure proper lighting along walkways and entrances
  • Remove or secure potentially hazardous gardening tools
  • In the laundry room, ensure all cleaning products and bleach are locked securely. Check the dryer ducts for lint as they can turn into fire hazards.
  • A garden can be a delightful respite for dementia patients. Ensure that there is a fence and a locked gate and that the garden is well-lit and clutter-free. Placing colored stickers on all glass doors is very helpful. If the patient gets confused easily, he or she should have company and supervision while enjoying the outdoors.

6. Technology and Monitoring Solutions

• • Install sensors that can detect the patient leaving the house. GPS tracking systems monitor the patient’s general movements within the house.
  • There are monitoring systems to remind the patient when to take his or her medication. Optimally, the caregiver will oversee medications.
  • The family and/or caretaker can ensure the patient has a fall alert monitoring system.

7. Working with Professional Caregivers

• • Collaborating with experienced Professional Caregivers. These caregivers need to be familiar with the patient’s history, family, hobbies, favorite activities, and daily routine. This enables them to work with and bond with a real person instead of a “patient.”
  • Maintain honest communication about changing requirements. Communication between professional caregivers and family members is essential when caring for a dementia patient. The needs of the patient can change all too frequently, and everyone needs to remain aware. Personal follow-up or update phone calls should be scheduled regularly, perhaps weekly or twice a week. This is the time to discuss any change in the patient’s behavior or needs and to set up an appropriate action plan. Appreciation for a hardworking caregiver can help caregivers and families bond and work as a team.
  • Ensure that Caregivers are Trained in Dementia Care Best Practices. In-home care for dementia patients requires specific caretaker skills. The patient will likely move through states of the illness as more symptoms develop, and the caretaker needs to adapt to each changing stage and the associated symptoms. This requires training in developing personalized care plans and the understanding that each patient is unique. In addition to medical skills, the caregivers require training in genuine compassion and understanding of what their patients are experiencing. It is a demanding yet critical role.
  • Create Emergency Protocols and Keep Contact Information Readily Available. The caregiver and the family must develop clear action protocols in the event of a medical emergency, natural emergency evacuation, fire, etc. Each person in the home should have a designated role. First aid kits should be in an easy-to-each, designated marked area, and a clear procedure for helping the dementia patient should be in place. The caretaker should keep a list of emergency phone numbers and addresses for the local hospital, fire department, police, and emergency transportation such as cab or Uber.

8. Regular Assessment and Implementation

• • Care conferences that include the patient’s family, relevant caregivers, and medical personnel are critical for discussing problems, reviewing progress, and addressing general concerns. The patient may also be a part of these meetings. Discussions should include future plans, the emotional state of the family, and current and future medical needs. A physician’s office is an appropriate place for such a conference.
  • Monitor for new challenges or concerns – The caregivers should monitor changes in cognitive abilities and daily behavior habits. This includes moods, handling of simple tasks, ability to communicate and comprehend, and sleep habits. This is a big responsibility for the caregiver, and any observations should be discussed with the patient’s medical team.
  • We have already discussed the need for a room-by-room safety check in the patient’s home. The safety arrangements will likely change as the patient progresses with his or her illness. Handrails in the bathroom may be needed. Caretakers and family should keep changes to a minimum to prevent the patient from becoming confused, but, as changes become necessary, they should be implemented.
  • Keeping family and caregivers informed of changes – Caretakers can easily keep the entire family updated on changes involving the patient by sending regular (such as weekly) emails or text messages. This keeps everyone in the loop and involved.
  • Document Successful Strategies and Areas Needing Improvement – Caregivers, family, and the medical team should meticulously document the patient’s behavior (both improved and diminished) to help everyone develop a clear, overall picture of which strategies are working and which can be improved. A successful team effort can benefit the patient tremendously.

9. Maintaining Dignity and Independence

• • Involve the patient in the decision-making process whenever possible. Caretakers should not assume that their dementia patient cannot make decisions about his or her daily life until proven otherwise. Help maintain the patient’s dignity by asking simple questions about his or her preference, such as “What would you like for dinner,” or “Do you want to watch television or go for a walk?” For the patient, making decisions equals dignity.
  • Choose Solutions that Maintain a Homelike Atmosphere. It has been demonstrated that dementia patients cope better in their own home, a familiar environment, rather than in a care facility. Caretakes and family can help by focusing on familiar routines (gardening, walks, etc.) pictures that may boost memories, and displaying familiar and treasured objects. It’s wise to remember that sound (favorite music) and odors (favorite cooking aromas) can stimulate the patient’s senses and memories.
  • Balance Safety with Patient’s Preferences – For the caretaker to consider the patient’s autonomy versus his or her safety can be a balancing act. Focusing on the patient’s wishes is a strong part of dementia-focused healing and providing him or her with a higher-quality lifestyle. However, studies indicate this high-wire act requires logical limitations, especially when outdoor activities are involved.

Promote Continued Participation in Daily Activities

The caretaker can do much to preserve the patient’s dignity by encouraging the patient to participate in important activities:

• • Arrange for grooming and meals to happen at the same time each day to confuse the patient less. Permit him or her to help to any extent possible.
  • Ensure that each day includes activities that the patient enjoys and looks forward to.
  • Provide loose-fitting, easy-to-wear clothes that enable the patient to dress him or herself.
  • The caretaker can include the patient in activities by discussing them, such as, “We are putting away the groceries. Can you put this in the refrigerator?” Discussion can create an experience for the patient.

Focus on Enabling Rather than Restricting Activities – We have discussed the importance of designing a dementia-safe home. An environment that supports independence will encourage the patient to feel safe in exploring more of the immediate world around him or her. This allows for a wider range of activities instead of a more restrictive existence. An unsafe environment will become disorienting and discourage simple explorations.