Behavioral and cognitive changes in people with Alzheimer’s disease can make it difficult for them to remain safe in their home environments. This could mean forgetting how to use appliances, difficulty recognizing hazards, or failing to recognize changes in familiar surroundings. They may wander off, become disoriented or confused when leaving the house, and be unable to remember safety instructions.
Dr. Dung Trinh, MD, owner and founder of Healthy Brain Clinic, says people with Alzheimer’s disease may also experience changes in their balance and coordination, which can increase their risk of falls. Other changes associated with dementia, such as aggression or agitation, may lead to unsafe behavior that puts them and others at risk.
“Taking steps to make the home environment safe is an important part of managing Alzheimer’s disease,” says Dr. Trinh. “A thorough area-by-area home safety check can help identify areas where additional safety measures may be needed.”
Cathy Habas, Senior Safety expert at SafeWise.com, says that caregivers must be proactive about creating a safe environment. “Caregivers should be using technology to create early warning alarms where appropriate (such as when the person with dementia gets out of bed or tries to exit the home), and redirecting the person’s attention to a more suitable activity.”Both experts share insight on prioritizing safety throughout your loved one’s home and offer a collaborative approach to incorporating safety measures. At the end of this article, you’ll find a complete safety checklist to help you safeguard each area of your loved one’s home.
When it comes to home safety and Alzheimer’s disease, there are three things to prioritize when implementing safety measures throughout your loved one’s living environment:
Preventing falls and accidents
Individuals with Alzheimer’s disease and other causes of dementia are at a significantly higher risk of falling and injuring themselves, which is why Dr. Trinh insists that reducing the risk of falls and other accidents is one of the most important aspects of home safety.
“Falls are the leading cause of fatal and nonfatal injuries among older adults, so it’s essential for family caregivers and their loved ones to look for potential hazards in each room or area of the home.”
Follow these measures throughout the home to help prevent trips, slips, and falls:
- Avoid clutter and keep all waking areas free of furniture and cords to prevent tripping hazards.
- Eliminate throw rugs or area rugs wherever possible.
- If there is carpeting throughout the home, ensure it’s firmly secured without rips or buckles.
- Use textured strips or nonskid wax on hardwood and tile floors to prevent slipping.
- Add grab bars to stairways and bathrooms.
- Make sure all rooms, walkways, and stairways are well-lit; consider installing motion-sensored lights and automatic timers on lamps.
- Put a nightlight in every room and hallway, then cover any unused electrical outlets with childproof plugs.
Safeguarding against wandering
Wandering is a common behavior of people with Alzheimer’s disease, making it one of the biggest safety concerns inside of the home — a concern that can extend beyond the home’s four walls if the right measures aren’t taken.
“[Wandering] could lead to a fall if there’s uneven flooring, slippery rugs, or other obstacles. Or, if the person thinks they’ve forgotten to go to work, to run an errand, or to ‘go home,’ they might wander right out the door,” says Habas.
She suggests setting up a safe path for wandering if the home allows for it (clear walkways, adequate lighting, etc.), and securing doors with locks or blocking them with banners. Habas says caregivers concerned about blocked doors creating a restrictive environment may decide to use caregiver alarms instead. This can be pressure mats, motion sensors, or contact sensors that set off the caregiver’s pager whenever someone wanders into a dangerous area.
The senior safety expert also suggests these other tactics as safeguards against wandering:
- Keep photographs and memory boxes scattered throughout the home.
- Redirect them to activities they enjoy, like flipping through magazines, watching birds at the feeder, or listening to music.
- Post signs that remind them what to do in each room, such as “wash hands” above the bathroom sink, or “watch TV” in the living room.
Making changes for safety — not restriction — and involving your loved one in the process.
“The most important thing for caregivers to remember is that safety does not have to equate to restriction. Although it is essential to make changes in the home environment that keep your loved one safe, these changes do not have to be overly restrictive or create an oppressive atmosphere,” says Dr. Trinh. “Caregivers can involve their loved one in creating solutions that promote safety while still allowing them to feel comfortable and encouraged to move around the home.”
Try these tactics for a collaborative approach:
- Communicate openly with your loved one about any changes that are being made in the home, and explain why these changes need to be made and how they are intended to keep them safe.
- Educate them on home safety by providing them with information about potential hazards.
- Involve them in choosing and purchasing safety devices and items and consider their input when deciding where and how to place these new devices and items throughout the home.
- Listen to your loved one’s feedback and adjust the safety measures as necessary in order to ensure the changes are not overly restrictive.
- Ensure that your loved one understands how to use the different pieces of equipment, such as walkers and wheelchairs, and feels confident in their ability to use them safely.
Dr. Trinh reminds caregivers the importance of taking the time to check on the safety of their loved ones’ home regularly, making adjustments as necessary. “By inspecting each area of the home for potential hazards and documenting any safety concerns, the family can ensure that their loved one’s home is as safe and secure as possible.”
Alzheimer’s disease home safety: A caregiver’s room-by-room checklist
Use this checklist as you move through each area of your loved one’s home to evaluate, document, and improve its safety.
Windows and doors
- Install secure locks on all outside doors and windows; consider installing alarms that notify you when a door or window is open.
- Remove locks on interior doors to prevent your loved one from locking themself in rooms.
- Hide a spare house key outside in case your loved one accidentally locks themselves, a caregiver, or a family member out of the house.
- Put removable stickers, bright tape, or decals on large glass doors and windows, and furniture with glass panes.
- Ensure all home entrances are well-lit, including driveways and walkways. You can install automatic lights to ensure they turn on when it gets dark.
- Keep walkways and doorways clear of tripping hazards, like loose bricks or stones, garden hoses, buckling cement, and overgrown bushes and foliage.
- Ensure steps are even and sturdy to prevent falls in wet or icy weather. Consider adding texture strips and marking each step edge with reflective tape.
- If steps are becoming too challenging for your loved one, consider installing a ramp with handrails as an alternative for home entry.
- Hang a “NO SOLICITING” sign on your loved one’s front gate, window, or door.
Hallways and stairs
- Use night lights in all hallways and stairways, and place light switches at the top and the bottom of the stairs. You may even take an additional step to line the edges of the steps with glow-in-the-dark tape.
- Install handrails on both sides of a stairway that extend beyond the first and last steps.
- Make sure stairs are carpeted or have safety grip strips; each step tread should be deep enough to support a whole foot.
- If your loved one has balance issues and trouble using the stairs, consider putting a gate across the stairway or adding a ramp.
Bedrooms and living spaces
- Keep a phone close to the bed and near favorite sitting areas.
- Install safety railings around the bed to prevent rolling or falling. If necessary, replace your loved one’s bed with a hospital bed or a bed with reclining features.
- Monitor the use of electric mattress pads, electric blankets, electric sheets, heating pads, and space heaters. Never leave your loved one alone with an open fire in the fireplace.
- Remove swivel and wheeled chairs; replace them with sturdy, stationary chairs.
- If mobility is an issue for your loved one, consider investing in an electric power lift recliner that helps them out of the chair.
- Put a sturdy bench or chair near their bed to help with dressing.
- Keep decor simple; patterned wallpaper, busy art, and wall mirrors can confuse your loved one.
- Secure large furniture (cabinets, large TVs, bookshelves, etc.) to walls to prevent them from tipping.
- Use appliances with an automatic shut-off feature and unplug the microwave.
- Equip the stove with safety covers on the knobs and an automatic shut-off switch; if your loved one has a gas stove, consider turning off the gas when it is not in use.
- Secure cabinets and drawers with childproof door latches; lock away all household cleaning products, matches, knives, scissors, blades, small appliances, and anything valuable.
- Discard decorative fruits and vegetables or food-shaped kitchen magnets they could mistake as edible.
- Consider disconnecting the garbage disposal; at the very least, insert a drain trap in the kitchen sink to catch debris and prevent your loved one from reaching into the drain.
- Mark food with purchase date; regularly check for and throw away expired items.
- Store food and frequently used items in easy-to-reach places to avoid needing a step stool.
- Install handrails beside the toilet and in the tub/shower for stability. You can also purchase a raised toilet seat with handrails.
- Line the tub and shower with nonskid adhesive strips, decals, or mats; consider doing the same on the floor next to the tub, toilet, and sink to prevent slipping on wet tile floors.
- Use a foam rubber faucet cover, a hand-held shower head, and a plastic shower stool to make bathing more accessible and safer.
- Along with night lights, consider glowing light switches or motion-activated lights that illuminate the toilet seat.
- Lock up medicines, vitamins, razors, and bathroom cleaning supplies in cabinets and drawers equipped with childproof latches.
- Remove small electrical appliances (like electric razors or hair dryers) and cover electrical outlets.
- Set the water heater at 120°F to avoid scalding tap water.
Yard and garage
- If possible, create an enclosed area in your loved one’s yard as a safe resort for outside time; a locked gate will help prevent them from wandering.
- Cover and lock your outdoor barbecue grill; you may consider removing the fuel source and fire starters from any grills when not in use.
- If your loved one has a swimming pool and/or hot tub, ensure they are covered and fenced in with a locked gate. You can also install a pool alarm with an electric sensor.
- Lock away all power tools, machinery, and toxic materials such as paint, fertilizers, insecticides, gasoline, and cleaning supplies in a secure cabinet or storage area.
- Secure and lock all motor vehicles and make sure the keys are out of reach if your loved one shouldn’t be driving.
Substances, weapons, and hazardous materials
- Remove all guns and other weapons or lock them up.
- Keep all medications (prescription and over-the-counter) locked away with child-resistant caps if needed.
- Remove all poisonous plants and securely store cleaning products, such as liquid laundry pacs and bleach, to avoid possible ingestion.
- Keep all alcohol in a locked cabinet or out of reach.
- If your loved one smokes, remove matches, lighters, ashtrays, cigarettes, and smoking devices to reduce fire hazards.
- Install smoke alarms and carbon monoxide detectors near the kitchen and all bedrooms; regularly check their functioning and batteries.
- Place a list of emergency numbers near all phones — police, fire, poison control, and contacts for family members and a trusted neighbor.
- If you’re concerned about your loved one wandering, consider using a GPS device to help prevent wandering or locate them if they’ve wandered off.
- Make sure they always wear a medical alert bracelet or a lanyard with their name, address, and emergency contact numbers.