How to Create an Alzheimer’s-Safe Home
Over time, people with Alzheimer’s disease become less able to manage around the house.
For example, they may forget to turn off the oven or the water, how to use the phone during an emergency, which things around the house are dangerous, and where things are in their own home.
As a caregiver, you can do many things to make the person’s home a safer place. Think prevention—avoiding accidents by controlling possible problems.
While some Alzheimer’s behaviors can be managed medically, many, such as wandering and agitation, cannot. It’s more effective to change the person’s surroundings—for example, to remove dangerous items—than to try to change behaviors.
Changing the home environment can give the person more freedom to move around independently and safely.
Things You Need
Add the following items to the person’s home if they are not already in place:
- Smoke and carbon monoxide detectors in or near the kitchen and in all bedrooms
- Emergency phone numbers (ambulance, poison control, doctors, hospital, etc.) and the person’s address near all phones
- Safety knobs and an automatic shut-off switch on the stove
- Childproof plug covers for unused electrical outlets and childproof latches on cabinet doors
You can buy home safety products at stores carrying hardware, electronics, medical supplies, and children’s items.
Recommended Carbon Monoxide and Smoke Alarm:
If you don’t already have a combination CO/smoke detector, I recommend the (very popular) Kidde KN-COSM-BA Combination Carbon Monoxide & Smoke Alarm, which provides two important safety devices in a single unit.
This alarm includes a voice warning system that announces ‘Fire, Carbon Monoxide, Low Battery and Smart HushTM Activation.’
This alarm clearly announces a smoke or carbon monoxide danger, or if your battery is in need of replacement.
A voice alarm is particularly important for anyone who has dementia, because its verbal instruction eliminates confusion.
It’s battery operated, protecting you even during a power outage (when many incidences occur).
Remove These Items
Lock up or remove these potentially dangerous items from the home:
- Prescription and over-the-counter medicines
- Cleaning and household products, such as paint thinner and matches
- Poisonous plants—contact the National Poison Control Center at 1-800-222-1222 or poison.org to find out which houseplants are poisonous
- Guns and other weapons, scissors, knives, power tools, and machinery
- Gasoline cans and other dangerous items in the garage
Mobility Safety in the Home
Try these tips to prevent falls and injuries:
- Simplify the home. Too much furniture can make it hard to move around freely.
- Get rid of clutter, such as piles of newspapers and magazines.
- Have a sturdy handrail on stairways.
- Put carpet on stairs, or mark the edges of steps with brightly colored tape so the person can see them more easily.
- Put a gate across the stairs if the person has balance problems.
- Remove small throw rugs. Use rugs with nonskid backing instead.
- Make sure cords to electrical outlets are out of the way or tacked to baseboards.
- Clean up spills right away.
Make sure the person with Alzheimer’s has good floor traction for walking. To make floors less slippery, leave floors unpolished or install nonskid strips.
Shoes and slippers with good traction also help the person move around safely.
Recommended Non-Slip Footwear For Indoors
Non-slip socks are a good alternative to slippers; they’re often more comfortable for long periods, and they’re much easier to wash and keep fresh. These Unisex Rymora Non-Slip Grip Socks have terrific reviews.
Minimizing Risks in the Home
People with Alzheimer’s disease may not see, smell, touch, hear, and/or taste things as they used to. You can do things around the house to make life safer and easier for the person.
Although there may be nothing physically wrong with their eyes, people with Alzheimer’s may no longer be able to interpret accurately what they see.
Their sense of perception and depth may be altered, too. These changes can cause safety concerns.
- Make floors and walls different colors. This creates contrast and makes it easier for the person to see.
- Remove curtains and rugs with busy patterns that may confuse the person.
- Mark the edges of steps with brightly colored tape so people can see the steps as they go up or down stairs.
- Use brightly colored signs or simple pictures to label the bathroom, bedroom, and kitchen.
- Be careful about small pets. The person with Alzheimer’s may not see the pet and trip over it.
- Limit the size and number of mirrors in your home, and think about where to put them. Mirror images may confuse the person with Alzheimer’s disease.
- Use dishes and placemats in contrasting colors for easier identification.
Sense of Touch
People with Alzheimer’s may experience loss of sensation or may no longer be able to interpret feelings of heat, cold, or discomfort.
- Reset your water heater to 120°F to prevent burns.
- Label hot-water faucets red and cold-water faucets blue or write the words “hot” and “cold” near them.
- Put signs near the oven, toaster, iron, and other things that get hot. The sign could say, “Stop!” or “Don’t Touch—Very Hot!” Be sure the sign is not so close that it could catch on fire. The person with Alzheimer’s should not use appliances without supervision. Unplug appliances when not in use.
- Pad any sharp corners on your furniture, or replace or remove furniture with sharp corners.
- Test the water to make sure it is a comfortable temperature before the person gets into the bath or shower.
Sense of Smell
A loss of or decrease in smell is common in people with Alzheimer’s disease.
- Use good smoke detectors. People with Alzheimer’s may not be able to smell smoke.
- Check foods in your refrigerator often. Throw out any that have gone bad.
Sense of Taste
People with Alzheimer’s may not taste as well as before. They also may place dangerous or inappropriate things in their mouths.
- Keep foods like salt, sugar, and spices away from the person if you see him or her using too much.
- Put away or lock up things like toothpaste, lotions, shampoos, rubbing alcohol, soap, perfume, or laundry detergent pods. They may look and smell like food to a person with Alzheimer’s disease.
- Keep the poison control number (1-800-222-1222) by the phone.
- Learn what to do if the person chokes on something. Check with your local Red Cross chapter about health or safety classes.
Sense of Hearing
People with Alzheimer’s disease may have normal hearing, but they may lose their ability to interpret what they hear accurately. This loss may result in confusion or overstimulation.
- Don’t play the TV, CD player, or radio too loudly, and don’t play them at the same time. Loud music or too many different sounds may be too much for the person with Alzheimer’s to handle.
- Limit the number of people who visit at any one time. If there is a party, settle the person with Alzheimer’s in an area with fewer people.
- Shut the windows if it’s very noisy outside.
- If the person wears a hearing aid, check the batteries and settings often.
Again, it may not be necessary to make all these changes; however, you may want to re-evaluate the safety of the person’s home as behavior and abilities change.
Risks of Being Home Alone
This issue needs careful evaluation and is certainly a safety concern. The following points may help you decide.
Does the person with Alzheimer’s:
- Become confused or unpredictable under stress?
- Recognize a dangerous situation, for example, fire?
- Know how to use the telephone in an emergency?
- Know how to get help?
- Stay content within the home?
- Wander and become disoriented?
- Show signs of agitation, depression, or withdrawal when left alone for any period of time?
- Attempt to pursue former interests or hobbies that might now warrant supervision, such as cooking, appliance repair, or woodworking?
You may want to seek input and advice from a healthcare professional to assist you in these considerations.
As Alzheimer’s disease progresses, these questions will need ongoing evaluation.
Alzheimer’s Home Safety Checklist
Use the following room-by-room checklist to alert you to potential hazards and to record any changes you need to make to help keep a person with Alzheimer’s disease safe.
You can buy products or gadgets necessary for home safety at stores carrying hardware, electronics, medical supplies, and children’s items.
Keep in mind that it may not be necessary to make all of the suggested changes.
This article covers a wide range of safety concerns that may arise, and some modifications may never be needed.
It is important, however, to re-evaluate home safety periodically as behavior and abilities change.
Throughout Your Home
- Display emergency numbers and your home address near all telephones.
- Use an answering device when you cannot answer phone calls, and set it to turn on after the fewest number of rings possible. A person with Alzheimer’s disease often may be unable to take messages or could become a victim of telephone exploitation. Turn ringers on low to avoid distraction and confusion. Put all portable and cell phones and equipment in a safe place so they will not be easily lost.
- Install smoke alarms and carbon monoxide detectors (see my recommendation above) in or near the kitchen and all sleeping areas. Check their functioning and batteries frequently.
- Avoid the use of flammable and volatile compounds near gas appliances. Do not store these materials in an area where a gas pilot light is used.
- Install secure locks on all outside doors and windows.
- Install window and door sensor alarms to alert you when a door or window is opened.
- Hide a spare house key outside in case the person with Alzheimer’s disease locks you out of the house.
- Avoid the use of extension cords if possible by placing lamps and appliances close to electrical outlets. Tack extension cords to the baseboards of a room to avoid tripping.
- Cover unused electrical outlets with childproof plug covers.
- Place red tape around floor vents, radiators, and other heating devices to deter the person with Alzheimer’s from standing on or touching them when hot.
- Check all rooms for adequate lighting.
- Place light switches at the top and the bottom of stairs.
I’m a fan of these Stick Anywhere Motion Sensor Lights from Mr Beams because there isn’t always an outlet where you really need light. These LED lights are very popular and have excellent reviews.
- Stairways should have at least one handrail that extends beyond the first and last steps. If possible, stairways should be carpeted or have safety grip strips. Put a gate across the stairs if the person has balance problems.
- Keep all medications (prescription and over-the-counter) locked. Each bottle of prescription medicine should be clearly labeled with the person’s name, name of the drug, drug strength, dosage frequency, and expiration date. Child-resistant caps are available if needed.
- Keep all alcohol in a locked cabinet or out of reach of the person with Alzheimer’s. Drinking alcohol can increase confusion.
- If the person with Alzheimer’s smokes, remove matches, lighters, ashtrays, cigarettes, and other means of smoking from view. This reduces fire hazards, and with these reminders out of sight, the person may forget the desire to smoke.
- Avoid clutter, which can create confusion and danger. Throw out or recycle newspapers and magazines regularly. Keep all areas where people walk free of furniture.
- Keep plastic bags out of reach. A person with Alzheimer’s disease may choke or suffocate.
- Remove all guns and other weapons from the home or lock them up. Install safety locks on guns or remove ammunition and firing pins.
- Lock all power tools and machinery in the garage, workroom, or basement.
- Remove all poisonous plants from the home. Check with local nurseries or contact poison control (1-800-222-1222) for a list of poisonous plants. There’s a list of 10 (common) poisonous house plants on dengarden.
- Make sure all computer equipment and accessories, including electrical cords, are kept out of the way. If valuable documents or materials are stored on a home computer, protect the files with passwords and back up the files. Password protect access to the Internet, and restrict the amount of online time without supervision. Consider monitoring computer use by the person with Alzheimer’s, and install software that screens for objectionable or offensive material on the Internet.
- Keep fish tanks out of reach. The combination of glass, water, electrical pumps, and potentially poisonous aquatic life could be harmful to a curious person with Alzheimer’s disease.
Outside the Home
- Keep steps sturdy and textured to prevent falls in wet or icy weather.
- Mark the edges of steps with bright or reflective tape.
- Consider installing a ramp with handrails as an alternative to the steps.
- Eliminate uneven surfaces or walkways, hoses, and other objects that may cause a person to trip.
- Restrict access to a swimming pool by fencing it with a locked gate, covering it, and closely supervising it when in use.
- In the patio area, remove the fuel source and fire starters from any grills when not in use, and supervise use when the person with Alzheimer’s is present.
- Place a small bench or table by the entry door to hold parcels while unlocking the door.
- Make sure outside lighting is adequate. Light sensors that turn on lights automatically as you approach the house may be useful. They also may be used in other parts of the home.
- Prune bushes and foliage well away from walkways and doorways.
- Consider a “NO SOLICITING” sign for the front gate or door.
- Remove scatter rugs and throw rugs.
- Use textured strips or nonskid wax on hardwood and tile floors to prevent slipping.
- Install childproof door latches on storage cabinets and drawers designated for breakable or dangerous items. Lock away all household cleaning products, matches, knives, scissors, blades, small appliances, and anything valuable.
- If prescription or nonprescription drugs are kept in the kitchen, store them in a locked cabinet.
- Remove scatter rugs and foam pads from the floor.
- Install safety knobs and an automatic shut-off switch on the stove.
- Do not use or store flammable liquids in the kitchen. Lock them in the garage or in an outside storage unit.
- Keep a night-light in the kitchen.
- Remove or secure the family “junk drawer.” A person with Alzheimer’s may eat small items such as matches, hardware, erasers, plastics, etc.
- Remove artificial fruits and vegetables or food-shaped kitchen magnets, which might appear to be edible.
- Insert a drain trap in the kitchen sink to catch anything that may otherwise become lost or clog the plumbing.
- Consider disconnecting the garbage disposal. People with Alzheimer’s may place objects or their own hands in the disposal.
Try to meet these needs by offering food and fluids and scheduling ample toileting.
- Use a night-light.
- Use a 2-way audio monitoring device (like those used for infants) to alert you to any sounds indicating a fall or other need for help. This also is an effective device for bathrooms.
- Remove scatter rugs and throw rugs.
- Remove portable space heaters. If you use portable fans, be sure that objects cannot be placed in the blades.
- Be cautious when using electric mattress pads, electric blankets, electric sheets, and heating pads, all of which can cause burns and fires. Keep controls out of reach.
- If the person with Alzheimer’s disease is at risk of falling out of bed, place mats next to the bed, as long as they do not create a greater risk of accident. Consider a well-placed bed rail, which can also aid in getting into and out of bed.
- Use transfer or mobility aids.
- If you are considering using a hospital-type bed with rails and/or wheels, read the Food and Drug Administration’s safety information.
- Do not leave a severely impaired person with Alzheimer’s alone in the bathroom.
- Remove the lock from the bathroom door to prevent the person with Alzheimer’s from getting locked inside.
- Place nonskid adhesive strips, decals, or non-slip mats in the tub and shower. If the bathroom is uncarpeted, consider placing these strips next to the tub, toilet, and sink.
- Use washable wall-to-wall bathroom carpeting to prevent slipping on wet tile floors.
- Install grab bars in the tub/shower. A grab bar in contrasting color to the wall is easier to see.
- Use a foam rubber faucet cover (often used for small children) in the tub to prevent serious injury should the person with Alzheimer’s fall.
- Use a plastic shower seat and a hand-held shower head with an extra long hose to make bathing easier.
- In the shower, tub, and sink, use a single faucet that mixes hot and cold water to avoid burns.
- Set the water heater at 120°F to avoid scalding tap water.
- Insert drain traps in sinks to catch small items that may be lost or flushed down the drain.
- Store medications (prescription and nonprescription) in a locked cabinet. Check medication dates and dispose of outdated medications.
- Remove cleaning products from under the sink, or lock them away.
- Use a night-light.
- Remove small electrical appliances from the bathroom. Cover electrical outlets.
- If a man with Alzheimer’s disease uses an electric razor, have him use a mirror outside the bathroom to avoid water contact.
Living Room and Family Room Safety
- Clear electrical cords from all areas where people walk.
- Remove scatter rugs or throw rugs. Repair or replace torn carpet.
- Place window decals at eye level on sliding glass doors, picture windows, or furniture with large glass panels to identify the glass pane.
- Do not leave the person with Alzheimer’s disease alone with an open fire in the fireplace. Consider alternative heating sources.
- Keep matches and cigarette lighters out of reach.
- Keep the remote controls for the television, DVD player, and stereo system out of sight.
Laundry Room Safety
- Keep the door to the laundry room locked if possible.
- Lock all laundry products in a cabinet. Laundry detergent pods can be fatal if eaten by accident.
- Remove large knobs from the washer and dryer if the person with Alzheimer’s tampers with machinery.
- Close and latch the doors and lids to the washer and dryer to prevent objects from being placed in the machines.
Garage, Shed and Basement
- Lock access to all garages, sheds, and basements if possible.
- Inside a garage or shed, keep all potentially dangerous items, such as tools, tackle, machines, and sporting equipment either locked away in cabinets or in appropriate boxes/cases.
- Secure and lock all motor vehicles and keep them out of sight if possible. Consider covering vehicles, including bicycles, that are not frequently used. This may reduce the possibility that the person with Alzheimer’s will think about leaving.
- Keep all toxic materials, such as paint, fertilizers, gasoline, or cleaning supplies, out of view. Either put them in a high, dry place, or lock them in a cabinet.
- If the person with Alzheimer’s is permitted in a garage, shed, or basement, preferably with supervision, make sure the area is well lit and that stairs have a handrail and are safe to walk up and down. Keep walkways clear of debris and clutter, and place overhanging items out of reach.
The home is an important place for everyone. For the person with dementia, a familiar environment can help create a connection with the past and maintain a sense of who they are.
However, some practical changes may need to be made to keep the home “dementia-friendly.”
When modifying your home environment, keep it familiar, striking a balance between safety and independence. Too many restrictions can make it difficult for him or her to take part in daily activities, and can seriously affect her self-esteem.
Keep in mind some of the changes that occur with dementia:
- decreased balance and reaction time
- visual-perceptual problems
- physical limitations that make it more difficult to walk; memory
- judgment and insight.
- Also keep in mind that you are more likely to be tired, and feel under pressure, making it more difficult for you to anticipate risk and prevent accidents.
Adapt the task to the person’s current abilities. For example, a person who enjoyed wood-working may no longer be able to use power tools but may still be able to nail, sand and paint in the workroom.
Be aware of changes as they happen and re-evaluate the need to make further changes to adapt to his abilities.
Have I missed something? Please share your tips and experience!
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- How to Live Better With Alzheimer’s: New Study! (from my other blog)