Home safety and dementia
Families worry about a person with dementia who lives alone at home. They often fear for their safety and sometimes they become over cautious.
“The day after I got the diagnosis, my wife wouldn’t even let me take the bins out.”
One man with dementia told me, “The day after I got the diagnosis, my wife wouldn’t even let me take the bins out.” It’s wrong to unnecessarily restrict what a person can do, just because they’ve got some impairments caused by brain disease. It is never possible to guarantee safety, but taking some basic measures can help you to reassure yourself without curtailing freedom. The worst thing is if someone is made to move into a care setting prematurely just because others are worried about accidents.
Here are five hints for safety at home.
Go room by room to check for trip hazards. Falling over and having to go to hospital as a result can be the top of a slippery slope towards someone losing their freedom. Change as little as possible otherwise because change increases stress, and that increases symptoms and makes life harder for the person. Nevertheless, it makes sense to remove obvious trip hazards. Increase the light level and replace any older energy saving lamps that might take a long time to light up and be less luminescent than they used to be. Being able to see things means there is less stress trying to remember where they are. Make life easier, not harder.
Find a way of managing medication that reduces the risk of confusion and someone making themselves unwell by taking the wrong medicine at the wrong time if they have lots of different medications to manage. Medication reminders come in a wide range. Social services might even provide a staff member who calls at intervals to remind the person, but only if they can’t use one of the products that can help. If the person is still able to adapt to new things, an electronic pill reminder is good, as long as they remember what the alarm sound is prompting them to do. Telephone prompts are possible. Pharmacies will provide medication in well labelled blister packs that help the person to see what they should take and whether they have already taken it.
Use assistive technology to the max. This includes movement sensors that can alert the carer if the person behaves in an unusual way within the home, for example staying in the kitchen for an hour in the night, which indicates that they might have gone there for a glass of water and fallen over. GPS tracking devices can alert when the person leaves the home, and a geofence can be created so that if they travel over a certain distance, a call centre or family member is informed, to check if they are lost. Voice activated personal assistants (such as Alexa) can be used to make a smart home, and family can keep the house at an appropriate temperature as the weather changes with an online system such as Hive.
People with dementia living at home are sometimes vulnerable to financial abuse, for example from rogue traders or telephone scams at home. Prepare for this with banking arrangements that allow the person the dignity of managing enough of their money without help, but with the majority of their resources tied up in a less accessible way to prevent someone extorting cash from them, which they can access with the help of their attorney.
One scary place at home is the garage, and if the car is still there and the person has the keys, consider whether they are fit to drive and whether you should disable or remove the vehicle. A diagnosis of dementia in itself does not automatically end driving but the insurance company must be told. To be safe to drive the person must have good eyesight but also good judgement, and the flexibility to look around them and speed of reaction to deal with emergencies. It’s not safe to leave the car with someone who has dementia if you’re doubtful about any of these things.
When someone with dementia is living at home, it is always possible that you won’t get it right and that an accident will happen, but taking some basic steps will help reduce your own stress, and work to sustain the independence and dignity of the person with dementia.
