Dementia - safety issues

Dementia affects each person differently. Symptoms such as confusion, memory loss and disorientation are common, while limited mobility and coordination may affect safety. It is important that family, friends and health professionals help the person with dementia to feel and be as secure as possible.

Safety inside the home for people with dementia

The best living environment for a person with dementia is one that helps them to be as happy and independent as possible. Familiarity with environment and routines is important for a person with dementia. The home environment should help them know where they are and help them find where they want to go. Changes in the environment may add to confusion and disorientation.

Some tips for making the home a safe environment for the person with dementia include:

• Arrange furniture simply and consistently and keep the environment uncluttered.
• Remove loose rugs and seal carpet edges that may be safety hazards.
• Install night-lights in the hallways and in the toilet that may be useful to help a person find their way to the bathroom at night.
• Dispose of, or safely store, all old medications and hazardous materials such as kerosene.
• Remove electric blankets and hot water bottles that can be a safety hazard for a person with dementia.
• Install safety switches, which are now recommended, in homes.
• Use hot water jugs and other appliances with automatic cut-off mechanisms.
• Replace more dangerous forms of heating, such as bar radiators, with safer heating options, such as column heaters.
• Check appliances like heaters and toasters to make sure they do not present any safety hazards.
• Replace long electrical cords on appliances with coiled or retractable cords.
• Consider thermostats to control the temperature of water that comes out of the hot water taps.
• Check that smoke detectors are fully functional – a person with dementia may need someone else to check the battery and make sure the alarm is loud enough.

Safety outside the home for people with dementia

Some people with dementia may become disoriented and get lost in unfamiliar, or even previously familiar, surroundings. It is important that they carry appropriate identification at all times, including their name and address and an emergency contact number. An identity bracelet is ideal.

Some tips for making the area outside the home safe for the person with dementia include:

• Keep paths well swept and clear of overhanging branches.
• Check catches on gates.
• Remove poisonous plants and dispose of hazardous substances from sheds and garages.

Home safety checklist

It may be useful to go through the house, room by room, to check for any safety hazards. The following checklist can assist you to remove hazards and make the home a safer environment.

Access to the home

Safety checkpoints include:

• steps
• paths.

Around the house

Safety checkpoints include:

• arrangement of the house – not cluttered
• lighting – adequate
• floor coverings – non-slip
• doors, windows and heating.

Living area

Safety checkpoints include:

• chair heights
• protruding furniture.

Kitchen

Safety checkpoints include:

• floor
• flammable materials
• taps
• electrical and gas equipment
• kettle
• poisons – storage
• cupboards
• drainage in floor
• electrical connections – check they are away from possible contact with water or heating sources.

Bathroom

Safety checkpoints include:

• floor – how slippery
• hot water thermostat control
• poisons – storage
• toilet height
• toilet paper – visibility.

Laundry

Safety checkpoints include:

• poisons – storage
• drainage in floor
• electrical connections – check they are away from possible contact with water.

Bedroom

Safety checkpoints include:

• bed height
• chair in bedroom for dressing.

Wandering

As well as making the home safer, it is important to make sure the person with dementia is as safe as possible if they go outside the home.
Safety checkpoints include:

• identification bracelet
• identification and emergency contact number in wallet
• bell – on door, window and gate.

Independence aids for the person with dementia

Aids to independence and safety include:

• hand-held shower hoses that allow a person to direct the flow of water as desired
• a shower chair or bath seat that allows a person to be seated while bathing and eliminates the need to lower oneself into the bath
• handrails near the bath, shower and toilet to provide support and balance
• easy-to-read clocks and large calendars to help orient to date and time
• heat sensors or alarms in case of emergency
• a list of contact names and numbers in large print placed by the telephone allows the person to stay connected more easily.

Independent Living Centres in each Australian state and territory offer a number of services designed to promote safe living. Information is available on a number of products, including smoke detectors, hot water service temperature regulators and monitoring services. Advice is also available on home modifications and home design.

Changes to the environment for people with dementia

Solving problems involves continual assessment and planning. Principles you can use to guide any changes to the environment of a person with dementia include:

• Involve the person with dementia in identifying problems and deciding on changes to their environment, where possible.
• Make sure that modifications suit that person.
• Respond to specific problems – don’t introduce standard modifications.
• Change as little as possible – keep the familiar.
• Build on strengths and maximise their independence.
• Try simple solutions first.
• Make sure that modifications are home-like and dignified.
• Changes should be appropriate to the person’s age and culture.
• Weigh up risks and try to achieve a balance between safety and independence.
• Make sure that family, carers and workers have a safe working environment.

Adapted from At home with dementia,Family and Community Services, NSW Government.

Where to get help

• Your GP (doctor)
• Your local council
• Your local community health centre
• National Dementia Helpline, Dementia Australia Tel. 1800 100 500
• Aged Care Assessment Services Tel. 1300 135 090
• My aged care Tel. 1800 200 422
• Cognitive Dementia and Memory Service (CDAMS) clinics
• Carers Victoria Tel. 1800 514 845
• Carer Gateway Tel. 1800 422 737
• Dementia Behaviour Management Advisory Service (DBMAS) Tel. 1800 699 799 – for 24-hour telephone advice for carers and care workers