Safety in the home

Tips: Ways to Manage Risks in the Home

There are a number of ways to make a home and surrounding areas safer for someone living with dementia.

1. Seek advice from a care manager
Care managers provide practical support to help people live as independently as possible. This includes day-to-day tasks, hobbies, interests and activities. Care managers can:

Suggest ways to carry out daily living activities (e.g. bathing, eating, dressing)
Help to select and use assistive technology and equipment to enable safe activity, and make adaptations to the home (e.g. hand rails in the bathroom)

2. Avoid falls
Falls are a common and potentially serious problem affecting older people. The risk of falls increases with age. This may be because of a range of factors: medical conditions (such as stroke), medication, balance difficulties, visual impairment, cognitive impairment and environmental factors. Falls can have detrimental effects on people, including injuries, loss of confidence and reduced activity.For some people with dementia, the condition can also increase the likelihood of falling. They may be less likely to recover as successfully as someone who does not have dementia. People who have been diagnosed with Parkinson's dementia or dementia with Lewy bodies are at a higher risk of falling.There are a number of things that can be done at home to reduce the risk of falling:

Home safety - Check the home for potential hazards such as rugs, loose carpets, furniture or objects lying on the floor. An occupational therapist may be able to help with identifying hazards and suggesting appropriate modifications.
Exercise - Regular exercise can improve strength and balance and help to maintain good general health. A referral to a physiotherapist may also help. Speak to your GP to find out more.
Healthy feet - Foot problems, including foot pain and long toenails, can contribute to an increased risk of falls. Seeing a podiatrist can help.
Medicines - Medication can have side effects, including dizziness, which could increase the risk of a fall. Changes to medication or dosage, as well as taking multiple medicines, can increase a person's risk of falling. Speak to the GP about a medicine review if the person with dementia is taking more than four medicines.
Eyesight - Regular eye tests and wearing the correct glasses may help to prevent falls.
Keep objects in easy reach - If something is going to be used regularly, keep it in a cupboard or drawer that is easy to access.
Try not to rush - Do things at an appropriate pace; many people fall when they are rushing.
Improve lighting - As people get older they need more light to see clearly. This is because of age-related changes to the eyes. Dementia can cause damage to the visual system (the eyes and the parts of the nervous system that process visual information), and this can lead to additional difficulties.

3. Increase light levels and use daylight where possible.

Minimize glare, reflection and shadows. Glare can be distracting and can reduce a person's mobility.
Lighting should be uniform across any space, and pools of light and sudden changes in light levels should be avoided. This is because when a person gets older, their eyes adapt slowly to changes in light levels.
Remove visual clutter and distractions such as carpets with floral patterns.
Use color contrasts to make things clearer (e.g. a light door with a dark frame).
Leave a light on in the toilet or bathroom during the night. A night light in the bedroom may help if someone gets up in the night.

4. Store dangerous substances safely
Dangerous substances, including medicines, should be stored somewhere safe. If the person with dementia is unable to administer their own medication safely, arrangements should be made for someone else to do this. A mediset could be helpful. These have separate tablet compartments for days of the week and/or times of day such as morning, afternoon and evening.

5. Make adaptations to the home
As people get older they may experience difficulties in managing everyday activities such as cooking or bathing, for a variety of reasons. People with dementia may experience additional challenges as their dementia progresses, because of memory problems or a reduced ability to carry out tasks in the correct sequence.
Adapting the home can help people with dementia to maintain their independence and reduce the risk of harm. It can also help to adapt some everyday tasks slightly. The following tips may help:

Label cupboards and objects with pictures and words so that they can be identified.
Where possible, use devices that only have one function and are easy to identify
Place clear instructions that can easily be followed somewhere visible.
Make sure the kitchen is well lit.
If there are concerns about using gas or electrical appliances inappropriately, contact the gas or electricity company and ask for the person to be put on the priority service register. This means that they will be eligible for free regular safety checks and will be able to get advice about safety measures such as isolation valves.
Fit an isolation valve to a gas stove so that the stove cannot be turned on and left on. Devices are also available for electric stove.
Look into products that may help to maintain independence and safety such as electric kettles that switch off automatically.
If the person's ability to recognize danger is declining, consider removing potentially dangerous implements such as sharp knives, but place other items for everyday use within easy reach.

6. Avoid fire
There are ways to minimize the risk of fire in the home, including fitting smoke alarms and carbon monoxide detectors, and checking home appliances.
Local fire and rescue services can provide free home safety visits. They offer advice about how to make the home safer, as well as fitting smoke alarms and planning escape routes.
Electric and gas appliances can be dangerous. It is important to check appliances to make sure they are working safely. Some appliances will have built-in safety features.

7. Arrange access
Make plans for how someone can gain access if the person with dementia or their care partner are unable to answer the door.
One option is to consider a key safe. A key safe is a secure box fitted outside the home where keys can be placed. Each key safe has an individual access code. This can be given to anyone who needs access if the person with dementia is unable to answer the door (e.g. a family member or caregiver).
Community alarms are available to buy. These are pendants that enable someone to call for help in an emergency or when they are having difficulties, by pressing a button.
It is a good idea to keep a list of useful phone numbers in a convenient location, or to program them into the phone. These might include the numbers for:

Caregivers, friends or family members
Local hospital
Social worker and/or home care agency
Gas, water and electricity providers (especially in an emergency)
Local police

Source: Alzheimer’s Society