How to keep people with dementia safe at home: A comprehensive guide

According to Johns Hopkins researchers, over 90% of patient needs in those with dementia were home safety-related. To help address this, learning how to keep people with dementia safe at home is crucial for ensuring a high quality of life and reducing anxiety for both the person with dementia and their caregivers. This guide offers practical strategies for creating a secure and supportive home environment, room by room.

Quick Summary

Creating a safe home for those with dementia involves addressing potential hazards like falls and wandering, managing behavioral changes, and using technology for support. A structured, familiar, and calm environment can significantly reduce confusion and risks while promoting independence.

Key Points

• Modify the home environment: Adapt each room by installing safety features like grab bars, securing appliances, and eliminating trip hazards.

• Prevent wandering: Secure doors with high or low-mounted locks and alarms, remove cues for leaving, and use a GPS tracker.

• Manage agitation and sundowning: Establish a consistent daily routine, reduce noise and clutter, and use calming activities to minimize confusion and anxiety.

• Leverage technology: Use assistive devices like GPS trackers, smart home assistants, and automated pill dispensers for enhanced safety and independence.

• Prioritize caregiver support: Utilize respite care and support groups to manage stress and avoid burnout.

• Create a calm atmosphere: Use soft lighting, familiar objects, and calming colors to make the environment feel secure and predictable.

• Prepare for emergencies: Keep an emergency kit with medical information and essential supplies, and inform local authorities about the person's condition.

As dementia progresses, a person's cognitive and physical abilities change, making their familiar home environment a potential source of confusion and danger. Simple changes to the living space, daily routines, and a supportive attitude can make a profound difference. By proactively addressing common risks like falls, wandering, and household hazards, caregivers can foster independence and comfort.

Room-by-room safety modifications

Creating a dementia-friendly home can be approached systematically, focusing on different areas to identify and mitigate risks.

Kitchen safety

Kitchens are filled with potential hazards, from hot appliances to sharp utensils. The following modifications can make the kitchen safer:

• Lock up dangerous items: Use childproof locks on cabinets and drawers to secure knives, scissors, and cleaning products.
• Secure appliances: Install safety knobs and an automatic shut-off switch on the stove. Consider removing knobs or disconnecting the garbage disposal.
• Check food safety: Regularly inspect the refrigerator and pantry for expired or spoiled food, as a person with dementia may not recognize it has gone bad.
• Limit access to poison look-alikes: Remove artificial fruit, magnets, and other food-shaped items that could be mistaken for food.

Bathroom safety

Falls are a major risk in bathrooms due to wet, slippery surfaces. The following changes can greatly reduce risk:

• Install grab bars: Put grab bars in contrasting colors near the toilet and inside the tub or shower for easier visibility.
• Prevent slips: Place non-slip adhesive strips or mats in the tub and shower. Use a rubber mat outside the shower area.
• Control water temperature: Set the water heater to 120°F or less to prevent scalding. Label hot and cold faucets.
• Remove door locks: Take locks off the bathroom door to prevent the person from locking themselves inside.
• Store toiletries safely: Lock away items like shampoos, lotions, and perfumes, which may be mistaken for food.

Bedroom safety

Making the bedroom a safe, comfortable space can help reduce nighttime confusion and wandering.

• Enhance visibility: Use nightlights in the bedroom and along the path to the bathroom.
• Cover mirrors: If reflections cause confusion or fear, consider covering or removing mirrors.
• Eliminate electrical hazards: Avoid space heaters, electric blankets, and heating pads. Keep electrical cords tucked away securely.
• Remove tripping hazards: Clear clutter and remove throw rugs.

Strategies for managing wandering and agitation

Wandering is common in people with dementia and requires a proactive approach to ensure safety. Agitation and sundowning are also frequent challenges.

Preventing wandering

• Use locks and alarms: Install deadbolts at the top or bottom of exterior doors, outside the person’s line of sight. Add chimes or sensors that alert you when a door or window is opened.
• Create visual deterrents: Place a large, dark rug or a "STOP" sign in front of exit doors, as some people with dementia may perceive a dark area as a hole.
• Remove departure triggers: Keep car keys, coats, and shoes stored away and out of sight to minimize the impulse to leave.
• Ensure identification: Have the person wear a medical alert bracelet or GPS tracking device at all times.
• Inform neighbors and police: Let trusted neighbors and local law enforcement know that the person has dementia and may wander.

Managing agitation and sundowning

• Establish a routine: A consistent daily schedule for meals, activities, and bedtime can reduce confusion and anxiety.
• Minimize stimulation: Reduce loud noises, bright lights, and clutter, especially in the evening. Create a calm, quiet environment.
• Engage in meaningful activities: Offer simple, repetitive tasks like folding laundry or a favorite hobby to provide a sense of purpose and reduce restlessness.
• Redirect and reassure: If agitation occurs, use a calm voice and gentle touch. Redirect their attention to a pleasant activity or distraction.

Technology and tools for enhanced safety

Modern technology offers powerful tools to complement environmental changes and provide extra peace of mind.

Comparison of assistive technologies for dementia

Technology	Purpose	Pros	Cons
GPS Trackers	Monitor location to prevent getting lost.	High accuracy, peace of mind, discreet options (bracelets, watches).	Can be expensive, requires charging, some may feel liberty is limited.
Automatic Shut-off Appliances	Prevents burns and fires from forgotten appliances.	Increased fire safety, reduces constant supervision needs.	Requires replacing older appliances or adding new devices, upfront cost involved.
Door/Window Alarms	Alert caregivers if an exit point is opened.	Provides immediate notification, simple to install, offers peace of mind.	Can be intrusive or confusing for the person with dementia, potential for false alarms.
Smart Home Assistants (Alexa/Google)	Voice-activated reminders and controls.	Can set reminders, answer questions, and play music, promoting independence.	Requires learning new technology, may not be suitable for all stages of dementia.
Daily Pill Dispensers	Organize and remind for medication adherence.	Improves medication safety and consistency.	Requires setup and refilling by a caregiver.

Developing a caregiver-focused approach

Beyond physical changes, a caregiver's approach significantly impacts safety and well-being.

Communication and routines

• Maintain predictable routines: Keep daily schedules consistent, as familiarity reduces anxiety and confusion.
• Use visual cues: Label rooms, drawers, and cabinets with simple words and pictures. Use contrasting colors on floors or stairs to improve depth perception.
• Observe and interpret behaviors: Wandering or agitation may signal unmet needs like hunger, thirst, pain, or the need to use the bathroom. A calm investigation can reveal the underlying cause.

Caregiver support and self-care

Caring for a person with dementia is physically and emotionally demanding. Resources are available to help caregivers manage stress and prevent burnout.

• Respite care: Arrange for short-term care to allow yourself regular breaks and personal time.
• Support groups: Connect with other caregivers online or in person to share experiences and receive mutual support.
• Professional help: Seek assistance from organizations like the Alzheimer's Association or local agencies for expert advice and services.

Conclusion

Keeping a person with dementia safe at home is an ongoing process that requires a thoughtful, multi-faceted approach. By implementing room-by-room safety modifications, managing challenging behaviors with patience and routine, and leveraging technology for extra support, caregivers can create a secure and calming environment. Prioritizing caregiver self-care is equally important for maintaining resilience. With these strategies, people with dementia can continue to live at home safely and with dignity, enhancing their overall quality of life. For more resources and support, consider visiting the Alzheimer's Association website.

Optional outbound link

For more resources and information, visit the Alzheimer's Association.

Frequently Asked Questions

How can I prevent a person with dementia from wandering away from home?

To prevent wandering, install door locks that are out of sight, such as high or low on the door. Add chimes or alarms to exterior doors and windows to alert you when they are opened. Remove items like keys, coats, and purses from plain sight near the entrance, and have the person wear a GPS tracker or ID bracelet at all times.

What are some of the most important home modifications for fall prevention?

Focus on clearing pathways of clutter, securing or removing all throw rugs, and ensuring good, consistent lighting throughout the home, including nightlights. In the bathroom, install grab bars and use non-slip mats in the shower and near the toilet.

How can I make the kitchen safe for someone with dementia?

In the kitchen, use childproof latches on cabinets holding sharp objects or toxic cleaners. Install safety knobs and an automatic shut-off feature on the stove. Regularly check and dispose of expired food from the refrigerator and pantry.

How can technology assist in keeping a person with dementia safe at home?

Technology can help in several ways. GPS trackers and wearables can monitor a person's location. Motion sensors can alert you to unusual activity. Smart home assistants can provide voice-activated reminders for tasks like taking medication. You can also use automatic pill dispensers and door alarms.

What should I do if the person with dementia becomes agitated?

If agitation occurs, stay calm and speak in a soft, reassuring voice. Try to identify the cause, which could be unmet needs like hunger, thirst, or pain. Gently distract or redirect their attention to a simple, familiar activity or comforting object, rather than arguing.

How can I prepare for an emergency if I am caring for someone with dementia?

Create a disaster plan that includes an emergency kit with two weeks' worth of medications, medical documents, and supplies. Inform trusted neighbors and local emergency services about the person's condition. Keep a recent photo and emergency contacts readily available.

Should I remove all mirrors from the home?

Consider covering or removing mirrors if they cause confusion or fear. Some people with dementia may no longer recognize their own reflection, mistaking it for a stranger, which can be distressing. Observe the person's reaction to mirrors and decide based on their individual needs.