Caring for individuals with dementia often requires home modifications that support physical as well as cognitive limitations. Education for caregivers on what to expect in the various stages of dementia is the first step in planning for modifications. Financial considerations and structural limitations of the home itself will impact the scope of what can be done. Consultation and guidance in this area can be provided by care managers, occupational therapists, physical therapists, architects, and other knowledgeable professionals.
Increasing care recipient safety and independence within the home requires attention to the following areas:
- Accessibility: If there are stairs to enter the home, railings on both sides increase safety. Wheelchair ramps or evenly-leveled entryways may be necessary for individuals with mobility aids.
- Barriers to physical mobility: Reducing clutter, removing throw rugs, extension cords, and other obstacles, and arranging furniture so that individuals can move freely about the home, with or without mobility aids, can help people with dementia manage tasks and find items more easily. Adequate lighting is also important.
- Fall prevention: Decreasing the risk of falls may include the installation of safety railings for exterior and interior stairs, as well as interior railings and grab bars. Safety features for the bathroom may include a walk-in shower, handheld showerhead, or shower seat, grab bars, and non-skid bathmats.
- Behavioral concerns: Wandering is common in people with dementia, and can present a significant safety risk if the person becomes lost and disoriented. Low-tech interventions to prevent wandering outside the home include devices that signal when a door or window is opened, such as motion detection sensors, door chimes, or electronic alarms. Other simple measures can include hiding the doorknob with a curtain and placing locks out of the person’s line of sight. Other options include medical ID pendants or bracelets, such as MedicAlert® + Alzheimer’s Safe Return® or services that use tracking devices and charge a monthly monitoring fee such as Project Lifesaver.
The Alzheimer’s Association Home Safety Checklist provides helpful tips on how to create a safe environment for individuals with dementia and maximize their independence. However, flexibility and diligence on the part of caregivers is key. As the individual’s dementia progresses over time and/or there are changes in the person’s physical abilities, adaptions to the home may become more challenging and extensive.