Patients with memory disorders such as dementia and Alzheimer’s disease (AD) function best in a calm and well-structured environment. That means eliminating potential sources of trouble as much as you can.
According to the National Center for Injury Prevention, falls are the leading cause of injury deaths in adults aged 65 and older. One in every three older adults falls at least once each year. One out of every five falls causes a serious injury such as a broken bone or head injury. Every 13 seconds, an older adult is treated in the emergency room for a fall; every 20 minutes, an older adult dies from a fall. Among people aged 65 to 69, one out of every 200 falls results in a hip fracture; that increases to 1 out of every 10 falls for those age 85 and older. In 2013, the total cost of fall injuries in the United States was $34 billion and is expected to increase to $67 billion by 2020.
For a dementia patient, that half-inch step into the kitchen could be disastrous, leading to a serious fall and maybe even hospitalization.
Patient proofing your home
In addition to locking up knives and other sharp objects in the kitchen, you should lock up matches and lighters. You should also put a kill switch on your stove or remove the knobs so your loved one can’t accidentally start a fire. Put childproof latches on all your cabinets, and if you have any throw or area rugs in the kitchen, remove them. Remove any electrical wires that run across open spaces to prevent tripping, and put childproof plugs in all your electrical outlets.
Walk around your house and look at each room with a critical eye. If you see something that looks like it could cause a problem for your loved one, remove it or secure it so it no longer presents a hazard. Then you can rest assured that you have done your best to patient proof your home. Even with all reasonable precautions taken, accidents can still happen. Don’t blame yourself. Seek treatment for whatever injuries your loved one may have and move forward.
Here are some more specific tips:
- If your loved one wanders, you need to secure the entire house and yard to keep him from getting lost. Install locks on top of entrance doors to keep your loved one from getting outside unsupervised. Install locks on windows and use childproof doorknobs to make it more difficult for him to escape. Put locks on your garden gates, and if your yard isn’t fenced, consider putting in a high fence as soon as possible so you can keep your loved one secure at home while allowing him to engage in normal, healthy outdoor activity. But remember, no fence is tall enough and no gate is secure enough to substitute for your supervision!
- Disengage the garage door opener. Install alarms at the exits to let you know if someone is trying to get out. You also can use alarm mats that sound if someone steps on them. If you can’t afford alarms, hang a bell on the door to alert you if someone is leaving (although this may not be enough to wake you from a sound sleep).
- Let your neighbors know about your loved one’s condition so they can alert you if he manages to sneak out despite all your precautions. You may even want to take your loved one on a nice walk around the neighborhood to introduce him to your neighbors, but remember, discuss your concerns with neighbors, either before or after this visit. As you might imagine, patients don’t like to be discussed as if they weren’t standing right there.
- If you have a flight of stairs in your home, you must put gates at both the top and the bottom to keep your loved one from trying to go up and down unassisted. Mark the first step, top and bottom, with a wide, brightly colored tape so they’ll be aware of where it is. Make sure a handrail is securely fastened to the wall on both sides of the stairs and will support the weight of a falling person. If the handrails are flimsy, have them replaced.
- Use technology to help. Cameras, coined as Grannie-cams, can allow monitoring over the Internet, and baby monitors can provide audio monitoring from another room in the house. Alert-button necklaces or bracelets also allow someone to push for help in the event of a fall or other emergency.
- Install smoke alarms and don’t use portable space heaters because they’re a huge fire risk. Cover the fireplace and put cushioned corner bumpers on sharp edges of furniture to prevent injury in case of a fall.
Keeping track of an Alzheimer’s patient
No one knows exactly why Alzheimer’s patients wander, but the reality is that a certain number of them do. If your loved one wanders, it probably scares you to death. To help make sure the wandering isn’t a tragic experience, a number of programs are available to help find your loved one and return him home.
Use iron-on labels with your loved one’s name, address, and phone number imprinted on all his clothing, even his socks. This could make a big difference between a speedy return or a lot of red tape if your loved one gets lost.
Getting clutter out of the way
Something you may live with every day and not pay too much attention to is clutter, but clutter can be dangerous for your loved one.
You may love your stacks of magazines and newspapers and laugh when you open a cabinet and 20 plastic containers come tumbling down. But what seems cozy to you may present a real danger for your loved one. In his weakened condition with diminished ambulatory skills and impaired balance, it may be almost impossible for him to navigate around your treasures.
If you just can’t bear to part with all your treasures or simply don’t have time to deal with cleanup at the moment, gather your stuff in boxes and cart it to a mini storage. But be careful about reorganizing your loved one’s familiar environment too quickly and too drastically. Familiar spaces and old routines are the dementia patient’s friend; changing too much too quickly can trigger undesirable behavior or cause anxiety or paranoia. These clutter tips are for you, not for your loved one.
When you walk through and assess your house, you may come to the conclusion that certain areas simply aren’t going to work, no matter how much reorganizing you do. At that point, you may consider remodeling part of the house to accommodate your loved one’s needs.
Talk to local contractors. It may be more economical to build a small addition with a bedroom and accessible bath than to tear out an existing bath and walls to remodel. Whether you remodel depends on your financial situation and your loved one’s needs. Perhaps by combining two households, you can find the capital to make the needed structural changes in your own home.
Sam Friedmann, 23th April 2019
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