Safety in the Home
Dementia is the name given to the broad range of symptoms resulting from illnesses that cause degenerative intellectual functioning.
The onset and symptoms present differently in each situation with side effects ranging from confusion, memory loss and disorientation, to the reduced ability to finish thoughts or follow directions. For some individuals their dementia may also be combined with decreased mobility, loss of balance and decreased co-ordination.
As the disease progresses these symptoms can impact on everyday life as individuals struggle to perform familiar tasks, remember recent events, or understand and recognise potential problems and solutions.
For those living with someone with dementia it can be a confusing and scary time, however these are some simple ideas which can be quite effective in making the home a safer and more user-friendly environment.
ARRANGING THE HOME ENVIRONMENT
Providing an uncluttered home environment not only eliminates falls/tripping hazards, but it also removes potential distractions which may add to confusion and disorientation. Some people with dementia are particularly sensitive to the sensory environment and can find too much clutter confusing. For example, a dark mat before a door may look like a hole in the floor creating concern, or patterned flooring may be mistaken for steps causing the person to alter their walking gait and fall.
Suggestions for arranging the home environment include:
* Remove loose rugs and mats, seal up carpet edges and provide non-slip flooring.
* Provide a well lit environment during both day and night as people with dementia may not have the insight to look for light switches, i.e. install a path of night lights from the bedroom to the toilet.
* Remove potentially disorientating visible barriers, such as closed doors.
* Provide pictures/labels around the home to identify rooms and cupboards, i.e. a picture of a toilet seat on the toilet door, a photo of each family member on their bedrooms, labelled clothing draws.
* Do not hide important items, i.e. ensure toilet paper is clearly visible without the need to search it out.
* Remove or lock up potential hazards, i.e. medication or any materials that could be mistaken for food, drink or current medication.
* Remove items that have the potential to cause disaster/injury if mismanaged, i.e. hot water bottles, electric blankets, hair straighteners, bar radiator heaters, sharp knives etc.
* Remove locks from bathroom/toilet doors so individuals cannot lock themselves in and become panicky.
* It is important to monitor the temperature of the home as individuals with dementia can loose their insight into how hot or cold it is. In winter install a timed heater which switches on in the morning and off at night, in summer do the same with an air conditioner.
* If wandering is a concern consider putting extra locks on either the upper or lower parts of the door as these are harder to see since they are not in the direct line of sight.
* Make the bathroom environment safer with grab rails, slip resistant mats and floor treatments or equipment such as shower chairs and toilet seat raisers.
* Install electrical safety switches, gas leak detectors and smoke alarms.
* If possible look at setting the hot water system to a ‘safe’ temperature. Alternatives, although slightly more expensive, include tempering valves and thermostatic mixing valves.
* Place bells or chimes on doors and gates to sound if someone is coming…or going
* Create a safer garden environment by removing overhanging branches, cluttered pathways and hazardous substances in garages.
* Consider getting a home safety assessment from an occupational therapist who can look at potential needs such as; grab rails around the home, modifying/eliminating steps; creating shower alcoves; installing hand held shower hoses and setting the correct heights of furniture.
SAFETY EQUIPMENT, TIPS AND GADGETS
It is impossible to have a completely risk free environment and you need to accept that minor incidents can and probably will occur. The following are some examples of gadgets and ideas which can help promote a safer home environment.
* Consider installing isolation valves on gas stoves and heaters which turn the equipment off after a designated period of time.
* ‘Access proof’ your home buy installing magnetic cabinet locks, stove guards, oven locks, tap covers and cupboard latches.
* If keeping track of time and appointments is a problem, consider a talking watch which verbalises the time and alarms a message as programmed. Other handy ideas include easy-to-read electronic clocks and calendars with automatic day, date and time.
* In order to keep track of medication consider using pill boxes or Webster packs with separate compartments for each day of the week (can be split into morning and afternoon). Some pill boxes also have a system which locks the pill box against opening until a pre-programmed time then alarms a reminder.
* If falling is a concern hip protectors may provide some prevention against injury.
When introducing new ideas or items of equipment it is often important to implement these during the early stages of dementia as during the later stages it becomes harder to introduce new skills or adjust to new ideas and ways of doing things
WANDERING
Wandering can be a common concern for people living at home with dementia. Some simple ideas to easy the worry includes:
* Visiting neighbours and shops in the local area to explain the situation and provide a contact phone number if needed.
* Avoid having items which may trigger the idea of wandering lying about, i.e. hand bag, coat and keys.
* Ensure the wanderer is wearing a personal identification bracelet and has a list of emergency contact numbers and identification in their wallet or purse.
* If there is a concern regarding someone getting locked inside a house during a potential emergency, rather than altering the house locks against wandering, consider making the garden secure so they can leave the home and have a safe environment to wander in.
* Consider installing movement detection devices such as bed and chair sensor mats which alarm when pressure is taken off the mat. Other options include portable infra red motion detectors which can be placed near doorways to alert a pager if the person leaves the room or body worn transmitters which alarm when the person moves beyond a certain range from the alarm panel.
For further information on these and other ideas on how to make the home a safer environment please contact the Independent Living Centre: www.ilc.asn.au/
*Source: Disability SA Independent Living Centre
