Caregiver Tips on Reducing Accidents and Injury in People with Alzheimer's
Caregivers need to consistently monitor issues of safety. If you start in the early stages of the disease it will makes adjustments less confusing than if you do it in the late stage of Alzheimer's (stage 6 and 7). Changes are incorporated into new routines and that helps reduce confusion. The aim is to forward think what potential dangers room design and activities have and to maximize safety. We want to reduce mobility as little as possible and promote self-care!
Room Design and Layout
Making adjustments to room design and thinking about safe movement between rooms, especially the bathroom, is basic to safety. Have familiar objects and personal possessions in their room. Simplifying their room and shared rooms by removing unnecessary objects without depersonalizing them is good. This encourages maximum safe mobility in familiar surroundings and continued interest in looking after their home.
When internal stairs become a hazard then you need to think about gates on the bottom and at the top of the stairs. These allow free movement on one floor level but can alert caregivers at night if the person with Alzheimer's gets lost or wanders (more sleep at night for caregivers!).
Door handles that need to be opened in combination will reduce the chances of a confused person gaining access to unsafe areas such as stairs and external yards and gardens unless supervised. Devices can be purchased that require key pad codes and swipe cards. You want easy access and devices that do not present hazard to caregiver supervision during escape from incidents such as fires.
Plan for Toilet Visits
One of the most important safety issues are bathroom trips. Easy access in familiar surroundings maximizes continence even when people are severely affected by Alzheimer's. Making sure a mobile patient can easily access the bathroom is one of the most important safety issues you need to address to prevent falls and accidents.
- Here is how a question on Night time Use of the bathroom was answered.
- More information on the types of incontinence.
Remember, people with Alzheimer's get sick too, so if incontinence suddenly starts it needs to be medically investigated. It could be a urine infection that can be cured, thus resolving the issue.
Lighting and Safety
Insure good, safe lighting for rooms and when in outside areas. Provide a night light and try to reduce shadows as is practical.
Install & Maintain Fire Alarms!
Bedroom and Bed Safety
Put their bed mattress and springs on the floor if they are prone to falls. Use appropriate support and bed cot sides. I do not believe that restraint should be use unless in an emergency for a very brief period of time.
‘Childproofing' Hazardous Chemicals and Objects
Household chemicals, knives dangerous objects such as tools and equipment
- Use childproof locks on cupboards, remove to a room not accessed.
- Guns: a sharepost from Dorian gives more information ‘Guns and Alzheimer's Don't Mix'.
- Fires and heaters-Fireguards, box in hot radiators, Change heating system if hazard too great.
- High windows-Window locks.
- Cars and driving- Here is more on this very difficult subject:
- Fall prevention alarms- These sound when someone tries to get out of bed or a chair.
Managing Confusion of Alzheimer's Disease
De-personalization will increase confusion. Include the person in decision making whenever possible. Feeling you have some control over your environment is very important for maintaining skills, interest and for self esteem.
It is important to encourage self-care and get them to give you feedback, i.e. are you comfortable? Do you want to clean your teeth/have a shower etc.?
- More tips on managing confusion in Alzheimer's disease
- The Alzheimer's Association has a safe return program that helps find people with Alzheimer's who have wandered off.
Safety Without Restraints
I do not believe that restraint should be used unless in an emergency and only then for a very brief period of time.
Comfort and Safety
Fundamental to safety is comfort. People with Alzheimer's are less likely to wander if they feel safe, are not hungry, constipated or ill (for instance with fever & delirium). The list is endless as to how bodily function environment affects us all. Try to keep room temperature between 21°C to 23.8°C (70F-75F) for comfort and to increase alertness and mobility.