When caring for someone afflicted by Alzheimer's disease in a home setting, caregivers must take a critical look at the living environment. Adapting the home to prevent accidents and ensure optimal safety for your loved one is paramount. It is sometimes necessary for a caregiver to place himself of herself in the position of the person suffering from Alzheimer's to help anticipate possible concerns or dangers. Caregivers will find that such approaches will be dependent upon the person for whom care is being provided. The most important aspect of caregiving in a home is safety and security, for both patient and caregiver.
In the long run, adapting the home environment is much easier than trying to adapt behaviors that may be exhibited by a loved one in various stages of the condition. Making necessary changes within the home environment may not only decrease physical hazards, but also reduce the amount of stress that is places upon both the caregiver and the care receiver.
Creating a Safe Living Environment
When assessing a home or apartment for someone suffering from Alzheimer's, one of the most important things to consider is preventing access of use to areas or equipment that may harm the patient. Such dangers include:
- Hazardous areas within the house
- Basements and garages and tool sheds
- Kitchen and bathroom appliances
A person suffering from dementia may not be able to rationalize the difference between safe and unsafe. Locking doors that lead to areas that contain tools, equipment, or materials that may prove harmful to the patient is necessary.
Removing electrical equipment or appliances from the bathroom and kitchen area will help to reduce the risk of electrical shock. Something as innocuous as a kitchen blender may cause injury to someone suffering from cognitive function and loss. To prevent accidents, knives and cooking implements should also be stored in a safe, secured location and cooking appliances in the kitchen can be made safer by removing knobs or installing hidden circuit breakers and gas valves.
Refrigerator should be checked frequently for food spoilage. In many cases, people suffering from various stages of Alzheimer's may be unable to distinguish between fresh and rotten food. Sense of taste and smell may also be altered due to medications.
Gardening tools, gasoline and equipment normally stored in tool sheds or garages should be placed in a secured area to prevent accidents; the car keys and keys to larger pieces of home or yard maintenance equipment should be stored in a protected location.
Ensuring Safety Inside the Home
Family members see rugs and carpets as home decorations, but the caregiver often sees those very same rugs and carpets as potential fall hazards. Many times, older people are extremely reluctant to change things, but by using firm yet gentle explanations, caregivers may successfully eradicate potential hazardous situations from a home. Top-heavy floor lamps and cords should be placed against walls or underneath carpets. Caregivers can discuss such issues with their loved ones and gain their cooperation and help of other family members to help remove clutter to make the home a safer living environment.
Those suffering from Alzheimer's may experience vision complications. Depth perception, as well as the ability to distinguish colors is often compromised as stages of Alzheimer's progress. Whenever possible, using color contrast when it comes to rugs, floor covering, bedding, and window coverings will help a patient to perceive space and depth within the home. Many Alzheimer's also patients experience difficulty seeing dark objects, as they are often perceived as large, black holes. It is recommended that caregivers avoid wearing black or very dark brown colors, as it may cause agitation and anxiety in the patient for that very reason.
Child-proof locks can be placed on cabinets within the house and doorknob covers used on doors that provide access to areas that cannot be locked for practical purposes. Deadbolts placed near the top or near the base of exterior doors will help to ensure the safety of your loved one.
Bathrooms provide special challenges for caregivers. Whenever possible, bathtub and toilet areas should supply adequately anchored grab bars in both bathtub area and around the toilet.
Products such as raised toilet seats, sidebars, or grab bars, make it much easier for a patient to access toileting needs. Such situations may prove embarrassing for a loved one, which is where the caregiver's compassion and simplistic approach to such needs are especially important.
Getting in and out of bathtubs also provides a challenge. Non-skid mats or other stick-ons should be placed in the bathtub and on top of bathtub surface to help prevent slipping. In many cases, those experiencing anxiety may feel much more comfortable sitting on a special stool or chair made for shower bathing. Fear of falling is a major issue with many Alzheimer's patients, and eradicating such fears will help to ensure that you are able to adequately care for his or her cleanliness and hygiene.
Make sure that water temperatures are adequate for bathing or washing, and that water heaters do not exceed 120 degrees. If pipes are exposed, pad them as necessary to prevent burns.
While many patients may be able to toilet themselves, brush their teeth, their hair, and other personal hygiene tasks, some may need help getting to and from bathroom areas. To avoid injuries, bathrooms should be equipped with adequate stools or chairs, and adequate lighting fixtures for greater comfort and safety.
Poor vision in many patients will need to be addressed in all areas of the home. Providing contrast with objects from walls and floors will avoid problems caused by depth perception issues. For example, in an all-white bathroom, an all-white toilet may be difficult for some patients to see. A caregiver can alleviate this problem by placing a colored toilet seat cover or cushion on the seat for the patient as a strong visual clue of location.
Bedrooms also provide special challenges in safety. Adequate lighting in bedroom areas needs to be provided for easier reading or television watching during any time of the day or night. Those suffering from various stages of Alzheimer's may fear the dark, so a night-light placed in the room may help. In addition, adequate lighting needs to be made available during nighttime hours in case your loved one needs to find the bathroom in the middle of the night.
In many cases, placing a large picture of a toilet or the word "Toilet" on the bathroom door will help to offer guidance. Bed clothing should be easy to open or close. Caregivers should be available to offer assistance whenever possible, and if desired.
In some situations, a caregiver may need to learn how to help a loved one use a bedpan or a urinal if nighttime trips to the bathroom are not feasible for a variety of reasons. Because of this, a communication system needs to be established for nighttime needs. An intercom-type system or even a bell to address calling for help for toileting, dressing or other needs should be implemented as necessary.
In the Kitchen
Kitchen areas of any home or apartment often contribute to the most injuries because of ovens, stoves, microwaves, hot plates, or crock-pots, all of which may burn or otherwise harm a patient. The caregiver must determine the cognitive abilities of their loved one to ensure that the use of such equipment is safe under any circumstance.
In the homes of patients suffering from cognitive disabilities, cooking with flame can be a fire hazard. Food left on the stove too long may scorch and burn, and in some circumstances, catch fire. A can placed inside a microwave not only damages the microwave, but also may cause an explosion or injury. To ensure safety, the caregiver may cook foods in advance and then unplug or otherwise disable such appliances to prevent injury. Avoid keeping step stools or small ladders in the kitchen area in order to prevent falls and injuries.
For patients with vision difficulties, brightly colored plates, drinking cups, placemats and napkins will often help alleviate the embarrassment and difficulty in choosing the right utensils for eating. "Caregivers need to understand that it's the same person as before, but because of the complexity of the process of eating, the person may be confused and embarrasses, and thus refuse to participate," says Occupational Therapist and founding editor of Alzheimer's Care Quarterly Carol Bowlby Sifton.
Living with Alzheimer's
A safe living environment will ensure that the patient remain in their home as long as possible. Challenges to caregivers caring for those afflicted with Alzheimer's can be incredibly stressful. However, through careful planning, many of those potential stresses, worries, and dangers can be anticipated and a home environment made as safe as possible for both the caregiver and the person suffering from Alzheimer's.
Information and prevention is the key to maintaining optimal safety and comfort, for both patient and caregiver.