Safety in the home

If you are caring for someone with dementia you will need to find the right balance between protecting them for the sake of safety and encouraging independence. Rather than wrapping them in cotton wool and completely curtailing their freedom you may need to accept that some minor accidents may occur. But there are some sensible precautions you can take. Here are some suggestions.

You will need to be alert for changes in the capabilities of someone with dementia. In the early stages they may be able to take baths and cook on their own. Later they will need reminders and then help.

Of course, each person with dementia is different and every home situation varies. However, carers need to be aware that accidents are more likely to happen because:

• Dementia will affect the person's memory and judgement.
• Our sense of balance and speed of reaction tends to decline as we get older.
• Physical disabilities make it harder to carry out some activities.
• Carers may feel pressurised and accidents tend to occur when people are stressed.

Avoiding accidents

You are bound to feel tired and irritable at times. However, the more agitated you are the more flustered the person with dementia is likely to become. Take some deep breaths and try to slow down or better still sit down for a few minutes.

There are a number of ways to make the home safer. An occupational therapist (OT) can advise on this and on aids for the person with dementia. You can contact an OT through your GP or social services.

Lighting

• Make sure the lighting is bright.
• Leave a good light on in the hall and a night light in the bedroom if the person with dementia is likely to get up at night.

Aids

Aids such as handrails in the hall, stairs, bath or toilet will assist the person if they are unsteady on their feet. An OT can advise (see above).

Falls

Falls are particularly common among elderly people and can be dangerous. Check the home for anything that may cause a fall such as:

• loose carpet, especially on the stairs
• broken stair rods
• slippery or highly-polished floors
• loose mats
• trailing flexes
• unsteady furniture
• old or worn footwear
• clutter or objects lying on the floor

If the person has a fall that seems serious, do not try to move them or give them anything to drink in case they need anaesthetic. Keep them warm and call for an ambulance.

Dangerous substances

• Put medicines somewhere safe after they have been taken in case the person forgets and takes an extra dose.
• Lock away any poisonous substances such as cleaning fluids, paint stripper or disinfectant in case the person with dementia drinks them by mistake.

If you think the person may have swallowed something poisonous phone for an ambulance or take them immediately to the nearest accident and emergency department. Take the container and the remains of any substance with you to help the doctor decide what treatment to give.

Kitchen

• Place items in everyday use in easy reach so the person does not have to stretch or climb on a chair to get them.
• Put away sharp knives or any appliances that the person can no longer safely use. Fit an isolation valve with a 'nursery' switch to a gas cooker to prevent them turning on the cooker when you are out.

If the person scalds or burns themselves pour cold water over the affected area for at least ten minutes to reduce the heat on the skin and lessen the pain. Remove anything tight such as watches or rings as burnt skin can swell. Do not apply ointment. Cover with a clean non-fluffy cloth and contact the GP or take the person to the nearest accident and emergency department.

Heating

Fires or heaters can be a danger for someone with dementia. They should always have a fixed guard.

• Never dry clothes over a fire or heater as this can cause a fire.
• Never take a portable electric heater into the bathroom. It could be fatal.
• If there is a gas water heater make sure it is serviced regularly and that the room is well-ventilated.
• You can fit an isolation valve and 'nursery' switch to a gas fire to prevent someone turning it on while you are out.
• You can regulate central heating and many electric fires with a time switch.

Other precautions

• Fitting gas detectors, if gas is used, and smoke alarms are helpful if other people are present in the home. The person with dementia may not know what the alarm sound means.
• The person with dementia should avoid using electric blanket if there is any risk of incontinence.
• If the person with dementia smokes make sure they do not drop lighted matches or cigarettes. Make sure they do not smoke in bed. You may need to look after cigarettes and matches or a lighter for them.

Useful numbers

Keep a list of useful numbers on a board or by the phone where you or anyone else looking after the person with dementia can easily find them. You might include:

• emergency numbers for gas, water, electricity
• GP, local hospital, social services
• local police
• local electrician, plumber, builder, taxi or minicab service
• numbers where you or other close relatives can be reached.

Give any useful information such as where the gas and water can be turned off, where the fuse box is, where the first aid box is and where a torch and spare light bulbs can be found.

Ask the neighbours

If the person lives on their own or you are out for long periods a friendly neighbour may be able to watch out for signs that something may be wrong. Leave a set of spare keys and a phone number where you can be contacted.

March 1997

Page Text supplied by The Alzheimer's Disease Society of Great Britain