Keeping the person with Alzheimer’s safe
Over time, people with Alzheimer’s lose the ability to do household chores.
For example, they may forget:
- Turn off the oven or the water tap
- How to use the phone in an emergency
- Distinguish which things in the home are dangerous, such as medicines or cleaning products
- Where are things in your own home
As a caregiver for someone with Alzheimer’s, you can do a number of things to make your home safer.
Add the following things to your home if you don’t already have them:
- Smoke and carbon monoxide alarms in or near the kitchen and in all bedrooms
- Emergency phone numbers (ambulance, poison control center, doctors, hospital, etc.) and home address posted near all phones.
- Safety knobs on the stove and a switch that disconnects the stove.
- Childproof plugs on all live electrical outlets
Lock up or remove the following from your home:
- All medications, including those prescribed by a doctor and over-the-counter
- Cleaning products or hazardous chemicals, such as paint thinners, matches, etc.
- poisonous plants. Contact Poison Control at 1-800-222-1222 (toll free, English and Spanish) to find out which houseplants are poisonous
- Guns and all kinds of weapons, including scissors and knives
- Gasoline containers and other dangerous objects that you have in the garage
Do the following to keep the person with Alzheimer’s safe:
- Simplify your home. Having a lot of furniture can make it difficult for the person with Alzheimer’s to move freely.
- Remove clutter, such as piled up newspapers and magazines.
- Have a firm handrail on the stairs. Carpet steps or add non-slip stair treads.
- Get rid of all small throw rugs.
- Put a special gate on the stairs to block access if the person has problems with their balance.
- Make sure the floor has good traction for walking. Having good traction reduces the chance that a person will slip and fall. The three factors that affect traction are:
- The type of floor surface. A smooth or waxed tile, linoleum, or wood floor can be a problem for people with Alzheimer’s. Look for ways to make the floor less slippery.
- The spills. Be very careful with spills and be sure to clean them up right away.
- The shoes. Buy shoes and sneakers with good traction. Check the bottom of the shoe to verify the type of material and sole.
Other tips to keep your home safe
People with Alzheimer’s tend to become more confused as time goes by. They may also no longer be able to see, smell, hear, touch, and/or taste things the way they used to.
There are certain things you can do at home to make life easier and safer for the person with Alzheimer’s:
- Use different colors on the walls and floors. This creates contrast and makes it easier for the person with Alzheimer’s to see.
- Eliminate curtains and rugs with complicated patterns that can confuse the person.
- Mark the edges of the steps with brightly colored masking tape so that the person can see the steps when going up and down the stairs.
- Use brightly colored signs or simple pictures to mark the bathroom, bedroom, and kitchen.
- Be careful with small pets. The person with Alzheimer’s may not see the pet and may bump into it.
- Limit the size and number of mirrors in your home, and consider where to place them. Images reflected in mirrors can confuse a person with Alzheimer’s.
- Set the temperature of your water heater to 120 degrees Fahrenheit to avoid burns.
- Mark the faucets, hot red and cold blue, or write “hot” and “cold” near the faucets.
- Post signs near the oven, toaster, griddle, and other things that can get hot. The sign may say: Stop! or Don’t Touch! Very hot! Make sure the sign is not so close that it could catch fire.
- Pad any sharp corners on your furniture or replace or remove furniture that has sharp corners.
- Feel the water to make sure the temperature is comfortable before the person gets into the tub or shower.
- Use smoke detectors. The person with Alzheimer’s may no longer be able to smell smoke.
- Check the food in your refrigerator often. Throw away anything that has decomposed.
- Keep salt, sugar, and other seasonings out of the person’s reach if you notice they are being used too much.
- Store toothpaste, lotion, shampoo, alcohol, soap, perfume, or laundry detergent packets in a safe or locked place. To a person with Alzheimer’s these things can look and smell like food.
- Keep the Poison Control phone number ( 1-800-222-1222 , toll free, English and Spanish) near the phone.
- Learn the steps to take if the person is choking on something. Check with your local hospital or local Red Cross office about health or safety classes.
- Do not put the television, radio or music very loud and do not turn them on at the same time. Loud music or different noises at the same time can be too much for a person with Alzheimer’s.
- Limit the number of people visiting at the same time. If there is a party, take the person with Alzheimer’s to an area with fewer people.
- Close the windows if there is a lot of noise outside.
- If the person wears a hearing aid, be sure to check the battery and settings frequently.
Drive a car safely
Good drivers are attentive, think clearly, and make good decisions. When a person with Alzheimer’s can no longer do these things he must stop driving. But it is very likely that the person does not want to stop doing it or even thinks that there is no problem. You will need to talk with the person with Alzheimer’s about why you need to stop driving. Do it lovingly. Try to understand that for the person with Alzheimer’s it can be very sad to reach this new stage.
Be prepared and find other ways for the person to travel on their own for as long as possible. Your local agency on aging has information on transportation services in your area. These services may include free or low-cost buses, taxi services, or trips where multiple seniors share a vehicle. Some churches and community groups have volunteers who take seniors where they want to go.
Here are some things you need to know about memory loss and driving:
- A person with some memory loss may sometimes be able to drive safely. But he may be unable to react quickly when faced with a surprise on the road, which can be dangerous. If the person’s reaction time slows, then you should stop the person from driving.
- The person may be able to drive short distances on local streets during the day, but may be unable to drive safely at night or on the freeway. If this is the case, then limit the times of day and places the person can drive.
- Some people with memory problems choose not to drive. Other people do not want to stop driving and deny that they have a problem.
These may be signs that the person with Alzheimer’s should stop driving:
- Your vehicle has new dents and scratches
- The person takes a long time to run a simple errand and cannot explain why it took so long. This may indicate that the person was lost.
Also consider asking a friend or family member to follow the person when they drive. What they see can give you a better idea of how the person with Alzheimer’s is driving.
Here are some ways to prevent someone with Alzheimer’s from driving:
- Try to discuss your concerns with the person.
- Ask your doctor to tell the person with Alzheimer’s to stop driving. The doctor can write “Don’t drive” on a prescription sheet and you can show it to the person. Some State Departments of Motor Vehicles (DMVs) require doctors to notify them if the person with Alzheimer’s should no longer drive.
- Ask family and friends if they can provide transportation for the person.
- Take her to take a driving test.
- Hide the car keys, park the car somewhere else, remove the distributor cap, or disconnect the car battery if the person doesn’t want to stop driving.
If the person does not stop driving, contact your state department of motor vehicles. Find out about having a medical checkup to see if a person can still drive safely. The person with Alzheimer’s may have to take the test again to drive. In some cases, the person’s license may be revoked.
Home Safety Checklist for Alzheimer’s Disease
Use the following room-by-room checklist to alert you to potential hazards and to record any changes you need to make to help keep a person with Alzheimer’s disease safe. You can buy products or gadgets necessary for home safety at stores carrying hardware, electronics, medical supplies, and children’s items.
Keep in mind that it may not be necessary to make all of the suggested changes. This article covers a wide range of safety concerns that may arise, and some modifications may never be needed. It is important, however, to re-evaluate home safety periodically as behavior and abilities change.
Throughout the Home
- Display emergency numbers and your home address near all telephones.
- Use an answering machine when you cannot answer phone calls, and set it to turn on after the fewest number of rings possible. A person with Alzheimer’s disease often may be unable to take messages or could become a victim of telephone exploitation. Turn ringers on low to avoid distraction and confusion. Put all portable and cell phones and equipment in a safe place so they will not be easily lost.
- Install smoke alarms and carbon monoxide detectors in or near the kitchen and all sleeping areas. Check their functioning and batteries frequently.
- Avoid the use of flammable and volatile compounds near gas appliances. Do not store these materials in an area where a gas pilot light is used.
- Install secure locks on all outside doors and windows.
- Install alarms that notify you when a door or window is opened.
- Hide a spare house key outside in case the person with Alzheimer’s disease locks you out of the house.
- Avoid the use of extension cords if possible by placing lamps and appliances close to electrical outlets. Tack extension cords to the baseboards of a room to avoid tripping.
- Cover unused electrical outlets with childproof plugs.
- Place red tape around floor vents, radiators, and other heating devices to deter the person with Alzheimer’s from standing on or touching them when hot.
- Check all rooms for adequate lighting.
- Place light switches at the top and the bottom of stairs.
- Stairways should have at least one handrail that extends beyond the first and last steps. If possible, stairways should be carpeted or have safety grip strips. Put a gate across the stairs if the person has balance problems.
- Keep all medications (prescription and over-the-counter locked up. Each bottle of prescription medicine should be clearly labeled with the person’s name, name of the drug, drug strength, dosage frequency, and expiration date. Child-resistant caps are available if needed.
- Keep all alcohol in a locked cabinet or out of reach of the person with Alzheimer’s. Drinking alcohol can increase confusion.
- If the person with Alzheimer’s smokes, remove matches, lighters, ashtrays, cigarettes, and other means of smoking from view. This reduces fire hazards, and with these reminders out of sight, the person may forget the desire to smoke.
- Avoid clutter, which can create confusion and danger. Throw out or recycle newspapers and magazines regularly. Keep all areas where people walk free of furniture.
- Keep plastic bags out of reach. A person with Alzheimer’s disease may choke or suffocate.
- Remove all guns and other weapons from the home or lock them up. Install safety locks on guns or remove ammunition and firing pins.
- Lock all power tools and machinery in the garage, workroom, or basement.
- Remove all poisonous plants from the home.
- Make sure all computer equipment and accessories, including electrical cords, are kept out of the way. If valuable documents or materials are stored on a home computer, protect the files with passwords and back up the files. Password protect access to the Internet, and restrict the amount of online time without supervision. Consider monitoring computer use by the person with Alzheimer’s, and install software that screens for objectionable or offensive material on the Internet.
- Keep fish tanks out of reach. The combination of glass, water, electrical pumps, and potentially poisonous aquatic life could be harmful to a curious person with Alzheimer’s disease.
Outside Approaches to the House
- Keep steps sturdy and textured to prevent falls in wet or icy weather.
- Mark the edges of steps with bright or reflective tape.
- Consider installing a ramp with handrails as an alternative to the steps.
- Eliminate uneven surfaces or walkways, hoses, and other objects that may cause a person to trip.
- Restrict access to a swimming pool by fencing it with a locked gate, covering it, and closely supervising it when in use.
- In the patio area, remove the fuel source and fire starters from any grills when not in use, and supervise use when the person with Alzheimer’s is present.
- Place a small bench or table by the entry door to hold parcels while unlocking the door.
- Make sure outside lighting is adequate. Light sensors that turn on lights automatically as you approach the house may be useful. They also may be used in other parts of the home.
- Prune bushes and foliage well away from walkways and doorways.
- Consider a “NO SOLICITING” sign for the front gate or door.
- Remove scatter rugs and throw rugs.
- Use textured strips or nonskid wax on hardwood and tile floors to prevent slipping.
- Install childproof door latches on storage cabinets and drawers designated for breakable or dangerous items. Lock away all household cleaning products, matches, knives, scissors, blades, small appliances, and anything valuable.
- If prescription or nonprescription drugs are kept in the kitchen, store them in a locked cabinet.
- Remove scatter rugs and foam pads from the floor.
- Install safety knobs and an automatic shut-off switch on the stove.
- Do not use or store flammable liquids in the kitchen. Lock them in the garage or in an outside storage unit.
- Keep a night-light in the kitchen.
- Remove or secure the family “junk drawer.” A person with Alzheimer’s may eat small items such as matches, hardware, erasers, plastics, etc.
- Remove artificial fruits and vegetables or food-shaped kitchen magnets, which might appear to be edible.
- Insert a drain trap in the kitchen sink to catch anything that may otherwise become lost or clog the plumbing.
- Consider disconnecting the garbage disposal. People with Alzheimer’s may place objects or their own hands in the disposal.
- Anticipate the reasons a person with Alzheimer’s disease might get out of bed, such as hunger, thirst, going to the bathroom, restlessness, and pain. Try to meet these needs by offering food and fluids and scheduling ample toileting.
- Use a night-light.
- Use a monitoring device (like those used for infants) to alert you to any sounds indicating a fall or other need for help. This also is an effective device for bathrooms.
- Remove scatter rugs and throw rugs.
- Remove portable space heaters. If you use portable fans, be sure that objects cannot be placed in the blades.
- Be cautious when using electric mattress pads, electric blankets, electric sheets, and heating pads, all of which can cause burns and fires. Keep controls out of reach.
- If the person with Alzheimer’s disease is at risk of falling out of bed, place mats next to the bed, as long as they do not create a greater risk of accident.
- Use transfer or mobility aids.
- Do not leave a severely impaired person with Alzheimer’s alone in the bathroom.
- Remove the lock from the bathroom door to prevent the person with Alzheimer’s from getting locked inside.
- Place nonskid adhesive strips, decals, or mats in the tub and shower. If the bathroom is uncarpeted, consider placing these strips next to the tub, toilet, and sink.
- Use washable wall-to-wall bathroom carpeting to prevent slipping on wet tile floors.
- Use a raised toilet seat with handrails, or install grab bars beside the toilet.
- Install grab bars in the tub/shower. A grab bar in contrasting color to the wall is easier to see.
- Use a foam rubber faucet cover (often used for small children) in the tub to prevent serious injury should the person with Alzheimer’s fall.
- Use a plastic shower stool and a hand-held shower head to make bathing easier.
- In the shower, tub, and sink, use a single faucet that mixes hot and cold water to avoid burns.
- Set the water heater at 120°F to avoid scalding tap water.
- Insert drain traps in sinks to catch small items that may be lost or flushed down the drain.
- Store medications (prescription and nonprescription) in a locked cabinet. Check medication dates and dispose of outdated medications.
- Remove cleaning products from under the sink, or lock them away.
- Use a night-light.
- Remove small electrical appliances from the bathroom. Cover electrical outlets.
- If a man with Alzheimer’s disease uses an electric razor, have him use a mirror outside the bathroom to avoid water contact.
- Clear electrical cords from all areas where people walk.
- Remove scatter rugs or throw rugs. Repair or replace torn carpet.
- Place decals at eye level on sliding glass doors, picture windows, or furniture with large glass panels to identify the glass pane.
- Do not leave the person with Alzheimer’s disease alone with an open fire in the fireplace. Consider alternative heating sources.
- Keep matches and cigarette lighters out of reach.
- Keep the remote controls for the television, DVD player, and stereo system out of sight.
- Keep the door to the laundry room locked if possible.
- Lock all laundry products in a cabinet. Laundry detergent pods can be fatal if eaten by accident.
- Remove large knobs from the washer and dryer if the person with Alzheimer’s tampers with machinery.
- Close and latch the doors and lids to the washer and dryer to prevent objects from being placed in the machines.
- Lock access to all garages, sheds, and basements if possible.
- Inside a garage or shed, keep all potentially dangerous items, such as tools, tackle, machines, and sporting equipment either locked away in cabinets or in appropriate boxes/cases.
- Secure and lock all motor vehicles and keep them out of sight if possible. Consider covering vehicles, including bicycles, that are not frequently used. This may reduce the possibility that the person with Alzheimer’s will think about leaving.
- Keep all toxic materials, such as paint, fertilizers, gasoline, or cleaning supplies, out of view. Either put them in a high, dry place, or lock them in a cabinet.
- If the person with Alzheimer’s is permitted in a garage, shed, or basement, preferably with supervision, make sure the area is well lit and that stairs have a handrail and are safe to walk up and down. Keep walkways clear of debris and clutter, and place overhanging items out of reach.
Driving Safety and Alzheimer’s Disease
Good drivers are alert, think clearly, and make good decisions. When people with Alzheimer’s disease are not able to do these things, they should stop driving. But some people may not want to stop driving or even think there is a problem.
As the caregiver, you must talk with the person about the need to stop driving. Do this in a caring way. Understand how unhappy the person may be to admit that he or she has reached this new stage.
People with moderate to severe Alzheimer’s disease should never get behind the wheel. People with very mild Alzheimer’s may be able to drive safely in certain conditions. But as memory and decision-making skills worsen, they need to stop because a driver with dementia may not be able to react quickly when faced with a surprise on the road. Someone could get hurt or killed. If the person’s reaction time or ability to focus slows, you must stop the person from driving.
Signs that the person should stop driving include:
- New dents and scratches on the car
- Taking a long time to do a simple errand and not being able to explain why, which may indicate the person got lost
- Two or more traffic tickets or increased car insurance premiums
- Comments from friends and neighbors about driving
- Speeding or sudden lane changes
- Confusing the brake and gas pedals
- Recommendations from a doctor to modify driving habits
- Other health issues that may affect driving ability, such as changes in vision, hearing, or mobility.
Some people with memory problems decide on their own not to drive, while others may deny they have a problem.
State laws vary regarding when a person with Alzheimer’s should stop driving. In some States, doctors are required to report to the State’s Department of Motor Vehicles whether a person has been diagnosed with Alzheimer’s or dementia. In others, anyone can report a potentially unsafe driver to the State. You may need to notify the person’s car insurance company, too.
It is a good idea to have the person’s driving skills assessed regularly by a professional. You can ask your State’s Department of Motor Vehicles or the person’s doctor to recommend someone who can test the person’s driving skills. Note that there may be fees associated with these types of assessments.
Department of Motor Vehicles staff may ask the person to retake a driving test.
When Driving Becomes Unsafe
Here are some ways to stop people with Alzheimer’s disease from driving:
- Try talking about your concerns with the person.
- Take him or her to get a driving test.
- Ask the person’s doctor to tell him or her to stop driving. The doctor can write, “Do not drive” on a prescription pad, and you can show this to the person.
- Hide the car keys, move the car, take out the distributor cap, or disconnect the battery.
Finding Other Transportation Options
If a person with Alzheimer’s can no longer drive, find other ways that the person can travel on his or her own. Look for free or low-cost buses, taxis, or carpools for older people. Some churches and community groups have volunteers who take older adults where they want to go. Family and friends are another great resource.