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“Safe at home” is more than an idea. For people with dementia, a safe home environment is a necessity.

When a person develops noticeable cognitive decline,* his ability to use judgement and think clearly in an emergency is damaged in unpredictable ways. A person with dementia can no longer be responsible for his own safety.

Be proactive and try to work with your loved one to make changes. If you’re met with resistance or refusal, evaluate and make physical changes to your loved one’s environment while he or she is absent. Start with the obvious hazards.

• Make an emergency plan for getting your loved one out, in case of fire. Plan for your loved one’s extreme agitation and resistant behavior in such a chaotic situation.

• Reduce tripping hazards by arranging furniture to create straight pathways, and removing loose rugs and under-foot clutter. People with dementia lose coordination early.

• Replace locking interior door handles.

• Lock up household and lawn chemicals

• Use a locking box to safeguard medications, fire arms, extra eye glasses, and car keys.

• Keep extra house keys in an exterior locking box so you can get into the house if your loved one locks you out.

• Eliminate small appliances which could start fires, such as a curling iron or immersion heater.

• Secure second-story windows against opening more than a few inches. Lock balcony doors with a key. People with dementia have impaired spatial/visual perception and can easily fall out of windows.

• Remove excess clutter. Less stuff makes it easier for the confused person to process information and function. (Keep a junk drawer with safe items for your loved one to sort through and “look for” lost items.)

In the kitchen and bathroom:

• Remove control knobs or have an electrician put the kitchen stove/cooktop on a hidden switch to disable it when not in use.

• Store knives and matches in drawers or cabinets with childproof locks.

• Store personal care products in a childproof cabinet. Some people with dementia eat non-edible items due to hunger or compulsion.

Brighten lighting

• Use higher wattage bulbs and open curtains and blinds. Dim, shadowy rooms can increase confusion and agitation in a person with dementia and increase the likelihood of falls.

• Install night lights. People with dementia can get lost in their own houses at night while trying to find the bathroom.

These changes might cause anger or agitation in your loved one. Expect him to take 1-3 weeks to adjust. “Therapeutic lying” can help you ease concerns and redirect a loved one’s attention. To use it, make short, clear responses and then change the subject.

Mom: “You’ve stolen my magazines!”

Daughter: “I’ve lent them for Sunday School at church. Let’s water the plants on the deck.”

My mother, while in early stages of Alzheimer’s, angrily refused to acknowledge any changes in her cognitive abilities. Doing any of the above would have been unthinkable for my Dad and me because we underestimated the dangers and dreaded her reactions. We had to learn the hard way to put safety first.

*See The 10 Signs, Alz.org

Lee Nyberg serves older adults and their families through education on aging issues and her company, Home Care Assistance.

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