Providing for safety is an important job for caregivers. A safe environment can help prevent injuries, and it can help the person with dementia feel relaxed and less overwhelmed. To enhance safety, assess the environment for hazards. Try to see the world through the eyes of a person who has Alzheimer’s and adapt the environment to his or her needs.
Focus on prevention
• Don’t expect the person to do things safely.
• Eliminate potential hazards.
• Be patient and slow down. Accidents can happen when a person is rushed.
• Simplify routines and provide step-by-step guidance, especially during complex personal care activities such as bathing, toileting and dressing.
• Be prepared to balance safety with needs for privacy and independence.
• Be realistic. You can’t anticipate every risk or prevent every problem.
Guard against choking and poisoning
• Due to changes in the brain, the person may not understand swallowing foreign substances could cause choking or poisoning.
• Lock cabinets and work rooms that contain toxic chemicals.
• Lock up all medications. Keep track of how many pills are being taken.
• Hide potentially dangerous toiletry items such as razor blades.
• Remove toxic plants such as poinsettias or mistletoe.
• Don’t let food spoil in the refrigerator or pantry.
• Test the temperature of food before it’s served. The person may not be able to tell when food is too hot to eat.
• Be prepared for the unusual. Some people may eat items such as gravel and dirt.
Be careful about knives, appliances and electric tools
• Be aware that the person may not remember how to use appliances and tools. Potential hazards include toaster ovens, stoves, coffee makers, power tools, lawn mowers and barbecue grills.
• Know that even apparently safe devices can be hazards. For example, a person may try to open a can by jabbing it with a screwdriver.
• Place at eye level appliances that the person can safely use.
• Discourage the person from entering the kitchen without you.
• Consider precautions such as locking up knives, hiding appliances and removing knobs from the stove when not in use.
• Unplug all heat-producing appliances, such as coffeemakers, when not in use.
• Consider turning off the gas and electricity in certain areas.
• Regularly check electrical cords for frays, breaks and other damage.
• Don’t let electrical cords dangle.
• Put safety covers on electrical outlets.
Be careful about heat, cold and fire
• Keep in mind that a person with Alzheimer’s may lose sensitivity to temperature extremes and may forget about their dangers.
• Be cautious about items such as stoves, space heaters, curling irons, microwave- prepared food, and electric blankets and heating pads.
• Take precaution against scalding hot water. Set your hot water heater to 110 degrees F. Install anti-scald devices on faucets. Help the person test water temperatures and mix cold water with hot.
• Avoid accidents associated with cooking and eating:
o Turn pan handles toward the middle of the stovetop.
o Do not let the person wear loose clothes while cooking.
o Do not place containers of hot liquid near the edges of tables and countertops.
o Pour hot liquids away from the person’s body; keep the pot as far away as possible.
o Test the temperature of microwave-prepared foods.
o Use place mats instead of tablecloths.
• Listen for sizzling and crackling sounds that indicate something is heating up.
• Cover all light bulbs with shades or globes.
• Hide matches and cigarette lighters.
• Keep the person from smoking, if possible. Or supervise an individual with dementia while he or she smokes. • Install fire extinguishers and smoke alarms; check them monthly.
Prevent slips and falls
• Make sure the person wears non-skid shoes.
• Reduce clutter.
• Remove throw rugs, extension cords and other obstacles; don’t let pets sleep in traffic areas.
• Provide sturdy items to lean against along frequently traveled paths.
• Avoid rearranging furniture.
• Make sure carpets are properly tacked down on all sides.
• Wipe up spills immediately.
• Make stairways safe. Keep them well-lit, provide handrails on both sides, make sure steps are even and uniformly deep, and consider using a contrasting color along the edge of steps.
• Install child-proof gates at both the head and foot of stairs.
• Make sure lighting is evenly distributed to avoid “hot spots” and shadows.
• Install night lights on the path to the bathroom.
Ensure safety in bathrooms
• Install devices such as grab bars, bath seats and commode chairs.
• Put non-slip mats or appliqués in tubs and showers.
• Remove electrical appliances to reduce the chance of electrocution or shock.
• Install ground-fault outlets near all water sources.
• Consider installing safety doorknobs.
• Put locks at the top or bottom of doors, out of the person’s line of sight.
• Camouflage the outside door or place a dark rug in front of it to discourage the person from approaching.
• Get an intercom system (such as those used in infants’ rooms) or install Dutch doors, so you can stay aware of the person’s activities while in another room.
• Hang chimes on doors.
• Install electronic alert alarms.
• Make sure the person wears an identification bracelet, like the one available through MedicAlert® + Alzheimer’s Association’s Safe Return®.
Get rid of guns
• Remove guns from the house. At minimum, lock guns away in a cabinet or drawer.
• Don’t keep guns loaded; store ammunition in a separate place.
• Never let a person with Alzheimer’s handle a gun.
Create emergency plans
• Prepare a list of emergency phone numbers, such as the police and fire departments, hospitals and poison control centers.
• Develop escape plans in case of fire.
• Recruit someone who lives nearby to help in case of emergency. Resources MedicAlert + Safe Return is a 24-hour nationwide emergency response service for individuals with Alzheimer’s or related dementia that wander or who have a medical emergency.
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