How to Create Safe Environments for People with Dementia

older woman with younger woman

When someone is diagnosed with dementia, his or her safety should become a top priority. Activities that once seemed simple and safe can turn into dangerous tasks as the symptoms progress.

“While dementia is most commonly recognized for the memory changes that occur, there are also physical and functional changes that can pose safety risks to patients,” said Karli Urban, MD, a geriatric medicine specialist with MU Health Care. “Even if someone has lived in the same house for 40 years, he or she might forget about the rugs in the hallway or the steps leading to the living room, and this can result in falls and injuries.”

Karli Urban, MD
Karli Urban, MD

Urban, who is assistant professor of Clinical Family and Community Medicine at the MU School of Medicine, said to clear all walkways of items that could be trip hazards and consider installing railings and safety gates in stairwells.

Beyond adjusting the home’s decor, Urban said the following four precautions will help create safe environments for people with dementia:

  • Supervise all cooking. Any household appliance can potentially pose a challenge to people with dementia, but the oven and stove might be the most dangerous.

    “It is not uncommon for patients with moderate and advanced dementia to forget about food they are cooking on the stove or in the oven,” Urban said. “Not only is this a major fire hazard, but it can also negatively impact the individual by resulting in missed meals.”

    Urban said to supervise all cooking in the home and to unplug the oven and stove when leaving loved ones unattended for long periods of time. If food must be heated, microwaves are usually the safest option because they shut off automatically, she said.
  • Monitor the exits. Sometimes, what was supposed to be a quick trip to the mailbox will turn into a much longer excursion that leaves friends and family worried. Urban said people with dementia can more easily get steered off course by distractions, or they might decide to walk toward a faraway destination after forgetting why they stepped outside.

    “Family members or friends who live with the affected individual need to know when he or she has left the house,” Urban said. “There are many solutions for this, ranging from high-tech home security apps to low-tech doorbells that chime when exterior-facing doors open.”

    Urban advised against locking your loved one inside the home because it’s important for him or her to be able to exit during an emergency. She said installing an inexpensive bell atop an unlocked door is a safer option.
  • Take the wheel. Cars become increasingly dangerous as dementia progresses. In addition to getting lost, Urban said patients with dementia may also have impaired reaction time or difficulty with visual and spatial reasoning. Each of these concerns further increase the risk of driving.

    “Sometimes, it can be as simple as removing the car keys from the house and telling your loved one that they are lost,” Urban said. “Other families prefer to remove the battery from the vehicle so it will not start, or they will physically remove the car itself from the home.”

    Urban said to speak with a physician about a formal driving assessment when concerned about a loved one’s safety behind the wheel.
  • Hide the guns. Gun safety is also something Urban emphasizes when speaking with families.

    “Even if someone has always been a safe and responsible gun owner, it might no longer be appropriate for him or her to operate weapons,” Urban said. “Secure all guns in an area that is inaccessible to your loved one, or remove them from the house altogether.”

When taking these safety precautions, Urban said to avoid arguing with loved ones about them. Attempting to justify the situation might only exacerbate their frustration. Instead, try to redirect their attention to another topic.

Lastly, she recommended speaking with the loved one’s primary care provider about safety concerns and precautions, because these recommendations will be tailored to his or her unique condition and living situation.

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