Precautions essential to keep Alzheimer’s patients out of harm’s way

The key to an Alzheimer's or other dementia patient staying in their own home is thinking ahead and
Occupational therapists Tina VanDerwerker, left, and Leslie Bennett demonstrate safe tub transfer at the Eddy Cohoes Rehabilitation Center.
PHOTOGRAPHER:
Occupational therapists Tina VanDerwerker, left, and Leslie Bennett demonstrate safe tub transfer at the Eddy Cohoes Rehabilitation Center.

Most people with Alzheimer’s disease or other forms of dementia want to stay in their homes for as long as they possibly can.

The key to that possibility, however, is thinking ahead and making sure the home environment is safe, said Leslie Bennett and Tina VanDerwerker, occupational therapists at the Eddy Cohoes Rehabilitation Center in Cohoes.

“When someone has Alzheimer’s disease and you are their caregiver, it’s not just about modifying the home,” said Bennett. “It’s about being able to make it safe enough for your loved one to live in but also functional enough for you.”

Alzheimer’s disease is a progressive, irreversible disease that affects brain cells and produces memory loss and intellectual impairment in as many as 4.5 million American adults.

Because the disease affects people differently, there is no one correct way to adapt your home, said Bennett.

“Everyone is different. So we really have to be sure we look at each person’s needs and modify appropriately to that person,” she explained.

“We have to look at what’s happening now and then think about and prepare for what might happen down the road. So you are always planning, evaluating and modifying the environment, appropriate for the behavior they are displaying to minimize danger.”

One should introduce the ideas of change through small, less intrusive modifications, and if repairs are needed such as adding railings on stairways, offer to help the individual make choices and deal with contractors.

Getting started

Some questions to ask yourself include:

— Is the person safe to live alone?

— Do they need a day program?

— Do they need 24-hour supervision?

Prevention begins with a home safety checklist.

“You really have to go room by room and say, ‘What do I need to do to make this room safe?’ ” said Bennett.

A good place to begin is by installing secure locks on all outside doors and windows and investing in an alarm system.

“You might also think about hiding a spare key outside that only you know where it is, so if you go out to get the mail and they lock you out, you always have a key to get back in,” said Bennett.

Cover unused electrical outlets with childproof plugs and put childproof locks on kitchen cabinets.

“You don’t want your loved one wandering into the knife drawer or even the junk drawer and finding scissors and not being able to handle them appropriately,” said Bennett.

Keep traps over kitchen drain so they don’t dump anything down the drain, and put a safety trap over the garbage disposal so they can’t put their hand down there.

Place red tape around floor heater vents to warn them to stay away so they won’t get burned.

Keep medications locked up. If you have guns, keep them empty and locked up.

If the person with Alzheimer’s is a smoker, sit with them while they smoke so they don’t cause a fire or burn themselves.

Neatness counts

Avoid clutter when possible.

“Clutter is very confusing for anyone with Alzheimer’s or any type of dementia,” said Bennett. “It can really affect their ability to go about the house. So keep things in a neat, orderly and simple way.”

Make sure any stairs on the outside or the inside of the house are nonskid, and install railings if there aren’t any. Place iridescent red tape around the edges of stairs to show where the next step is so they won’t trip and fall.

Remove knobs from kitchen burners so they can’t turn on the stove.

Because people with Alzheimer’s tend to become confused around strangers, place no-soliciting signs around your house.

When it comes to the bedroom, make sure there is a night light so they can see if they get up at night, said VanDerwerker.

“Remove any scatter rugs, because as patients wander around the house it’s easy to trip and fall,” she explained. “Also tack down any wall-to-wall carpeting that is coming up.”

Avoid using space heaters or fans where they might stick their fingers in.

“If they are using any kind of electric blankets or heating pads, make sure they are monitored, because it’s easy to leave them on and the person with Alzheimer’s could get a severe burn,” said VanDerwerker.

Move beds against the wall so there is less of a chance of the person with Alzheimer’s falling out of bed. Or put the mattress on the floor so height is not an issue.

Remove the lock from the bathroom door, or make sure there is a key available to unlock it in case the person with Alzheimer’s locks it and can’t get out.

Tub safety

Make sure the bathtub is lined with some kind of nonskid material, and leave a bath mat next to the tub so when the person gets out they won’t slide on the linoleum floor.

“You might want to install tub chairs, grab bars, tub benches, anything that’s going to make it easier for them to maneuver in and out of the tub,” said VanDerwerker.

Keep the hot water tank at 120 degrees so they can’t get scalded or burned if they use hot water.

“Remove any cleaning products from out from under the sink or put a lock on the cabinet so they can’t open it and get into the cleaning solutions,” said VanDerwerker.

Lock up all toxic paints or chemicals in the garage or shed.

“If there is an issue with driving, make sure the car is locked up and the keys are someplace where the person with Alzheimer’s cannot get to them,” said VanDerwerker. “If you have to, ask your doctor to write a prescription that says not to drive. Then offer to drive them around.”

Lock exit doors and hide the keys if the person likes to wander. “If they do tend to wander, make sure they wear a Medic bracelet that says “memory loss,” with their name and a person to contact.

“If you are close with your neighbors, let them know what’s going on,” said VanDerwerker. “If the neighbors see these people out of the house and they know they are not supposed to be out, they can take them in until you get back. Ideally, if you know they wander, don’t leave them by themselves.”

Have a backup plan in case you get sick.

“Consult with a lawyer and get a living trust and durable power of attorney,” said VanDerwerker. “Then talk with family and close friends to see who can take care of them, because you can’t do this job 24 hours a day seven days a week without help sometimes.”

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