Safety issues

Find out about some of the safety issues that need to be considered when caring for someone with dementia. Tips for safety inside and outside the home, and a basic safety checklist for use by families and carers.

Assisting people with dementia

Dementia affects each person differently. However symptoms such as confusion, memory loss and disorientation are usually present, and problems with mobility and co-ordination may also affect safety. It is important that family, carers, friends and health professionals assist the person with dementia to feel and be as secure as possible. 

Safety in the home

The best living environment for a person with dementia is one which helps them to be as happy and independent as possible. Familiarity is important for a person with dementia. The home environment should help them know where they are and to find where they want to go. Changes in this environment may add to confusion and disorientation.

Some safety tips

  • Arrange furniture simply and consistently and keep the environment uncluttered
  • Remove loose rugs and seal carpet edges that may be safety hazards
  • Nightlights in the hallways and in the toilet may be useful to assist a person to find their way to the bathroom at night
  • Dispose of or safely store all medications and hazardous materials such as kerosene
  • Electric blankets and hot water bottles can both be a safety hazard for a person with dementia and therefore are better removed
  • Safety switches are now recommended in homes
  • Automatic cut offs for hot water jugs and other appliances are recommended
  • Replace more dangerous forms of heating, such as bar radiators, with safer heating options such as column heaters
  • Check appliances, such as heaters and toasters, to make sure they do not present any safety hazards
  • Replace long electrical cords on appliances with coiled or retractable cords
  • Thermostats are available to control the level of heat that comes out of the hot water taps
  • Smoke detectors are important for everyone. A person with dementia may need someone else to check the battery and make sure the alarm is loud enough.

Safety outside the home

Some people with dementia may become disoriented and get lost in unfamiliar, or even in previously familiar surroundings. Therefore it is important at all times that they carry appropriate identification, including their name and address and an emergency contact number. An identity bracelet is ideal.

Some safety tips

  • Keep paths well swept and clear of overhanging branches
  • Check catches on gates
  • Remove poisonous plants and dispose of hazardous substances from sheds and garages.

Aids to independence and safety to consider

  • Hand held shower hoses allow a person to direct the flow of water as desired
  • A shower or bathseat allows a person to be seated while bathing and eliminates the need to lower yourself into the bath
  • Hand rails at bath, shower and toilet
  • Easy to read clocks, large calendars will help to orient to time
  • Heat sensors or alarms may help
  • List of contact names and numbers in large print placed by the telephone.

Safety checklist for the home

It may be useful to go through the house room by room to assess for any safety hazards. This checklist may help.

Access to the home

  • Steps
  • Path

House – general

  • Is the house cluttered?
  • Is lighting adequate?
  • Is floor covering non-slip?
  • Check doors, windows, heating

Living area

  • Chair heights
  • Protruding furniture
  • Kitchen
  • Floor
  • Flammable material
  • Taps
  • Electrical and gas equipment
  • Kettle
  • Poisons
  • Cupboards
  • Drainage in floor
  • Electrical connections away from possible contact with water or heating sources

Bathroom

  • Floor
  • Hot water thermostat control
  • Poisons
  • Toilet height
  • Toilet paper visible

Laundry

  • Storage of poisons
  • Drainage
  • Electrical connections away from possible contact with water

Bedroom

  • Bed height
  • Chair in bedroom for dressing

Wandering

  • Identification bracelet
  • Identification and emergency contact details in wallet
  • Bell on door, window and gate

Principles of problem solving

Solving problems involves continual assessment and planning. The following principles should guide any changes to the environment of a person with dementia:

  • Involve the person with dementia in identifying problems and deciding on changes to their environment, where possible
  • Ensure that modifications suit each individual
  • Respond to specific problems. Don’t introduce standard modifications
  • Change as little as possible. Retain the familiar
  • Build on strengths and maximise autonomy
  • Try simple solutions first
  • Ensure that modification are home-like and dignified
  • Changes should be era and culture appropriate
  • Weigh up risks and try to achieve a balance between safety and autonomy
  • Ensure that family, carers and workers have a safe working environment.

Adapted from At home with dementia, NSW Department of Ageing, Disability and Home Care.

Further Information

The Independent Living Centre (ILC) in each State and Territory offers a number of services designed to promote safe living. Information is available on a number of products including smoke detectors, hot water service temperature regulators and monitoring services. Advice is also available on home modifications and home design.

For more information call the National Dementia Helpline on 1800 100 500.