At home with Dementia

At home with Dementia

At home with Dementia

Tips for making your home dementia friendly and also guidance how to take care of your loved ones.

Information and advice you need to help you love later life. We’re Age UK and our goal is to enable older people to love later life.

We are passionate about affirming that your later years can be fulfilling years. Whether you’re enjoying your later life or going through tough times, we’re here to help you make the best of your life.

This information guide has been prepared by The Leading Care Company and contains general advice only, it should not be relied on as a basis for any decision or action and cannot be used as a substitute for professional medical advice. The Leading Care Company Neither nor any companies mentioned in this article accepts any liability arising from its use and it is the reader’s sole responsibility to ensure any information is up to date and accurate.

This article about At home with Dementia cover the following

  • What this guide is about
  • Why make changes in your home?
  • If you’re reading this as a friend, carer or family member
  • The importance of lighting
  • Useful technology
  • General tips for the whole home
  • The hall and stairs
  • Into the kitchen
  • On to the living room
  • Think about the bathroom
  • In the bedroom
  • Getting out and about
  • Useful organisations

What this article is about?

If you or someone you care for is living with dementia, you may be wondering if there are some practical things you can do at home which will make life easier.

This guide will help you to think about each room in the home and see what changes might be appropriate now or in the future. Simple changes can make a big difference to someone living with dementia and they don’t have to be expensive.

As far as possible, the information in this guide is applicable across the UK.

Why make changes in your home?

Dementia is a term used to describe a collection of symptoms that occur when the brain is affected by certain diseases or conditions.

Some of the symptoms of dementia might include:

  • problems with memory, concentration and learning new things
  • difficulty doing things that were once easy
  • getting muddled with time and place
  • problems with perception and understanding
  • communication difficulties
  • balance and coordination problems.

These symptoms can have significant effects and it can be helpful to make some changes in the home to make life easier and more comfortable for the person with dementia.

This guide contains suggestions for practical changes and adaptations you could make, if they are needed. Depending on what changes are made, they could:

  • enable someone living with dementia to live safely and independently in their own home for as long as possible
  • minimize problems which may arise
  • help family members or carers to have peace of mind.

It’s worth remembering that while someone’s symptoms of dementia may get worse over time, this doesn’t mean that their quality of life has to.

If you’re reading this as a carer, friend, or family member

As a carer, friend, or family member of someone diagnosed with dementia, you may be wondering what you can do to help. If you decide to make any changes in the home, they should be determined by what the person with dementia needs and what works for them. Some changes may be more or less suitable depending on whether or not you live with them.

Important things to remember:

Not all of the changes will work for everyone
Not all of the suggestions in this guide will be needed by everyone, so read through to see what might work for your situation. Some of these suggestions may be helpful now, while others may be more appropriate for the future. This guide is intended to be a toolbox of ideas that you can pick and choose from, and adapt to the needs and likes of the person with dementia.

Involve the person with dementia as much as possible
Whatever you decide to change in the home, it’s important to involve the person with dementia as much as possible. Depending on the extent of their illness, try to approach this as a team and work together to find solutions. Focus on changes that support the person to do things that they enjoy, rather than restricting their activities. Think about their likes and dislikes too, for example, which colors they prefer.

Conversations about what to do shouldn’t be overwhelming, so focus on one or two things at a time. It may be best to present a limited number of choices rather than all of the options, to make it easier to choose between them.

Don’t make unnecessary changes
Keep in mind that a person with dementia may struggle to learn something new or adapt to changes in their home, especially if things are moved or replaced with something unfamiliar. Where possible keep things in the same places, and if you buy new furniture or equipment, try to find items that are familiar in shape, color or brand.

Don’t wait until the last minute
Whenever possible, agree any changes sooner rather than later, so the person living with dementia has time to adjust and get used to them. It’s possible that they may forget that they have agreed to any changes. How a person reacts and adapts to change will depend on them individually and the extent of the changes that have been made.

Seek advice
It’s a good idea to seek advice and information about making changes in the home. You could consult an occupational therapist, as they work with people to help them identify what home adaptations may be helpful. You should be able to arrange an assessment with one through your local adult social services, your GP, or privately. There is information about support organisations for people affected by dementia in the section Useful organisations.

The importance of lighting

As we get older we need more light for our eyes to see well. This is even more important for someone living with dementia, because their ability to understand what they see can be affected.

Lamp  Here are some basic tips for improving the lighting in your home:

  • Let as much natural light into the home as possible. Pull back the curtains, and make sure the windows are clean and not blocked by anything outside, such as bushes or plants.
  • Minimise shadows, as some people resist going near dark areas. Lighting should be even around the home. If there are darker areas try using brighter light bulbs or lamps.
  • Reduce glare. Light on a shiny floor can produce glare and be mistaken for a puddle, so try to manage this where possible, for example, by using blinds.
  • Avoid spotlights where possible, as they can cast shadows on faces and make people look less friendly.
  • If necessary, use colored tape to highlight light switches.
  • Nightlights or motion activated lights which come on if the person gets up in the night can be helpful.
  • Check energy-saving light bulbs every year as they can dim significantly over time.
  • Try to use light colors for walls, furniture and furnishings where possible. Lighter colors make a room feel and look brighter, and reflect more light.
  • Consider installing emergency lighting if you live in an area prone to blackouts.

How bright?
The brightness of light bulbs is now measured in Lumens as opposed to Watts, although some light bulbs may have both measurements on their packaging to help you choose. The brightness of a bulb is depends on the Lumens measurement and the type of bulb it is. Check the packet if you are not sure.

Assistive technology and telecare

Pointing FingerThroughout this guide we mention equipment and gadgets which can help people with dementia. These are often referred to as assistive technology (AT) and telecare.

These products are designed to help people live more independently for longer in their own homes. The products can make life easier for people living with dementia, and can also provide family members and carers with peace of mind.

There are many different types of products available, and we only cover some of them in this section. Some are more expensive than others, and some may be provided free by your local council. See the organisations listed at the end of this section for where you can get more information.

Assistive technology
There are many useful products that can help people with everyday tasks that they are beginning to find more difficult. These items range from easy-to-use kitchen equipment to specially designed clocks for people who struggle to read the time or remember the date. Items like these are called assistive technology. Some examples of assistive technology include:

Item locators – Item locators are small tags attached to items that are commonly misplaced, such as keys or a handbag. The tag can be activated from a central unit which is kept in your home. When activated the tag makes a beeping noise so you can easily find it and the item it’s attached to.

Automated pill boxes – There are many different types of automated pill boxes available. Some have an alarm to indicate when the medicine needs to be taken. Others can be programmed so they allow access to medication only at the time it is needed.

Reminder aids – Recorded reminders can be programmed to play a message at a certain time, for example to remind someone to feed a pet. Some are activated by a movement sensor, for example when the front door is opened, and will play a reminder about locking the door. Some machines have pre-recorded messages while others allow you to record your own.

GPS devices – Some people with dementia may enjoy going for walks but find that they get lost, which can worry relatives and carers. Tracking devices, some in the form of a watch the person wears or a small mobile unit they carry, allow you to see where the person with dementia is if they become lost.

MapAlways consider the needs and rights of the person with dementia and involve them in decisions whenever possible. When choosing assistive technology it’s important to find a balance between the rights of the person using it and their need to be safe. For more information please read the Alzheimer’s Society’s fact sheet and position paper on AT .

Telecare
There is a range of equipment that provides help and support for people to remain safe and independent in their homes. This is commonly referred to as telecare and includes things like personal alarms, smoke detectors, and pressure sensors. Telecare equipment links to call centres which can contact a carer, relative, or the emergency services if a problem is detected. Some examples of telecare are described below.

Personal alarms – Personal alarms allow someone to call for help, for example if they’re unwell or have a fall and can’t reach a telephone. The alarm allows the person wearing it to contact a 24-hour response centre by pressing a button on a pendant or wristband that they wear. Staff at the emergency response centre will then call either a chosen contact person – a neighbour, relative or friend – or, if the situation is more urgent, the emergency services. A personal alarm can help to provide peace of mind, although they may not be suitable for everyone living with dementia. Search for a nearby provider at www.gov.uk/apply-for-community-alarm. Age UK also provides Personal Alarms.* For more information about Age UK Personal Alarms and the likely costs, call 0800 011 3846. In Berkshire, the Age Berkshire Personal Alarm** service is available. Call 0118 959 4242 for more information.

Pressure sensors – A pressure sensor used under a mattress or on the floor by a bed can raise an alert if someone has got up in the night, or if they haven’t returned to the bed within a set amount of time. The alert can be sent directly to an emergency response center or a chosen contact, such as a carer or neighbor.

Smoke, gas, and flood detectors – There are flood, smoke or heat detectors which sound an alarm directly to a response centre or to a chosen contact, such as a family member. Gas detectors trigger an alarm when a gas fire or oven is left unlit or if there is a gas leak. Some gas detectors can also switch off the gas supply when they detect a problem.

General tips for the whole home

There are some general changes you can make around your home to allow the person living with dementia to continue doing the things they have always done and stay independent for as long as possible. Remember to involve them in any decisions about what to change.

Staying in touch

  • Keep a list of important contacts, such as close friends, relatives and anyone else you think may be useful, by the phone.
  • Some phones let you include a person’s photo next to their pre-programmed number, which can make it easier to stay in touch with loved ones.
  • If the noise of the phone ringing is confusing or distracting, try using an answering machine with the volume turned down and set it to turn on after the fewest rings possible.

Use notes and reminders

  • Notes and reminders clearly written and placed where an activity is carried out can be very helpful. For example, you could have reminders to check that taps are turned off or to take keys when leaving the house.
  • You could have a board where you pin a daily schedule or To Do list, as a reminder of what to do and when.

Check your clocks

  • Consider using a clock that has the day of the week, date and time clearly displayed, or one with images such as a sun or a moon to show if it’s day or night time. This can help if the person with dementia has difficulty telling the right time or gets confused about what day it is.

Signposting around the home

  • Signs and notices around the home can identify where things are or which door leads to which room. They can be especially helpful if they include a picture as well as text.
  • Put signs and notices at a height that is suitable for the person who needs them.

Install smoke alarms and carbon monoxide detectors

  • Smoke alarms and carbon monoxide detectors should be installed in or near the kitchen and in all sleeping areas.
  • Check regularly that alarms are working, ideally twice a year.
  • If the person living with dementia would not recognize and act when the alarm sounds, it’s possible to install alarms that trigger an alert to a call center or a nominated person such as a carer – see our section on telecare.

Mark around hot appliances

  • If you are worried about the person burning themselves on floor vents, radiators or other heating devices, then you could place red tape around these appliances, as a reminder to avoid them.

Patterned curtains and carpets

  • Dementia can affect how some people see things. For example, patterns on curtains, cushions or wallpaper may be confusing, as a person with dementia may see images, for example faces, in the shapes.
  • A patterned carpet or rug might look like uneven ground or a hole, and rugs with speckled designs or dots may look as if they have things scattered on them.
  • If you are changing your carpet or wallpaper, consider replacing them with a design without patterns.

Use similar floor tones between rooms

  • A threshold between rooms can be seen as a barrier because it can look like a step. Keeping similar floor tones between rooms can encourage someone to move round more freely.

Contrasting furniture

  • Furniture that contrasts in tone with the wall and floor makes it easier to see.
  • Some colours – such as red and pink – blend into each other even though they are different, so choose contrasting tones with a mix of darker and lighter colours.
  • Make sure that the furniture suits the person’s individual taste, so involve them in any decisions.

Color coded keys and locks

  • You can buy different coloured tabs to put on your keys and paint the corresponding lock with the colour of the correct key to save confusion about which key fits in which lock.

Clutter

  • Clutter can be confusing on the eye and can act as a trip hazard. Try to keep things cleared away and avoid clutter where possible.
  • Remember to involve the person with dementia when clearing out any clutter.

Noise

  • Noise can be distracting or distressing for a person with dementia, especially if they can’t filter it out, or they don’t know what it is or where it is coming from. Shut doors between rooms to reduce background noise.

In the hall and on the stairs

It’s easy to overlook these areas, but depending on what the person with dementia needs some changes to the hall and stairs can make them more accessible and safe.

Recorded reminders

  • There are lots of reminder gadgets available, for example, to play recorded reminders for someone to pick up their keys or lock the front door. For more information about reminder aids, see the section on assistive technology.

Using the stairs safely

  • Marking the edge of each step with a contrasting tone can help, as some people with dementia find it hard to judge depth or see individual steps.
  • Consider installing a second banister rail, in a contrasting tone so it can be seen more clearly.
  • A stair gate at either the bottom or the top of the stairs could help for safety, but this would depend on the person’s needs and may work for some but not others.
  • Remember that rugs or mats at the top or bottom of the stairs can be a trip hazard.

Divert attention away from the front door

  • f you are worried about the person going out by themselves then you could make some basic visual adjustments to the front door. For example, you could place curtains over the door, paint the door so it blends in with the walls or place STOP signs on the door.
  • It can also be a good idea to keep keys, coats, hats and other signs of departure out of sight.
  • Keep the door unbolted on the inside so carers or visitors can still get in.

Into the kitchen

If the person with dementia likes to make their own tea or coffee, or if they enjoy cooking, some small changes in the kitchen can help them to continue to do this, depending on the person’s needs and wants. As getting used to change can sometimes be difficult, try to keep things familiar when possible.

Use labels

  • If the person finds it difficult to ignore things, you could label cupboards and drawers with ready-made labels or ones you make yourself. Labels with images can help too.
  • It might help to label frequently used items, such as tea and sugar, and keep them in sight or in clear containers.

Use glass-fronted cupboard doors and color contrasting handles

  • Clear (glass-fronted) cupboards or open shelving units make it possible to see inside them without the need for stickers or labels.
  • Try color contrasting or large handles on drawers and cupboards so they are easier to see and use.

Use charts and instructions for tasks

  • Charts and instructions for tasks such as tea-making can help the person to keep doing these things independently.
  • When using charts, place them where the activity will be carried out so they can be seen easily.

Insert a drain trap in the kitchen sink

  • A drain trap will catch any items that may accidentally be dropped down the sink.

Avoiding scalds and burns

  • Be aware that stainless steel kitchen appliances such as kettles or toasters, can get very hot and could cause a scald or burn.

Fit an automatic shut-off mechanism on the cooker

  • A person with dementia may start cooking and then forget they have left the cooker on. Some newer cookers have automatic shut-off mechanisms which can turn the cooker off after a certain amount of time.
  • If leaving the gas hob on is a problem you can get a gas detector alarm. See our section on telecare.

Store items away safely

  • Some people living with dementia may not recognize harmful substances or be able to use knives. If so, it’s a good idea to store away household cleaning products, matches, knives, scissors and anything else that could be harmful.
  • You may want to remove any artificial fruits and vegetables or food-shaped magnets that might appear to be edible.
  • Don’t store pet food in the fridge or cupboards with other food – make sure it’s kept safely somewhere else.

Use contrasting tones for cutlery, crockery and table cloths

  • sing contrasting tones for kitchen utensils makes it easier to identify the crockery and the food. For example, mashed potato on a white plate can be difficult to see, as can brown stew on a dark blue plate. A contrasting tone plate will make the food more noticeable.
  • Use plates, cutlery and table mats which contrast with the tablecloth to make them more visible.

CutleryHaving a diagnosis of dementia doesn’t mean that a person can’t do things and do them safely. Some of these suggestions may not be needed or wanted. Any changes in the home should reflect what a person can do and what they like to do.

On to the living room

Some small adjustments to your living room can ensure that it remains a comfortable and reassuring place.

Check for tripping hazards

  • Removing trip hazards like worn rugs, trailing wires, and clutter can help to prevent falls.
  • Avoid using glass furniture, such as coffee tables, as it is harder to see and could cause a stumble.

Display photos

  • Photos of family members, friends, occasions and old photos from childhood can be comforting and trigger memories. If necessary, photos can also be labelled with names and relationships.
  • An electronic picture frame can be useful as the photos change regularly and provide more variety, but don’t use one if it would cause any confusion.

Try music and radio instead of the TV

  • Music and the radio can have a calming effect. They can be used for background noise, or to remind people of favourite tunes or music.
  • The person may like to listen to music using a record player as this may bring back memories.
  • Music can sometimes be a better option than TV or film, as someone living with dementia may find story lines hard to follow.
  • Background noise can cause problems if someone is having a conversation or trying to remember something, so turn off the music if it becomes distracting.

Check decorative items

  • Decorative items with emotional value, such as vases, paintings or figurines, can be enjoyable and trigger memories. However, some people may find them visually confusing and may not be sure what they are seeing.
  • Remove items that cause any confusion and keep the ones which are a source of pleasure. Do this with the person so they are involved in the process.

Thinking about the bathroom

If you want to make the bathroom safer, these tips could help.

Use flood preventing plugs

  • You can buy inexpensive plugs that let water out automatically when the bath becomes too full. Some also change color if the water is too hot.

Use contrasting tones

  • Items such as toilet seats, grab rails, towels and soap that contrast with the surface beneath or behind them can be recognized more easily.

Keep medicines safe

  • Keep medicines out of reach and safely stored away if the person can’t manage them independently.
  • Clear out the medicine cabinet regularly and ask your local chemist to dispose of out-of-date or unwanted medications.

Make it easy to find the bathroom

  • A brightly colored bathroom door can help the person to find the bathroom more quickly if they have difficulty with this. Use a color that they like.
  • You could use a sign on the door, or leave the door open so the room can be seen.
  • Depending on their needs, you could remove the lock from the bathroom door to prevent someone accidentally getting locked inside.

Make sure taps are easy to use

  • If you are changing your sink or taps you might want to choose traditional designs with separate hot and cold taps, as some people may find these more familiar than modern mixer taps.
  • Set the hot water heater to a safe temperature to avoid scalding.

Check the mirrors

  • Some people with dementia get confused by mirrors. They may see a reflection in a bathroom mirror and think the bathroom is already occupied. Alternatively, they might still think of themselves as a younger person and find the reflection they see hard to understand. If this happens you could cover up the mirrors, for example with a roller blind, so that they can still be used when needed.

Consider bigger adaptations

  • You may find that the time comes when a bigger change to your bathroom is needed. This might include creating a walk-in shower, getting a bath seat installed, or even creating a wet room – where the entire room is tiled and there is no separate bath or shower.
  • For further advice about home adaptations, see our free information guide Adapting your home.

Medicine

Keep medicines out of reach and ask your local chemist to dispose of out-of-date or unwanted medications.

The bedroom

Adapting the bedroom doesn’t necessarily involve buying expensive equipment. There are lots of simple changes that can make a difference.

Make sure there is a night light near the bed

  • A night light is important if the person gets up during the night. However, if having a night light disturbs or confuses the person, you could install a motion-activated light that only comes on when they get out of bed.

Try bedclothes in contrasting tones to the floor and walls

  • Bedclothes that contrast in tone with the floor help the bed to be more visible. Choose a colour that the person likes – take them with you or show them pictures from a catalogue when deciding what to buy.
  • Avoid choosing highly patterned duvets and blankets, as these can be visually confusing.

Make it easy to find clothes

  • Try not to keep too many clothes, shoes or cosmetics in shelves or wardrobes. Too much choice can make it difficult to select things or choose between them.
  • You could leave out one set of clothes and footwear ready to wear where the person will see them.
  • If they have difficulty getting dressed and putting on their clothes in the right order, lay the clothes out in the order they should be put on, with underwear first.
  • It’s possible to buy wardrobe rails that go from front to back, so it’s easier for someone with dementia to get dressed if the clothes are hung in the right order.

Use pressure sensors in or beside the bed

  • Pressure mats can be placed under the mattress or beside the bed and detect if the person has got up and not returned to bed within a certain time.

Bed

It may take time, and trial and error, to find out what works in your circumstances. Remove anything that causes confusion or distress, as any changes have to be tailored to what the person living with dementia needs and what works for them.

Getting out and about

Getting fresh air and sunshine is good for physical and mental well being. Encourage the person to go out when possible. If they like going outside for a walk, gardening or sitting outdoors, then a few adjustments can enable them to continue to do this as safely and independently as possible.

Gardening

  • If the person with dementia likes gardening and can use tools, a set with brightly colored, long, or easy-grip handles could make gardening easier and more pleasant.
  • Store any tools that could be dangerous safely and out of sight.
  • Contact the organisation Thrive, which encourages and provides support for older and disabled people to do gardening, for further advice about equipment.

Key safes

  • If you are worried about losing a key or are concerned about access to the property, you could install a key safe on the side of your home. Key safes are used to lock away spare keys securely and can only be opened using a code or password. Only trusted friends, relatives or neighbors should be given the code, so they can access the property when needed. Only use a police-approved key safe and make sure you get it installed properly.

Transport

  • People with dementia may be eligible for a Blue Badge if they have reduced mobility.
  • If the person can no longer drive safely, make sure all vehicles are locked and and kept out of sight if possible, and store the car keys safely.
  • Some local authorities offer subsidized taxi schemes which may help people with dementia stay independent if they aren’t able to drive and don’t feel confident using public transport.

‘No cold callers’ signs

  • People with dementia can be vulnerable to scams and may find unwanted callers confusing. Put a no cold callers sign at the front door to deter doorstep sellers. See our guide Avoiding scams for more information.

Neighbors

  • If you have a good relationship with your neighbors, and the person with dementia agrees, you could tell them about the diagnosis. Then the neighbors can keep an eye out for anyone trying to take advantage of the situation and be aware of any concerns for the person’s safety.
  • If the person with dementia has favorite destinations, such as the post office, newsagent or a café, let the staff there know about the person’s condition (again, if the person with dementia agrees) so they understand and can offer assistance if needed.

Exterior handrails

  • If needed, think about fitting exterior handrails to make the garden and outside areas more accessible, and outside the front door if there is a step to get inside.

Help cards

  • Helpcards for people with dementia can be kept in a wallet or purse. These state that the person has dementia and contain basic personal information and contact details in case of emergency or if assistance is needed. Contact the Alzheimer’s Society for more information.
  • Some local authorities and carers’ support groups have cards for carers too. Ask your local authority if it has such a scheme.

Holidays

  • People living with dementia can still enjoy going on holiday. Contact Dementia Adventure to find out more about supported and specialist holidays.
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