Safety and Alzheimer’s
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The document provides safety tips and guidelines for caring for a person with Alzheimer's disease at home, including making environmental modifications, supervision recommendations, and strategies to address common behaviors like wandering, rummaging, and agitation. It also discusses driving safety, back-up care planning, and the importance of caregiver self-care. The author is a nurse with experience in long-term care and dementia who provides these recommendations and resources.
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Safety and Alzheimer’s
- 1. Safety & Alzheimer’s Providing safety at home for the person with Alzheimer’s
- 3. Natalie McFarland, RN BS Nursing 2002 Southern Illinois University LTC Since 2002 Sycamore Village 2005, Deficiency Free 6 years Certified through Alzheimer’s Association Best Friends Approach Trainer
- 4. MISSION To be our community’s resource for dementia care, research and education To provide comfort, care, love and education to both our residents and their families living with dementia To reach out beyond our walls and support healthcare providers, caregivers, family members and other in the greater community challenged by this degenerative disease through prevention, education, early detection and research initiatives To return the love to those we are privileged to serve by fostering friendships and acknowledging their live stories
- 5. What is Alzheimer’s disease? Is a progressive and fatal brain disease Causes plaques and tangles in the brain that destroys brain cells Is the most common form of dementia Has no cure
- 6. What are the symptoms of Alzheimer’s Disease? Memory problems and cognitive impairment Difficulties with thinking and reasoning Confusion and poor judgment Difficulty finding words, finishing thoughts, or following directions Agitation, irritability, or passiveness Wandering from home, elopement Not being able to tell the difference between day and night
- 7. General Safety Principles 1. Think Prevention 2. Adapt the Environment 3. Minimize danger
- 8. Is it Safe to Leave the Person with Alzheimer’s Disease alone? Does the person with Alzheimer’s: Become confused or unpredictable under stress? Recognize a dangerous situation, such as fire? Know how to use the telephone in an emergency? Know how to get help? Stay content within the home? Wander and become disoriented? Show signs of agitation, depression, or withdrawal when left alone for any period of time? Attempt to pursue former interests or hobbies that might now warrant supervision, such as cooking, appliance repair, or woodworking?
- 9. Home Safety Room by Room
- 10. Throughout the Home Display emergency numbers and your home address near all telephones. Use an answering machine when you cannot answer the phone. Hide a spare key outside in case the PWA locks you out of the home. Cover unused electrical outlets with childproof plugs. Stairways should have at least one handrail and carpeting is the safest flooring or safety grip strips. Use gates if the PWA has balance problem Turn ringers on low. Avoid the use of extension cords. Check all rooms for adequate lighting.
- 11. Throughout the Home Keep all medications locked. Keep all alcohol in a locked cabinet or out of reach of the PWA. Remove all guns and other weapons from the home or lock them up. Lock all power tools and machinery in the garage, workroom, or basement. Remove all poisonous plants. Protect computer files with passwords and back up the files. Keep hazardous chemicals out of reach.
- 12. Entryway Avoid clutter and throw out or recycle newspapers, etc. Remove rugs. Use textured strips or nonskid wax on hardwood and tile floors to prevent slipping. Keep walkways free of furniture.
- 13. Kitchen Remove or secure the family “junk” drawer Remove artificial fruits and vegetables or food magnets Consider disconnecting the garbage disposal. Store prescription and non-prescription medications in a locked cabinet
- 14. Bedroom Use a night light. Be cautious when using electric blankets or heating pads. Anticipate reasons a PWA might get out of bed, such as hunger, thirst, going to the bathroom, or pain.
- 15. Bathroom Use a night light. Do not leave a severely impaired PWA alone in the bathroom. Remove the lock from the bathroom door. Place nonskid adhesive strips, decals, or mats in the tub and shower and on floor. Use a raised toilet seat with handrails or grab bars. Install (contrasting) grab bars in the tub/shower. Use a plastic shower stool and a handheld shower head. Remove small electrical appliances from the bathroom. Set the water heater to 120 degrees.
- 16. Living Room Clear electrical cords from walkways. Remove rugs. Do not leave the PWA alone with an open fire in the fireplace. Keep the remotes controls out of sight.
- 17. Garage/Shed/Basement Lock access. Keep potentially dangerous items locked away in cabinets or boxes. Secure and lock all motor vehicles. Cover ones that are not frequently used. Keep all toxic materials out of view. Make sure area is well lit and walkway is safe.
- 18. Home Safety Behavior by Behavior
- 19. Wandering PWA should wear nonskid shoes. Place locks high on exit doors. Use doorknob covers. Use door alarms. Disguise doors. Place signs on doors. Keep departure items out of sight. Install safety device on windows.
- 20. Wandering Obtain a medical ID bracelet. Place ID labels in garments. Use a monitoring device. Notify neighbors. Keep a current photo on file with local police department. Do not leave a PWA who has a history of wandering unattended!
- 21. Rummaging/Hiding Things Remove old/spoiled foods. Simplify the environment. Create a rummaging area. Close access to unused rooms. Keep all trash cans covered or out of sight. Check trash cans before emptying them in case something has been hidden there or accidentally thrown away.
- 22. Fire Safety Install smoke alarms near kitchen and all sleeping area. Check batteries and functioning frequently. Do not keep flammable compounds accessible. If smoking is permitted, monitor the PWA while he/she is smoking. Remove smoking reminders. Install safety knobs on the stove.
- 23. Agitation Decrease noise levels. Remove mirrors. Keep furniture in the same place. Avoid violent television programs. Keep temperatures comfortable.
- 24. Special Gatherings/Holidays Consider a more intimate gathering. Have family visit in small groups. Simply your holidays to avoid stress. Avoid flammable, toxic, or breakable decorations.
- 25. Vision Create a color contrast between floors and walls. Keep colors solid. Use dishes and placemats with contrasting colors. Mark edges of steps with bright colored tape. Place pictures on doors to identify rooms such as a toilet on the bathroom door.
- 26. Taste Keep condiments hidden. Remove or lock up items such as toothpaste, perfume, lotion, etc. that may smell like food. Keep the poison control number by the telephone. Keep a bottle of ipecac. Learn the Heimlich.
- 27. Warning Signs of Unsafe Driving Does the PWA: Get lost while driving to a familiar location? Fail to obey traffic laws? Drive at inappropriate speeds? Become easily frustrated or more confused while driving? Make slow or poor decisions?
- 28. How to Stop your Loved One from Driving Be supportive. Give simple explanations. Talk to the doctor. Park the car at a friend’s house. Hide the keys.
- 29. Planning Back-Up Care Consult a lawyer. Consult with family and friends. Maintain a notebook. Preview long-term care facilities in your community.
- 30. Care for the Caregiver “Caregivers are at increased risk for depression and illness, especially if they do not receive adequate support from family, friends, and the community.” ~ National Institute on Aging
- 31. As you take on the commitment to care for a person with Alzheimer’s, please take on the equally important commitment to care for yourself.
- 32. References Department of Health & Human Services NIH Publication NO. 02-5179
- 33. Contact Us www.sycamorevillage.net www.facebook.com/sycamorevillage www.youtube.com/sycamorevillage www.flickr.com/sycamorevillage www.twitter.com/sycamorevillage Phone: 618-222-2571 Email: nmcfarland@sycamorevillage.net
Notes de l'éditeur
- Sycamore Village is an assisted living home specializing in Alzheimer’s and Dementia care. We have earned a 100% deficiency free state survey for the past five consecutive years. We were recognized by the AFA as 1 in 18 homes in the nation for Excellence in Care, a Dementia Program of Distinction. And we are at the forefront of culture change, working closely with the Pioneer Coalition and the Alzheimer’s Association.Sycamore Village is an assisted living home specializing in Alzheimer’s and Dementia care. We have earned a 100% deficiency free state survey for the past five consecutive years. We were recognized by the AFA as 1 in 18 homes in the nation for Excellence in Care, a Dementia Program of Distinction. And we are at the forefront of culture change, working closely with the Pioneer Coalition and the Alzheimer’s Association.
- 1. As many as 5.3 million Americans are living with AD today. The disease progresses over time and is fatal. It is the 7th leading cause of death in the U.S. 2. Plaques are caused deposits of protein called beta-amyloid. Tangles form inside dying cells, beginning in areas important in learning and memory and then spreading to other regions. 3. AD accounts for 50 – 80 % of dementia cases. 4. But treatment for the symptoms combined with the right services and support can make life better for those living with the disease.
- There is no “typical” person with Alzheimer’s disease. Many changes in the person with Alzheimer’s will present problems for caregivers. Therefore, knowledge and prevention are critical. Caregivers need to know that while the challenges are great, specific actions can reduce some of the safety concerns that accompany AD.
- It is difficult to predict what a PWA might do. Just because something hasn’t occurred does not mean it should not be cause for concern.It is more effective to change the environment than to try and change most behaviors.By minimizing danger, you can maximize independence. A safe environment can be a less restrictive environment where the PWA can experience increased security and more mobility. (Use example of a child in a china shop)
- As AD progresses, these questions need ongoing evaluation.
- Prevention begins with the safety check of every room in your home. As you go through the checklist, some of the changes you make many impact your surroundings positively, and some may affect you in ways that may be inconvenient or undesirable. You must try to strike a balance. You may want to consider setting aside a special area for yourself, a space off-limits to the PWA and arranged exactly as you like. Everyone needs private, quiet time, and as a caregiver this becomes especially crucial.
- A PWA may be unable to take messages or could become a victim telephone exploitation. Loud ringers can cause distraction and agitation.
- PWA are at risk for medication overdosing or taking the wrong medications. Drinking alcohol can increase the PWA confusion and put them at an increased risk for falling.
- A PWA may try to eat things that appear edible and small items such as matches, hardware, erasers, etc.
- PWA cannot sense hot or cold sometimes and are at a higher risk of burning themselves. Try to meet or prepare for the needs of the PWA before they go to bed. Have snacks and a drink at the bedside. Bedside commode if are at risk for falling in the bathroom. Pain prevention.
- Potentially dangerous items such as tools, tackle box, machines, sporting equipment. Cover vehicles including bicycles that are not frequently used. This may also reduce the possibility that the PWA will think about leaving.
- Although a number of behavior and sensory problems may accompany AD, not every person will experience the disease in exactly the same way. As the disease progresses, particular behavioral changes can create safety problems. The PWA may or may not have these symptoms. However, should these behaviors occur, the following safety recommendations may help reduce risks.
- Placing locks high will make them out of direct sight. Use loosely fitting doorknob covers so that the cover turns instead of the actual knob. Use door alarms such as loose bells above the door or devices that ring. Place scenic posters on the doors, curtains, or matching wallpaper to divert the attention of the PWA. Place signs such as STOP, DO NOT ENTER, or OUT OF ORDER. Keep departure items such as keys, coats, hats, out of sight. Install safety devices found in hardware stores to limit how much windows can be opened.
- Check with the local Alzheimer’s Association about the Safe Return program.
- The PWA may rummage for food but may not be able to distinguish if it is spoiled. The PWA may not remember what a trash can’s function is.
- Turn off extra noise such as televisions not being used. Remove or cover up mirrors if they disturb the PWA. The PWA may believe a story on television is real. The PWA may not be able to tell you if he/she is hot or cold.
- Large gatherings may cause a PWA extra confusion and anxiety. Consider a more intimate gathering with only a few people in your home. Think about having shifts of family visit in small groups. Try to have space available where the PWA can rest or be alone. Simplify the holidays by having a potluck rather than cooking to help relieve stress. Instead of elaborate decorations, consider just having a few select items. The PWA may start a fire with candles or may try to eat non-edible decorations such as holly berries.
- PWA may experience a number of changes in visual abilities. They may lose their ability to comprehend visual images. Although there may be nothing physically wrong with their eyes, PWA may no longer be able to interpret accurately what they see because of brain changes. Creating color contrasts helps with depth perception deficiencies.
- PWA may lose taste sensitivity. As their judgment declines, they also may place dangerous or inappropriate items in their mouths. If the PWA uses too much condiment, keep it hidden such as salt, sugar, or spices because too much can be irritating to the stomach or cause other health problems. Only use ipecac if instructed from poison control or 911.
- Driving becomes increasingly difficult for the PWA due to memory loss, impaired judgment, confusion, impaired visual perception, slow reaction time, certain medications, etc. PWA who continue to drive are a danger to themselves, their passengers, and the community. PWA often cannot recognize that they should no longer drive.
- “Dad, I know you’re a good driver, but…” “You cannot drive because of the medications you are taking.” Have the doctor write on a prescription pad “Do Not Drive” and explain “The doctor has prescribed that you no longer drive.” While the car is at a friend’s house, explain “The car is getting worked on at the shop”)
- It is important to have a plan in case of your own illness, disability. Consult a lawyer about setting up a living will, durable power of attorney for health care and finances, and other estate planning. Consult with family and friends to decide who will take responsibility for the PWA. Maintain a notebook for the person who will assume caregiving. Include information such as current problem behaviors and solutions, ways to calm the PWA, type of assistance needed, favorite foods and activities, life story.
- We have focused primarily on the safety and well-being of the PWA, but it is also just as important to care for yourself too. Make sure you have quiet time, time out, and time to take part in something you enjoy. Protect your own emotional and physical health.