Creating a dementia friendly home - Lizzy Care Guide

Making changes around your loved one’s home can help them to remain independent, safe and comfortable in their own living space for longer.

Whether your loved one lives alone, with you or is in facility based care, making their space safe and comfortable takes thought and effort. Some changes will seem obvious, like picking up that rug that you always trip over but some might not occur to us, like investing in some brightly colored crockery so it’s easier for your loved one to see the edge of their dinner plate.

Dementia affects many aspects of the brain and when coupled with our increasing frailty as we get older it makes getting around and conducting everyday tasks a real challenge. 

Making some changes around their home can help your loved one to remain independent, safe and comfortable in their own home for longer. If your loved one is in the earliest stages of the disease you can start off with some of the simple home modifications but you’ll need to constantly adapt as the conditions and their cognitive function declines. 

As you think about the right adaptions to make here are some of things to consider about your loved one:

Ability: 

Can your loved one get around easily? Are they steady on their feet? Can your loved one still easily use the things around the home? Is it easy for them to keep their home clean and tidy? Do you need to consider buying adaptive appliances? How is their vision and hearing? 

Orientation: 

Dementia affects our sense of time and place, making it easy to get lost even in your own home. What changes can be made to make it easier for your loved one to find their way around as well as find the things they need? Using objects like large clocks and calendars can also help keep someone orientated to the time of day and date. 

Understanding: 

Does your loved one still remember how to use the objects around the home? Do they need help preparing meals? Do they become easily confused? 

Depending on the answers to the questions above you can think about which of the recommendations that appear in this course are the right choices for your loved one. 

It is usually best to discuss any proposed changes with your loved one and involve them in the process. Sometimes it can be hard for your loved one to accept the need for changes and so be patient and explain why you think the changes will help them. Stay positive and provide them with lots of reassurance. 

Home assessments

Medical professionals such as Occupational Therapists (OTs) and Physical Therapists (PTs) can conduct home safety evaluations and will make recommendations on the specific things you can do to improve the home of your loved one. When conducting the assessment the OT or PT will not just look at the home itself, they will also examine how your loved one uses their home to make the best suggestions. 

Sometimes it can be helpful to have an outside eye who can help walk through the home and identify risks as well as provide suggestions on how you can make the home safer for your loved one as well as easier to manage and maintain so your loved one can maintain their independence. 

If this is something of interest to you then you can use the Meet section of the Lizzy app and choose Home assessment.

Reducing fall risk

One of the biggest reasons to make changes around the home is to reduce the risk of your loved one having a fall. People with dementia are much more likely to fall than older people who do not have a cognitive impairment and also at a higher risk of sustaining injuries and being hospitalized.  

Reduce clutter 

An untidy home can be distracting as well as providing lots of objects to trip over. When lots of items are around the home it can be hard for your loved one to find the things they need. Put away unnecessary items and put items that are regularly used in noticeable places. 

Keep hallways and thoroughfares free of objects and anything that your loved one might trip on or that will get in their way. Does your loved one use a walker or a cane? Make sure there is enough space to easily move around when using mobility aids. 

Lighting

Improved lighting reduces the risk of falls and also helps to avoid confusion. Ensuring there is good light in the bathroom, the stairs and hallways is particularly important in helping your loved one avoid trips and falls. 

Lots of natural lighting will help your loved one to see clearly in their home and is also good for the soul.  

• Remove objects that are blocking light from coming in through the windows. 
• Make sure curtains and blinds are easy to use. 
• Make sure the hedges and trees are cut back if they are blocking sunlight from getting in. 

Reduce any sources of glare, shadows and reflections. Shadows can confuse or even frighten someone with dementia. 

Light switches should be easy to spot and be at an accessible height. You could even consider purchasing glow-in-the-dark switches or using glow-in-the-dark stickers.

Make sure there is a light switch at both the top and bottom of the stairs. 

Add lights to dark cupboards and closets. 

Consider using nightlights along the hallway and ensure there is an accessible nightlight so if your loved one needs to get up during the night it’s easy for them to see. 

Make use of high wattage but low energy light bulbs. 

Add good drapes or blackout blinds to the bedroom to block out natural light to make sleeping easier and avoid seeing shadows or illusions from external light. 

Motion sensors can be used to automatically turn on lights around the home. These can be particularly helpful in the bathroom. 

Flooring

Check to make sure that the floor is safe to walk across. Are there any loose boards? Try to level off any uneven surfaces. Replace any damaged flooring or rippled carpets. 

Remove rugs, mats and carpets that can be  easy to trip over and the dementia may make them seem like objects that need to be stepped over. If you want to leave a rug in place consider using an anti-slip rug pad or secure it with double sided tape. 

Avoid shiny floors. A floor that looks like it might be wet will make your loved one uneasy or nervous. 

Make sure that there aren’t any loose cables getting in the way. Use cable tidies or fix cables to the wall. 

Edging 

Add some pipe insulation, cushions and padding to sharp edges or corners that could be of serious risk in the event of a fall. 

Use brightly colored, non-slip tape to highlight doorsills and the edges of step steps. 

Hardware

Installing grab rails, handlebars in places that they will help your loved one or they might trip. Railings on stairs and in hallways. 

If the walls are light in color then use a darker shade for handrails so that they will be easier to see. 

Fall detection devices

There’s a barrage of advertisements for fall detection devices and technologies but selecting the right system isn’t as easy as it seems. Standard medical alert systems might not be right for a loved one with dementia as your loved one may forget to wear their pendant or to charge it. Or simply won’t remember to push a button if something happens. 

False alarms are common with fall detection buttons and pendants. Sometimes a button gets pressed accidentally or your loved one is just testing out the system. Working with an alert system that can trigger an alert for non-emergency situations can be helpful to check on your loved one even when there’s no need for the emergency services. 

Some alert systems are connected to apps so that they will alert you if there is a fall or a request for assistance made. 

As well as the traditional pendant or watch based fall detection platforms that you need to wear and there are also wireless fall detection sensors that you can install around the home. These have the advantage that you do not need to remember to wear or charge them but of course will only cover your loved one when they are in their home. 

If your loved one is at risk of wandering you can look for an alert system that combines a GPS so that you can track your loved one’s location in an emergency. 

Creating a calm environment

Make a few changes around the home to make it more comforting and calming for your loved.

Smart use of color 

People with dementia are very sensitive to color and it may also affect their ability to tell the difference between colors. Clashing patterns and stripes can cause agitation due to the increase in visual stimulation. Light, single colors are ideal. Dark colors can be mistaken for empty spaces or holes. 

• Choose a contrasting color for the wall and the floor so that it’s easy to see the edge.
• It is usually best to paint walls in a single light color and baseboards in a darker tone.
• Using bright and bold furniture that contrasts from the walls will help them stand out. This might include the bed, table and chairs. 
• Adding contrasting colors on rails and banisters will also make them stand out

Doors are important 

People with dementia might start to forget where the rooms are in their home. Leaving interior doors open so that they’re visible makes it easier for them to navigate the house.

If there are rooms that they should not go into make sure those doors stay closed and add a no entry sign. Depending on your loved one’s sense of adventure a ‘do not open’ sign act as more of an incentive than a deterrent and so you might need to get a little inventive with your signs. Try using a ‘danger’ instead. 

Noise levels 

People with dementia are sensitive to loud and sudden noises. Reduce the business around the home. Carpets, cushions, curtains and drapes can all absorb background noise. 

Consider whether double glazing needs to be installed to reduce noise disturbances coming from outside. 

Turn off the television or radio if nobody is paying attention to it. 

Fix any squeaky cabinet doors! 

Also consider where your loved one’s bedroom is in their home in relation to noisy areas of the house. 

Think about noise coming from air conditioners, fans and heating systems. Does that need to be reduced? Can a better location be found? 

Create visual reminders

Add signs on cupboards and drawers so that it’s easy to know what’s inside them. Good signs should be clear, have both the word and a picture of the object. Consider your loved one’s height and gaze as you place the signs, older people tend to look downwards.

Make sure there is a consistent and obvious place for important objects like keys, wallet and phone so they are easy to put away and pick up as you leave.

Reflections

People with dementia can sometimes become distressed if they do not recognise themselves. If this is happening with your loved one then you can cover or remove any mirrors. 

Orientating items

Add an easy to read clock that clearly states the time of day to rooms where your loved one spends a lot of time. An LCD clock that also shows the time and date can be particularly helpful. 

Consider getting your loved one a large print calendar. 

Memories and keepsakes 

Placing photos of family and mementos around the home.  Promotes positive memories and encourages reminiscing.  

In the kitchen

The kitchen is an important place to get right. Not only does it contain a lot of potential risks, making sure that  your loved one can remain independent means making sure they can cook and prepare meals by themselves. As their dementia progresses your loved one may need adaptive utensils.

Finding things

Finding things in the kitchen or not putting things back in the right places can be one of the first signs that a loved one has dementia. 

Put signs or photos on the front of cabinet doors and drawers so that your loved one knows what’s inside and can find things easily. You could even consider removing cabinet doors or replacing them with see through doors. 

Consider using a buffet table to store crockery, cutlery and glassware and keep it near to the dining table so that your loved one can easily set the table by themselves. This will help them remain independent as well as providing a meaningful activity. 

Kitchenware

Use plates, cups and tablecloths with colors that contrast with food as well as placemats and tablecloths so that it’s easy to see the food on the plate as well as the edges of the plate when set down. If you are using table mats make sure that they’re non-stick. 

Use plastic storage containers so that it is easy to see what is inside. 

If you need to replace any of the kitchen appliances make sure you purchase a new one that works in a similar way to the old one and feel familiar to your loved one. 

If your loved one is struggling to grip and hold objects then you can purchase adaptive utensils, dishes and drinking cups to make it easier.

Oven safety 

If you are concerned about your loved one leaving the oven on then there are special stove monitoring appliances that can be fixed to an oven or stove that will automatically turn it off if it is left on. Stove monitoring devices are usually quite expensive and may require professional installation. 

Induction cooktops can be a safer option than gas or electric stoves. 

Make sure that there is a smoke or gas detector and a carbon monoxide detector installed and they have a working battery. Set a reminder to check the battery is still working each year. 

Bathroom

The bathroom is probably the room in the house that poses the most serious risks as we get older, especially when faced with dementia. Most falls occur while seniors are getting in and out of the bathtub or shower or while using the toilet.

Grab on

Add grips, handles and grab bars in the bathroom especially to assist with getting in and out of the bath or shower as well as on and off the toilet will make it easier. Make sure that any grab or handlebars are securely fastened to the wall. Traditional towel bars might not be able to support your loved ones weight. 

Bathtub

Use a non-slip mat or stickers in the bath so it is not so slippery.

Add a shower chair so that your loved one can sit when taking a shower. Make sure that the chair has a non-slip seat and has rubber tips on the feet so it won’t slide in the shower or tub.

Add a strip of colored tape along the curb and edge of the bathtub or showe so that it’s easy to distinguish

Consider switching your loved one from a bath, which they have to step over to get in and out of, to a standing shower. It’s also possible to convert the bathtub by cutting out a portion of the bath and for the more adventurous installing a water tight door so your loved one can still enjoy a bath. 

A bath bench can also help a loved one get in and out of the bath. The bath bench extends over the side of the bathtub so that two legs are resting on the floor. Your loved one can then sit on the bench and swing their legs over the side of the tub, and more safely stand back up.

A hand held shower head might make it easier for your loved one to wash themselves or for you to assist them while washing. 

At the sink

Adding a stool near the sink can help if your loved one is struggling to stand and wash, brush their teeth or apply make up. 

Label the facets with hot and cold. As we age our skin gets more delicate and we’re at increased risk of burns caused by hot water. 

The toilet

You could add a contrasting colored toilet seat to draw attention to it and make it easy for your loved one to find. Or simply removing the lid of the toilet can also make it easier to identify. 

A raised toilet seat can also make it easier for your loved one to sit and stand independently. 

If you’ve ever raised a boy then you might have come across toilet targets. They can be just as useful for older men with dementia as it helps them to see where they are aiming and to keep their pee inside the bowl.

Finding the bathroom 

Add a sign to the door with a picture so that it’s easy to identify the bathroom. 

You may need to get a lock that can be easily opened from the outside so that you can get to the bathroom easily if your loved one is stuck or has fallen. 

Towels and bathroom supplies

Remove any items and bottles that aren’t being used regularly. 

Purchasing towels and toilet paper that are in a contrasting color to the wall will make them easier to spot. 

Place items on shelves at eye level so your loved one doesn’t have to reach up into a cabinet or bend down to look inside a vanity to get what they need. Remember that as we age we tend to look down and so eye level might need to be a bit lower. 

Outdoor spaces

Outdoor spaces can offer lots of therapeutic benefits to your loved one as well as presenting risks from falls or if your loved one has taken to wandering. 

Gardening can awaken long-term memories as it is a sensory experience that involves sight, smell and touch.

Spending time in the garden

Make sure any paths are level and flat. Look out for patches of moss or mold that might make  a path slippy. Clear away overhanging branches. 

If there are any steps to make sure they are secure, add a support rail if needed. Use brightly colored tape to highlight the edge of steps. 

Adding a sheltered seating area can allow your loved one to stay outside for longer and relax. 

A green thumb

Adding raised beds can help your loved one to continue with gardening and tending to flowers and plants. Keep gardening tools handy and in an easily seen place to promote independence and to provide a meaningful activity for your loved one. 

Get a good kneeler to make it easy to get down to low gardens. 

Choose plants that help to reflect seasonal changes like fruit trees and bushes as well as growing vegetables. This can help orientate your loved one to time and place. 

Remove any plants that might be poisonous when in contact with the skin or eaten.

Security

If your loved one has started to wander then securing the outdoor space to make sure that they are kept sage will be important. 

Check fences provide a secure barrier to the garden. 

Using technology

There are many different technologies that can be incorporated in the home to help improve safety, promote independence and assist with orientation. These range from sensors to remote monitoring tools. 

What time is it? 

When thinking about technology don’t forget the trusty old digital clock. A clock that also displays the date, month and year can create a vital reference point to help your loved one orientate themselves. 

Who you gonna call? 

Making sure your loved one can keep in touch with friends and family is extremely important, it’s possible to get a phone that has extra large buttons as well as one that allows you to use pictures of friends and family instead of numbers. 

Fall detection devices 

We covered fall detection devices in the fall detection section. 

Automatic pill dispenser

An automatic pill dispenser can be pre-filled and then locked then when it’s time for your loved one to take their medication an alarm will go off and the right compartment will open so that your loved one takes the correct pills on time. Some devices will then trigger an alert to the family to let them know if medication has been missed. 

Smart home 

Reminder tools: There are now a number of devices that allow you to set reminders that can play on a schedule. These can help provide audio cues to help your loved one remember to take their medication or get in some exercise. 

Virtual assistants: 

Smart speakers or home hubs like Google Nest Home, Amazon Alexa or LifePod can be used to give voice commands and can then provide answers. They can be a great tool for adding reminders but they also do a lot more like act as a radio, control other devices around the home and answer questions. You can combine a virtual assistant with smart light bulbs or smart plugs so that your loved one can use their voice to turn on and off lights and other things around the home. 

Motion detecting lights: 

You can install lights that come on when they detect motion. These can be particularly useful in the bathroom as well as in hallways and stairways. 

Motion sensors: 

Motion sensors could be used to play a recorded message when there is a movement. For example, you could place a motion sensor at the door to the kitchen that will remind your loved one to turn off the oven. This might be a more affordable option than a stove monitor. 

Contact sensors: 

Contact sensors can be attached to doors and windows and can generate an alert if the door is opened or left open for too long. You can also use them on the fridge door to make sure that your loved one is remembering to eat. 

Smart smoke detectors: 

You should make sure your loved one’s home has a working smoke detector but if you are worried your loved one may not hear it or may panic, a smart smoke detector can also send out an alert to you and others over a smartphone app. 

Smart locks:

Smart locks can be used to make sure that things are locked up and secure at night time as well as sending an alert when opened if you are worried about a loved one who might wander. Avoid smart locks that require a numeric keypad to open as this will be confusing to your loved one. 

Stove monitoring:

In the Kitchen section we discussed that there are devices that can be attached to the stove that will automatically turn it off if it is left on. As mentioned earlier stove monitors can be very expensive, they also currently do not integrate with other smart home systems. 

Cameras

Not everyone likes the idea of installing cameras around the home as it can feel like an invasion of privacy. A few carefully placed security cameras can help if you want to check on who is coming and going into your loved one’s home, including your loved one. 

Further advice

Too much information? Feeling overwhelmed? We totally understand, when a loved one has dementia there is so much to think about. We’re here to help. We can help you conduct an assessment of your loved one’s home and make practical suggestions on how to make improvements or modifications to make it more dementia friendly. Just get in touch.