Home Modification

Home Modification Tips
If you decide to have your Alzheimer’s-afflicted loved one continue to live at home, it is important to consider certain safety modifications. Adaptations such as those in the following list can ease the burden on the caregiver and increase the independence, safety and dignity of the person with dementia.

Since each person with Alzheimer’s is different – both in the stage of disease and its manifestations – not all of the modifications suggested will apply in your situation. Use this list as a guide and adapt the suggestions accordingly. Some of these changes can be done by the homeowner, whereas others may need to be done by a handyman or contractor, which may involve a significant investment in some cases. Weigh such decisions against the risks involved, and look for low-cost alternative solutions as much as possible.

General Safety

  • Post emergency telephone numbers for doctor, police, fire, ambulance and readily available neighbors and family members near a centrally located telephone so that they can be found.
  • Disable automatic locks on storm/screen doors so that the person does not get locked out.
  • Hide an extra set of keys outside the house in case your loved one mistakenly locks everyone out.
  • Put decals on glass doors to prevent your loved one from walking into the glass.
  • Store household kitchen appliances that might present a danger under lock and key.
  • Store sharp kitchen tools in locked cabinets.
  • Store tools under lock and key to prevent accidents with dangerous objects.
  • Store firearms in a locked area.
  • Store razor blades in locked cabinets to prevent cuts.
  • Use an electric razor to prevent accidents while shaving.
  • Store medications in a locked cabinet to prevent your loved one from mistakenly eating potentially dangerous medicines.
  • Store household cleansers, chemicals and insecticides in a locked cabinet to prevent accidental ingestion of poisonous materials.
  • Install outlet covers to prevent accidental electrocution.
  • Use sturdy chairs that do not tip.
  • Remove furniture with sharp corners (or pad the corners).
  • Remove fake fruit and other “look-alike” decorations to prevent choking or injury to teeth (including magnets on the refrigerator).
  • Use sturdy plastic plates to prevent breakage.
  • Hide car keys if necessary to prevent your loved one from driving.

Fire Safety

  • Install smoke detectors, ensure their proper placement and check/replace batteries regularly to warn family members of a fire.
  • Keep fire extinguishers accessible in every room, in case of a fire.
  • Remedy overloaded electrical sockets and frayed electrical wires to prevent fires.
  • Install radiator covers and insulate hot water pipes to prevent burns.
  • Remove dials on stoves and ovens to prevent your loved one from mistakenly turning it on, being burned or starting a fire.
  • Remove auxiliary heating sources, such as space heaters and hot plates, which might present a hazard if touched.
  • Prevent fires by moving furniture so that it is not in contact with radiators.
  • Lower hot water temperature to 120 degrees to prevent scalding.
  • Store matches and lighters in locked cabinets to reduce the risk of a fire.
  • If your loved one smokes, restrict it to a non-carpeted area with a non-upholstered chair to minimize the chance of fire.
  • Provide large, deep ashtrays to reduce the risk that a cigarette on the edge of an ashtray might fall out and start a fire.

Preventing Falls/Improving Mobility

  • Build a ramp to the front and back doors of your house.
  • Install a stair/elevator chair to help your loved one get up and down stairs.
  • Install handrails in hallways and stairways.
  • Install grab bars in the bathroom.
  • Install a gate on the stairway.
  • Install locks on the doors to the cellar/basement and attic to prevent your loved one from walking up or down into potentially dangerous areas.
  • Improve poor lighting conditions in stairs, hallways and bathrooms.
  • Use a hospital bed or install bedrails onto an existing bed.
  • Add non-skid strips to the stairs, and repair or remove carpeting on steps.
  • Tape or paint stair edges to increase their visibility.
  • Use a shower chair or tub seat for bathing.
  • Remove clutter that may contribute to slips and falls.
  • Remove area rugs that might trip up an unstable walker.
  • Use assistive devices as necessary, whether a cane, walker, or wheelchair, which can help your loved one maintain his/her independence by remaining mobile.
  • Remove low furniture (e.g., coffee tables and stools) that might not be seen and could pose a tripping hazard.
  • Keep a clear path in the center of rooms so that your loved one can walk around safely and unencumbered by obstacles.
  • Avoid placing electrical cords across walkways, or tape them down if you cannot avoid that location. Relocate appliances if necessary.
  • Use non-skid mats in bathrooms, bathtubs and showers.
  • Use nightlights in hallways and bathrooms, especially if your loved one gets up at night.

Improving Activities of Daily Living

  • If more than one person shares care, post a list of specific responsibilities that each caregiver should perform to prevent misunderstandings and forgetfulness and help ensure the best care. Communicate regularly with other caregivers.
  • Post a calendar on an obvious wall, and cross off each day that passes. Also, record appointments and list activities as visual cues to help your loved one regain a sense of the passing of time and the events that punctuate his or her life.
  • Place clocks prominently in multiple rooms to help your loved one orient him or herself easily and frequently to the time of day.
  • Keep furniture arrangement consistent in all rooms because people who are disoriented may use these objects to mentally steady themselves. Anxiety can result when familiar surroundings are changed.
  • Post pictures or signs as cues to help your loved ones find his or her way and use objects appropriately.
  • Eliminate shiny, glaring surfaces, which might worsen depth-perception problems and cause confusion.
  • Use reflector tape on floor or walls to help your loved one find his/her way.
  • Keep your loved one’s belongings in the same place all the time to provide as much consistency as possible.
  • Simplify clothing to enable your loved one to dress more easily.
  • Use grooming tools specifically designed for people with motor skill deficiencies (e.g., curved hairbrush handles and toothbrushes) so that your loved one can be as independent as possible.
  • Use an automatic dial telephone so that your loved one can make a phone call more easily.
  • Add an additional bathroom to your home or have a portable toilet available to enable a person with incontinence to reach a toilet easily from any part of the home.
  • Protect upholstered furniture with plastic covering to prevent damage from incontinence, thus enabling your loved ones to sit anywhere without worry.
  • Install a hand-held shower wand to enable showers to be taken with the least amount of noise and potentially disorienting water-splashing.
  • Prepare food in portions that can be easily eaten with fingers and provide straws when serving liquids to help your loved one eat successfully without assistance.
  • Use a vinyl tablecloth that can be easily cleaned to help make messy eating less troublesome.
  • Store valuable items in a locked or inaccessible area to prevent damage.
  • Check the trash before removal in case your loved one has accidentally discarded something of value.

Managing Wandering

  • Fence in your yard to reduce the chance of your loved one wandering too far. Be sure there is a lock installed on the fence. Swimming pools should be fenced in to prevent injury or drowning.
  • Install additional locks, or an alarm or buzzer on exit doors to prevent your loved one from trying to leave without your knowing
  • Install safety locks on windows, and safety bars on windows above the first floor.
  • Install a motion detector to alert you if the person is up and about.
  • Provide your loved one with an identification or GPS bracelet in case of wandering.
  • Place an identification card in your loved one’s wallet along with a note describing his or her condition.
  • Have several photos of your loved one available should he or she get lost.
  • Notify the police (and offer photo of your loved one) who regularly patrol the neighborhood that your loved one has dementia and may wander.
  • Notify neighbors of your loved one’s condition, possible problems and caregivers’ schedules; ask them to call you if they see your loved one wandering unattended.

Managing Rummaging

  • Limit the number of places your loved one might rummage to those that are safe.
  • Install locks on closet doors.
  • Install a refrigerator lock to prevent rummaging in the refrigerator (and overeating).
  • Install childproof kitchen cabinet locks to prevent rummaging in cabinets that may result in injury.

John Zeisel and Patricia Baldwin. Housing Options for People with Dementia, Canada Mortgage and Housing Corporation, Ottawa, Canada. (Chapter 5 pp 27-49)
Nina M. Silverstein and Joan Hyde “The importance of a Consumer Perspective in Home Adaptation of Alzheimer’s Households” (Chapter 6 pp 91-112) in Susan Lanspery and Joan Hyde (eds) Staying Put: Adapting the Places Instead of the People, Baywood Publishing Company, Amityville, NY.