Alzheimer’s Disease & Your Home Pt. 1

Alzheimer’s Disease & Your Home

Alzheimer’s Disease (AD) affects over 300,000 Canadians. It is a disease that attacks the brain and results in mental, behavioural and physical changes. Although not all persons with Alzheimer’s Disease have the same symptoms, there are some symptoms that are typical.

The main mental changes include the following:

• gradual memory loss, especially recent memory
• loss of ability to make logical or sensible decisions
• difficulty making a connection between what they see and what the images mean
• less and less ability to learn new things
• a decline in the ability to carry out routine tasks
• loss of language skills (forgetting words and names and how to explain or describe something so that it can be understood)
• disorientation, (getting lost or confused about where they are).

The typical behavioural changes are:

• constant movement that seems to have no purpose, such as pacing and rummaging
• changes in sleep patterns (typically getting up in the night)
• a short temper, with anger often directed at the person who takes care of them (usually the husband or wife)
• fear of darkness and fear of being alone
• noticeable decline in personal grooming habits.

Although many persons with AD remain physically very fit well into the advanced stages of the disease, others experience physical changes, such as loss of muscle strength, sometimes resulting in the need for a walker or wheelchair, and the tendency to stumble (usually because of visual problems) and to suffer unexplained “very heavy” falls. AD victims eventually become unable to control their bladders or bowels, and totally incapable of caring for themselves.

A Study on Adapting Private Dwellings to Alzheimer’s Disease
About 80 per cent of people with Alzheimer’s Disease live at home with a caregiver, usually a husband or wife. To learn how caregivers adapt their homes to suit both their patients’ behaviour and their own needs, a national study was carried out in 1998. The focus of the study was on the practical physical changes made to private dwellings to accommodate the behaviour of persons with Alzheimer’s Disease and the special needs of their caregivers. The purpose of gathering and reporting this information was to provide Alzheimer’s caregivers with helpful ideas about practical changes they could make to their homes.

The information was gathered by means of telephone and face-to-face interviews across Canada and a national mail-out survey of caregivers of persons with Alzheimer’s Disease. The study was carried out by Nancy Gnaedinger, a consultant in gerontology in Victoria, BC, and was funded by the External Research Program of Canada Mortgage and Housing Corporation

To protect the safety of people with Alzheimer’s Disease in and around the home, and to ensure that they do not wander away and get lost or come to harm, the following precautions are suggested.

Locks for Safety and Security

• Place door and window locks in invisible or unusual places, such  as at the top of doors, above the normal line of vision.
• Slide a bolt from the closet door into the floor if the AD person rummages incessantly in the closet.
• Keep one closet in the house locked, where precious items can be locked away.
• Add a thermostat lock if the AD person is continually adjusting the temperature in accordance with their body temperature swings.
• Install second locks on exit doors (for example, add a chain lock to a dead bolt, to make the process of unlocking too complicated for the AD person to carry out) or lock the exit doors with a key from the inside and pocket the key.
• Lock large, openable windows in closed position.
• Add a fence to the back yard and a lock to its gate.

Safe Furniture/Furnishings

• Make swinging chairs stationary and remove rocking chairs.
• Move furniture away from the middle of rooms for patients using walkers.
• Use chairs with arms, and if purchasing new furniture, make sure it has rounded corners.

Safety Precautions in the Bathroom

• Keep pills out of reach, locked in a cupboard away from the bathroom (for example, in the pantry) or locked in the medicine cabinet.
• Install a grab bar by both toilet and tub (or clamp a grip handle to side of tub).
• Reinforce towel bars if they are used for balancing (a grab bar is better).
• Purchase a plasticized seat and a shower hose for bathing the AD person seated.
• Slip-proof the bottom of the tub or use a rubber mat.
• Keep shampoo and other liquids out of the bathroom so that they cannot be swallowed.
• Purchase a deep soap container so that the soap will not fall into the tub or on the floor.
• Stick contrasting coloured tape around the edge of the tub to help define its edges and depth.
• Lock large, openable windows in closed position.
• Add a fence to the back yard and a lock to its gate.

Safe Furniture/Furnishings

• Make swinging chairs stationary and remove rocking chairs.
• Move furniture away from the middle of rooms for patients using walkers.
• Use chairs with arms, and if purchasing new furniture, make sure it has rounded corners.

Safety Precautions in the Bathroom

• Keep pills out of reach, locked in a cupboard away from the bathroom (for example, in the pantry) or locked in the medicine cabinet.
• Install a grab bar by both toilet and tub (or clamp a grip handle to side of tub).
• Reinforce towel bars if they are used for balancing (a grab bar is better).
• Purchase a plasticized seat and a shower hose for bathing the AD person seated.
• Slip-proof the bottom of the tub or use a rubber mat.
• Keep shampoo and other liquids out of the bathroom so that they cannot be swallowed.
• Purchase a deep soap container so that the soap will not fall into the tub or on the floor.
• Stick contrasting coloured tape around the edge of the tub to help define its edges and depth.
• Install non-skid flooring and tiles that contrast with the tub, if building or renovating a bathroom with AD in mind.
• Use contrasting colours in bathroom so that fixtures will stand out.
• Install washable, rubber-backed bathroom carpeting to reduce chances of slipping on a wet bathroom floor.
• Always leave a night light on in the bathroom.
• Rent or buy a raised toilet seat.
• Remove the lock from the bathroom door, so that the AD person cannot get locked in.
• Do not put a waste paper basket in the bathroom (unless it is hidden in a vanity) because it may be confused with the shape of a toilet and used as one.

Safety in the Kitchen

• Hide away sharp knives and other small appliances in cupboards. This does not have to be elaborate; simply put the items out of sight.
• When not working in the kitchen, remove and hide the stove switch knobs, or take the fuses out of the stove or unscrew them, or turn off the gas underneath the stove, or switch off the circuit breaker for the stove.
• Leave countertops bare if items and food tend to be stuffed into pockets to be lost or to rot.
• Get a kettle that whistles when the water is boiling or an electric kettle with an automatic shut-off.
• Install plastic safety latches in all kitchen and bathroom cupboards if dangerous items and substances are not removed.
• Remove and hide sink stoppers to avoid overflow accidents.

Safety and Security Near and On Stairs

• Install an accordion gate or a wood or metal swinging gate (which looks less like a “baby gate”), or a piece of plywood at the top of the stairs, particularly stairs to the basement.
• Install solid handrails on both sides of stairways, especially in the steep stairwell to the basement or to the back door.

Other Safety and Security Measures

• Put away power tools, scissors and any other items that the AD person can no longer use safely, such as liquor, fans, keys, lamps with cords, lighters and matches, glassware from the china cabinet, and small electrical appliances (such as hair dryers).
• Put plastic plugs in all electrical outlets.
• Decrease the height of the AD person’s bed by removing the bed frame, so that a fall out of bed will not be so damaging.
• Remove sharp-cornered furniture and sharp objects.
• If the AD person smokes, put a little water in all ashtrays.
• Keep outside lights off at night to discourage the AD person from going out of the house (as darkness tends to frighten persons with AD).
• Remove the rug from under the table where you eat—it may be too difficult for the AD person to push a chair back and may cause a bad fall.
• It is also easier to clean up a bare floor.
• Distract the AD person from escaping through large windows or doors by camouflaging them with decorations—for example, a colourful hanging glass decoration in the window.
• Remove items that are precious and breakable, such as ornaments and delicate antiques.
• Give away poisonous house plants, which may be eaten by the AD person.
• Do not wax floors—the slippery finish is treacherous and the shininess may create frightening reflections.
• To avoid burns and scalding, lower the hot water temperature, cover the hot water pipes, and put pieces of furniture in front of hot radiators.
• If possible, make part of the house so safe that the patient can be up and pacing while the caregiver is asleep in another room.
• Close up the fireplace.
• Mark sliding glass doors with decals to prevent the AD person from walking into them.
• Leave a squeaky door or floor squeaky so as to alert the caregiver to wandering.
• Outline porch steps with bright coloured paint contrasting with the rise (to help define the edges of steps and prevent tripping).
• Install rubber treads on uncarpeted indoor and outdoor stairs to improve traction.
• Add a safety railing on outside steps or along verandah.
• Install bells or an electronic alarm system on exit doors.
• Remove locks from all inside doors

Contact your REALTOR at Coldwell Banker Vantage Realty for more tips and advice on what you can do make your home safe for someone with Alzheimers.

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