Keeping Them Safe

As your loved one’s abilities decline, keeping them becomes tougher and tougher. I always felt that we dealt with it in a “responding to catastrophe mode” rather than in a proactive manner. Here I really hope to give people the heads up on things they might expect and things that they can do in advance – before things happen, not in response to them. Please note that even if your loved one is in an assisted living facility, you should ensure precautions are taken and if you notice new problems which call for new precautions, actively make sure that they are attended to!

I do believe people need to be very real with themselves. Especially as dementia advances, there will be many changes that are required to keep loved ones safe. If you are living with a person with dementia in your home, you owe them a duty to take all necessary precautions.  Having everything locked up is very inconvenient, but the truth is you will get used to it.  If you are unwilling, then you really must realize that other living arrangements may be in their best interests.

This can be very tough to admit. Just because they never have gone outside by themselves unattended, does not mean that someday they might. Do not take for granted potential dangers. That is not to say that assisted living facilities are always safe either! My mom walked out of one by herself alone past a security guard to a busy street off a highway. She also fell several times and each time, the facility would tell me the accident happened while an aide was “right there.” 

1. Safety at Large

Wandering is tough to deal with. Here’s your grown mom or dad wandering off like a young child and not able to fully fend for themselves. 

Outdoors can mean all sorts of dangers even in the early stages of dementia. A bout of confusion can occur and suddenly your loved one can be lost or dependent on strangers. We were lucky a couple of times that friendly neighbors were the ones who caught my mother wandering and brought her back safely, but other times things may not be so good.

 - The first thing we did was get my mom a medical alert type of bracelet. We purchased my mom’s from a place called Laurenshope.com which I found on the web. There is no sponsorship or anything here with this company. What I can say though is that their products were reasonably priced, their service professional and they had a wide array of styles. My mom loved Brighton jewelry and they had one that looked very similar. This made it easier to get her to actually wear the bracelet. Their website has an article https://www.laurenshope.com/who-should-wear-medical-id/alzheimers?gclid=CjwKCAjwndCKBhAkEiwAgSDKQdza11qK8cgHffukSRXUA1qnm_7Wkg-vMEUB_PO4_hQeQHuDnBqIChoCoYcQAvD_BwE

that does a pretty good job describing why people should wear them and gives lots of examples of what you can put on them. I felt more secure knowing that if someone “found” my mom they would at least know how to contact us. Make sure you list at least two people’s phone numbers on the bracelet in case you are unavailable.

 - There are also tracker services which we obtained a little later. Here your loved one wears a tracker device, and it is hooked up to a service where you can track them on your phone with an app. We purchased ours from https://pocketfinder.com/. Again, there is no sponsorship here, I’m just telling you which one we purchased. 

 - Realize your limitations as a caregiver in ensuring the safety of a person who may impulsively dart off. It’s easy to think that you can just hold your loved one’s hand and hold on to them, but in public places that simply is not the case. The instances of my mom darting off were endless. The next time you are out and about, contemplate asking a family member or friend to assist you with your loved one so that you have an extra pair of hands and eyes.  

 - One second is all it takes for them to disappear. My mom loved going shopping and it was something she still truly enjoyed even when her condition became evident. Yet, she would dart off leaving all of us frantically looking for her. If you go shopping with your loved one, simply realize it is not the time for you to try to look at anything other than them. The answer is to go in a group and take turns watching your loved one.

 - We had an incident where my mom darted off at the luggage carousel at the airport. It took one instant for her companion to be reaching for one of their bags for her to dart off. Again, you must be creative in your solutions and think ahead. Perhaps put a large noticeable sticker across all your luggage so that you or a porter could easily identify it. Perhaps simply sit down somewhere until most of the other passengers have already taken their luggage off the carousel so there will not be a crowd. 

 - Do not think that you can leave the house or hotel room even for a short time because they are taking a nap. They could wake up and be very confused. My mom was left in a cruise ship room napping, but woke up and was found by ship personnel roaming the ship’s hallways.

 - Keep them in a bright or unusual color when you go out so they will be easier to spot. We are not advocating dying your mom’s hair platinum blonde, but the truth is my mom’s platinum blonde hair made her easier to spot!

 - Forget counter service restaurants and stick to restaurants where you can sit down and be served and pay. Being distracted for even a minute in a mall getting a cup of coffee can become a disaster. 

 - Never let them go to a public bathroom alone, no matter how familiar they are. Be extra cautious with crossing streets, going up and downstairs, and simply walking when they are in unfamiliar areas. Uneven pavement is something we all tend to notice and walk around, yet your loved one may not notice the potential dangers.

 - Realize they may have lost their impulse control. We were in a store and my mom simply grabbed a candy bar and started eating it, after I told her not to. Don’t make a scene, simply pay for the product, and try talking to them later. They might understand and they might not, but you cannot discipline your loved one in public, especially when they probably didn’t understand what they were doing was “wrong.” 

 - This brings us to the socially unacceptable behaviors your loved one may exhibit. Again, without impulse control or the ability to understand what they were doing, your loved one will do socially unacceptable things. I mean things like: picking their nose, eating with their hands, farting loudly, burping, grabbing food off another’s plate, “shoplifting,” not flushing the toilet, stripping off their clothes in public and that kind of thing. It will happen slowly, and the natural tendency is to think that you can tell them to stop. Yet, you can’t. Do your best to simply ignore it. You don’t want them to feel badly and while my mom may not have understood many things, she was always very sensitive to how people around her were feeling. Early on, we used to tell her she was doing things wrong, and she would get defensive or quiet. In hindsight, I now see she had no control over these things.

 - DO NOT leave them unattended – ever!

2. Safety in the Home in General

- Have a complete list of safety numbers right on the refrigerator for everything and anything you can think of. Remember, that if you are the primary caregiver, something might happen to you, then who is going to step in and who would they call? Have numbers for poison control, the police, fire, other relatives, even the vet.

- First thing is to put away and clean out the clutter in your home. If things are scattered around the floor they need to be immediately cleaned up. 

- Safety locks should be put on everything! I think you need, at least at some point, to safety proof your house just as you would for a small child, but not necessarily with the devices meant for children.  Put latches and deadbolts above or below eye level. Think of these areas:

A. Medicines – it is just too easy for a person with an impaired memory to confuse even simple medications like Tylenol with something else. Make sure all medications are locked away where someone else has the key. Unlike small children, my mom could open a standard “safety lock” so it does not necessarily help with adults.

B. Anything at all that could be poisonous or dangerous if misused. This is a broad area, but important. My mom even when she had real troubles wanted to be useful and that included her doing the laundry where rather than laundry detergent, she would use just about anything that was available in the laundry room.

C. Safety locks should go on all doors leading to the outside. The key here is that the locks need to be above the person’s level of reach or used with a key. Again, child’s locks won’t necessarily do the trick.

- Remove interior locks on doors, like bedroom and bathroom doors, so your loved one does not accidentally lock themselves in.

- Nightlights are important because it is common for those with dementia to be up at night. Especially make sure to light their way to the closest bathroom. Although it is not energy efficient, you might find it appropriate to leave the bathroom light on  or perhaps get a dimmer.

- Remove all guns and firearms or keep them locked up.

- Carefully check for slipping hazards. Throw rugs and loose cords can be very dangerous.

- The mail. One would hardly think mail could be “dangerous”, but my mom was on the mailing list of all sorts of clothing companies and numerous cruise lines. Early on when her impulse control was reduced, but she still had most of her wits, this led to unnecessary purchases of clothing and demands for vacations! Simply put, don’t leave this type of mail around to tempt your loved one; throw it out. Any unsolicited mail should be thrown out. This includes things like requests for charitable donations. If your loved one never believed in giving to a specific charity, be wary of their sudden desire to do so. The best thing to do is throw solicitations out.

- Their cellphones. Cellphones are a godsend and a curse for those with dementia. They are wondrous when it comes to keeping in touch with family and friends and for viewing pictures. Certain apps and websites can also be informative and entertaining. Yet danger lurks.

Email scams are rampant. You might consider taking their email off their phones and putting it on yours so you can check the emails first or you can regularly check their email online where you can delete scams and spam. 

Make sure you have a list of all their logins and passwords and make sure they are not all the same.

What stage they are in will determine how to properly handle cellphones. Again, you do not want to cut them off from their friends and family. You might consider setting specific times that they have their phones on and let others know about it so they could call or text or make the calls for them to others. 

- Garages are usually fraught with dangerous tools, chemicals and even a car that can be sat in and turned on. A special lock on the garage will probably be needed relatively early on for your loved one.

- Laundry rooms are another place where everything needs to be locked up including washers and dryers. My mom once poured silver polish into a load of laundry when she was just trying to be helpful. 

- Put childproof plugs in unused outlets.

- Consider keeping an extra set of home keys outside the house in case your loved one locks you out!

- Make sure you keep your smoke alarms and carbon monoxide detectors with fresh batteries and that they are functioning.

3. Safety in The Kitchen

The kitchen is fraught with dangers. Some are obvious, some not. Really be aware of what your loved one is doing so that you take needed precautions before bad things happen.

- Knives. When your loved one has early dementia, knives might not be a problem, but there will most likely come a time when they will be. Make sure they are locked away in a cabinet.

- Ovens, toasters, and toaster ovens. Even an easy-to-use toaster oven can be dangerous. Put them away and take them out when needed.

- Safety knobs on stoves are great for preventing them from accidentally being turned on.

- Disconnect the kitchen garbage disposal.

- Get in the habit of checking your refrigerator, freezer, and cabinets to make sure your loved one is putting food items back properly, so they do not spoil (and potentially get eaten spoiled). Also simply regularly go through the refrigerator and freezer to make sure bad food is thrown out so that it is not eaten.

- Locks may be needed on food cabinets if you notice them eating things they should not – uncooked rice or going through a whole bag of potato chips.

- Think of appliances with automatic off functions.

- Think to unplug electrical items and turn off gas access to others when not in use.

- Think of all potential dangers – plastic bags, scissors, lighters and others.

4. Safety in The Bedroom

When my mom moved into her first assisted living facility, we bought her brand-new gorgeous everything. Big mistake. Bedrooms for those with dementia are better simple.

- Make sure sheets and bedding aren’t slippery. Initially, my mom was falling out of bed a lot!

- The facilities suggested one of those big, long pillows to sleep with. It did not work for my mom, but it may help with sleep, to avoid falling out of bed or for comfort for your loved one.

- We purchased my mom a gorgeous sheepskin rug for her floor. I was quickly told this was a danger because it could slip and cause a fall.

- Corners of a side table or any table are a dangerous thing so effort should be made to avoid sharp corners.

- Nightlights are important.

- If you happen to be buying furniture, make sure the furniture has easy to grab handles to avoid problems.

- Make sure clothing in closets are easily accessible.

- A chair near their bed is not only a nice place for a visitor to sit, but also can be used to make dressing easier.

5. Safety in the Bathroom 

It is important to have those with dementia do as much as they can do while they still can. My mom was able to shower and bathe far in and needed assistance more towards the end. Yet bathrooms are thwarted with dangers. 

- Consider safety mats or stickers in tubs and showers. When we have all our wits about us, we are extra careful not to slip when getting out of the tub or shower. It is harder for one with memory loss.

- Break down those big shampoo, conditioner, and body wash bottles. Although it’s a real pain and we never did it, I think a great idea would be to fill travel-size bottles with cleansers. With judgment impaired, my mom would pour massive amounts of shampoo into her hand, making for a dangerous and slippery situation.

- Get in the habit or simply regularly checking their bathroom faucets to make sure they are turned off, tubs drained, and toilets flushed.

- All medicines and even vitamins should be locked away.

- Foam covers for the tub faucet, like those often used with children, can be wise for preventing a serious accident if your loved one falls in the tub.

- Think of lowering the temperature of your water to prevent burning water.

- All cleaners should be locked away.

- Q-tips should be put away. Although we shouldn't, many of us use these on our ears and for one with dementia it presents a special risk.

- Make sure clean towels are always readily available and not in a closet.

- Make sure toilet paper and wet wipes are always available, otherwise they may reach for whatever is available.

- Grab bars for the shower, tub, and near the toilet can be lifesavers.

6. Safety in The Backyard, Patio, or Deck

Backyards, patios, and decks present numerous challenges from dangerous tools to dangerous chemicals, to poisonous plants, to opportunities to slip and fall, and many other dangers. Take the same precautions you would inside your home in these areas.

7.  If you have animals…

Dealing with your loved one and your animals adds another layer to safety concerns. You need to make sure your dog or cat, its toys, and food do not make an unsafe environment for your loved one. Similarly, you need to make sure your loved one is not endangering your pets! My mom was always big on giving table scraps to the dogs, but as her dementia advanced, she had to be watched like a hawk as far as trying to give the dogs chocolate cookie bits (which could be lethal) and even down to her squeezing her little chihuahua a little too hard. Like everything, carefully watch and immediately clean things up and be on the lookout for ways to prevent dangers for both your pets and your loved one.

The above are just some steps you can take. Your loved one might need even more. It is important to provide a safe environment while protecting your loved one’s independence. Yet as dementia advances, you might consider even more “drastic” things – such as things like florescent tape to make things more easily seen, changing things like busy wallpaper which can be confusing, locking away things even like shampoo, which could be ingested, getting things like raised toilet seats, installing a walk-in shower and other things. The key is to regularly reassess the situation and keep your eyes open.