Making the person safe at home

 

coffee pot on stove
Consider how safe the person’s home environment is

 

If your loved one lives alone, it’s going to take some foresight to ensure they remain safe at home. They may still be independent but their needs will increase over time and they may already need help with certain tasks. Try to identify what the person currently needs help with, what help could be provided, and how that help will be provided.

Even if you are in a position where you can become a full time-carer, you will still need help as there will come a time when the person with dementia can’t be left alone. Don’t try and do it all on your own. Rikki Lorenti, an Admiral Nurse from SweetTree Home Care Services, recommends the following:

  • Seeking as much information about the health of the person from the Memory Clinic
  • Making sure the rest of your family are aware of the situation so that the burden of caring for the person can be shared
  • Seeking advice from a Dementia Care Adviser or your local Alzheimer’s Society
  • Finding someone to talk to such as a local carer’s support group
  • Finding out if there is a local Admiral Nurse in your area – Admiral Nurses were developed in the late 80s to provide support, guidance and knowledge for families on coping with dementia. They can recommend strategies and suggest practical ways of coping. To find out if there is an Admiral Nurse in your area, visit https://www.dementiauk.org/

In the early stages of dementia, it may be safe for the person to go out on their own and live reasonably independently. As their needs increase, they will be more likely to go out without a house key, leave the front door open or wander off. Identifying these possible scenarios now may help to prevent them.

Some extra support may be sufficient in the early days of the person’s diagnosis. It might be a case of someone coming in to do the housework once a week, or taking them to the shops every couple of days.

You could ask your parent what help they need but you may not get a straight answer and they may not like you implying they can’t cope on their own. They may tell you they don’t need help. Rely on your instincts and take note of what you see. Don’t rely solely on the information the person is giving you – they may genuinely think there is nothing wrong. Or they may be in denial.

It’s difficult to know when to take charge of certain situations but you should be strong and go with your instincts. Even if the person thinks they don’t need help, if the evidence tells you otherwise, then you have a duty to do your best for them. As the dementia progresses, you will become the parent, and they will become the child. You will become an expert at knowing what is best for them, in the same way that a parent knows what is best for a child.

You may meet with resistance when offering help but if you feel you there is a genuine need for it then be patient and gently persevere. At first, my mum didn’t want Meals On Wheels and complained about the food. I persuaded her to be patient and keep trying them. I said we would cancel the meals at the end of the week if she still didn’t like them. After a few days, she realised that each meal came with a pudding, and the pudding won her over! She grew to like the meals and I felt happier knowing that someone was delivering her healthy food every day, as it meant they were also able to check up on her.

Convincing the person that they need help may become a negotiation. Other times, you should just go with your instincts and do what you feel is right for the person and hope they get used to it. This may sound heavy-handed, but over time, you will know best. They may not always agree with you. Stand your ground.

There are many examples of where the person with dementia will need help, so keep observing them, but do it discreetly so that they don’t get defensive. If the person is wearing dirty clothing, or the laundry is piling up, then get someone in to help with washing, or load up the washing machine when you visit. Incidentally, the person with dementia may have forgotten how to use the washing machine. Or they may not even notice their clothes are dirty.

Domestic appliances may become a source of confusion. You may think that written instructions are an obvious solution but there is no guarantee that they will be able to process what you’ve written. If a washing machine or microwave breaks down and needs replacing, they may struggle to learn how to use a new one and you may need a care worker to come in and take care of some domestic tasks.

What needs doing?

When you visit, look around the house – are they changing their bedding regularly? Is the house messy or dirty? Is the garden becoming overgrown? Are they still able to do some of the things they liked to do before? My mother used to enjoy going out for a walk in her village. She knew the locals and they looked out for her. Eventually, she was unable to find her way back home and it became impossible for her to go out on her own. She lost confidence and stopped going out altogether. Each time I visited, I made sure we went out for lunch or to the shops, so that she was still getting some fresh air and stimulation. Think about what the person with dementia would like to do and what help they will need to keep doing what they enjoy. Then think about who can provide that help or support, be it a neighbour, a relative or a paid care worker.

A safe environment

How safe is the person’s environment? Will remember to turn the oven off, lock up at night and turn off the TV when they go to bed? You may want to spend the night to see how they are managing with these tasks… let them go through their bedtime routine of shutting everything off and see if they can do it, unprompted by you. If not you may need someone to come in and help.

Is it safe for them to cook their own meals? My mother hated cooking, so it was no biggie for me to disconnect her oven. You may need to turn the oven off at the mains, or arrange for the person to have a convection oven that turns itself off when food is cooked, though you’ve still got the challenge of them learning how to use it.

There are companies who can install monitors in the house and provide pendant alarms and GPS navigation, which will track the person when they leave the house. This may sound drastic and may not be needed at this stage, but it’s important to keep thinking ahead. Talk to Adult Social Care in the first instance.

Is it safe for the person to load the washing machine when they are at home alone? Consider disconnecting it and taking their laundry home with you. Disconnect any portable fires if you are concerned and set their central heating so that the house is warm and the heating automatically goes off.

Risk of falls

Mobility may be an issue and this could increase the risk of falls. The person’s home can be adapted to be made safer. It’s worth contacting social services or the local Alzheimer’s Society office if you have one. They may be able to arrange for an occupational therapist to come in and recommend changes or adaptations that may be provided by social services. This could include items like a handrail for the stairs, a bath seat, a raised toilet seat, a shower stool and mobility aids like a walking frame. Resources vary depending on where you live, and you may have to wait for this service, so if you feel it’s time sensitive, then you can buy a variety of walking aids online. A commode might be a good idea if the person with dementia is prone to waking at night, as it will mean they don’t have to move very far to reach the toilet. A small nightlight for the person with dementia may also be a good idea, so that they are less likely to fall over or get confused in the dark.

 

 

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