It is possible to live an independent life during certain stages of Alzheimer’s. One of the most important aspects of living an independent life is being able to live it safely.
Living in a familiar environment is helpful to the overall health of a person with Alzheimer’s. David LeVine, MD, chief medical officer of Menorah Life in St. Petersburg, FL, says, “There certainly are some advantages to keeping seniors independent in their own homes or in their caregiver’s home as long as they're comfortable in that environment.” But, he warns, “If precautions are not taken, the person could endure frequent trips to the hospital, rehab, or nursing home, which may be harmful to their continued well-being.” Studies agree, showing that frequent moves result in a high level of stress, as well as a decline in physical, mental, behavioral, and functioning in older adults.
For your loved one to live independently, you need to be aware of the details of their daily living conditions and needs. Whether in their own home or in your home, you can take steps to keep them safe and healthy.
Make Sure There Is Enough Lighting in the Home
Poor lighting can lead to anxiety, confusion, and falls. The following are some ways to improve lighting safety.
- Keep lighting consistent throughout the house. (For example, avoid a bright room leading to a dark hallway.)
- Add automatic lights with sensors or nightlights to dark hallways (especially those that lead from the bedroom to the bathroom).
- Install good lighting on stairways and in the bathroom.
- Install lights that turn on automatically when entering rooms or closets.
- For additional light, have lamps or wall switch-controlled lighting available.
- Install curtains or blinds to block out glare but allow for natural light.
Keep the Kitchen Stocked With Healthy Options
Good nutrition keeps your brain and body healthy. As Alzheimer’s progresses, lack of appetite, weight loss, and dehydration can cause health issues. You can help them avoid these complications by stocking the kitchen with appropriate types of eating tools and foods that make eating less frustrating and more pleasurable.
Try to buy healthy, flavorful, and easy-to-prepare foods like premade salads and single-portion foods that don’t have to be measured or chopped. Stock the freezer with foods that can be heated in the microwave instead of the oven. In some areas, community services, senior centers, or houses of worship may deliver free or low-cost hot meals to homes.
When shopping, ask about food choices your loved one typically enjoys. Too many options can be confusing, so offer two options at a time. For example, instead of “What bread do you want?” ask “Would you like bagels or white bread?”
To reduce frustration, buy utensils and dishes that reduce the chance of spills. Look for a spoon or fork with a large handle, and use bowls or plates with a rim to help keep the food from being pushed onto the table. Put plates on non-skid placemats, and use mugs or cups with lids to prevent spills. If a lid is not an option, fill the glass only half full and use a disposable or reusable bendable straw.
If you feel that your loved one cannot use the stove safely, safety knobs are available to prevent turning the stove on. Some stove timers can shut off the stove after a certain amount of time or after sensing that the person has left the kitchen.
Help Prevent Falls
Falls are a common concern for seniors. Statistics show the highest bathroom injury rates usually occur in or around the tub or shower during bathing or showering. It may be best to have a caregiver help your loved one during shower or bath time. But additional safety precautions can head off accidents as well.
- Install grab rails both inside and right outside of the shower.
- Place textured stickers or mats in the shower or tub to avoid slipping on wet tile.
- If the budget allows, consider replacing your bathtub with a walk-in shower or tub. Some models come with a seat or are wheelchair accessible.
- Buy a foam rubber faucet cover to prevent bumping against the hard faucet when moving around or in the case of a fall.
- Lower the water temperature on the hot water heater to below 120 F to prevent burns.
Falls can happen anywhere. Take a close look at the living space in every room. Remove scatter rugs and make sure that extension cords are tucked away or tacked to a baseboard and not stretched across areas where people walk. If the home has stairs, put brightly colored tape on the edges of the stairs so the person can see them better.
Make Sure Medications Are Taken
Put pills in an organizer on the bathroom counter or kitchen counter so they can be seen in the morning and afternoon. (Be careful with keeping medicines out on a counter if young children live in or visit the house.)
There are many types of pillboxes that you can buy, depending on individual needs. Some have compartments printed with the days of the week or have multiple rows to indicate day or night use. Some dispensers come with alarms that will sound when it is time to take the pills.
Because filling a pill container can be confusing, as the caregiver, you should dispense the pills from the pharmacy bottle into the pill dispenser. Then, lock up the pill bottles. If you are not available to fill the pill dispenser, consider having your pharmacist put together pre-packaged “blister packs” that contain all the pills needed for different times of the day.
Set an alarm for your loved one as a reminder to take the medication. You can set some virtual assistant technologies to give a verbal reminder that it is time to take the medication.
Even if you take all of these steps, a caregiver needs to monitor whether the loved one actually is taking their medication by visiting often and checking their pill containers. LeVine says, “Depending on the level of dementia, the person may forget to take their medication, decide that they do not need medications that they have been taking for years, or even think the caregiver is trying to poison them. Some may just throw it away.” In those cases, rather than argue, the caregiver may have to get a bit creative. LeVine says if the caregiver finds that the person resists taking their necessary pills, consider crushing the pills in ice cream and having a “delicious medicated ice cream visit” once a day.
How to Make Getting Dressed Easier
To keep the enjoyment and independence in dressing, here are a few tips.
- Keep choices simple. Closets that are filled with too many clothes may cause confusion or panic.
- Keep favorite clothes organized by color and already arranged in sets, if possible.
- Choose clothing that is simple to put on. Soft and stretchable shirts, blouses, and sweaters that button down the front with larger buttons are better than clothes that have to be pulled on over the head. Velcro is better than buttons for people who have limited hand movement. Clothing should be loose at the waist and hips.
- If your loved one is obsessed with wearing a certain outfit, consider buying more than one of the same outfit so that you can maintain hygiene by laundering the clothes and avoiding an argument.
- Shoes should be comfortable and have a non-slip sole. Try to avoid shoelaces that you have to bend to tie. Step-in shoes or Velcro closures can be helpful.
Because of forgetfulness or confusion, it is important to keep certain items stored away. Install locks on cabinets, and keep the following harmful substances and objects out of your loved one’s hands.
- Cleaning fluids
- Dangerous tools
- Guns (The National Institute on Aging recommends removing all guns and other weapons from the home or locking them up. Install safety locks on guns or remove ammunition and firing pins.)
Make sure that the home has a fire extinguisher, smoke detector, and carbon monoxide detector. Some types of these can send a signal to the caregiver’s phone to alert you that the detector has been triggered.
When It’s Time to Stop Driving
If your loved one has mild dementia, they still may be able to drive. If a person is capable of driving, the caregiver should continually monitor the person’s progress. Take a drive with your loved one. Some signs that your loved one is not driving safely include:
- Crashes or “near misses”
- Dents on car
- Difficulty understanding traffic signs or street signs
- Driving too fast or too slow
- Getting lost
- Horn honking from other drivers
- Tickets for traffic violations
If you notice any of these, the caregiver should discuss their loved one’s driving skills with the doctor, who can help to assess the person’s Alzheimer’s severity and cognitive abilities and also review medications that can affect driving. The doctor may refer you to a driving rehabilitation specialist or the state’s department of motor vehicles (DMV) for performance-based road testing. The agency may ask the doctor for the cognitive assessment. Doctors may also be able to recommend a social worker or community agency that provides transportation so that your loved one can still get to doctor’s appointments and other activities if they can’t drive there themselves.
Clutter causes confusion. Make sure that your loved one has several clocks and a big calendar so that they can keep better track of appointments and meeting times. Post all activities on the calendar. Put tags or labels on kitchen drawers and cabinets and on dresser drawers in the bedroom.
LeVine reminds caregivers to keep alert during visits, monitoring your loved one’s physical condition and environment. “Does the house smell like urine? Is there any indication that your loved one has been soiling themselves? Do they have any bruises or skin tears that they can’t explain? All of these are integral to making sure that they are taking care of themselves properly.”
As Alzheimer’s progresses, certain tasks and habits may become more difficult. Watch for trouble with basic hygiene like going to the bathroom, bathing, or brushing their teeth. While it would not be safe for a person with severe, late-stage Alzheimer’s to live alone, someone with mild or moderate Alzheimer’s may be able to live independently with the right precautions and frequent check-in visits. Health care professionals and caregivers can work together to provide a safe and pleasant independent quality of life for your loved one and peace of mind for the caregiver.