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SAFEPROOFING YOUR SURROUNDINGS
Turning a home into one that is dementia-friendly
can help minimize accidents and maximize well-being.
It can also give peace of mind and reduce stress for
at-home and long-distance caregivers.
Act before a crisis. In safeproofing
surroundings, it is best to take preventative steps,
rather than scramble around to solve an immediate
crisis. This way, options can be more carefully
weighed. The challenge is balancing a desire to keep
individuals with dementia as functional as possible
against the hazards posed by cognitive decline,
including poor judgment, difficulty with spatial
perception and inability to react appropriately.
Observing an individual's patterns and how they
navigate their environment, looking for red flags,
and pinpointing causes and effects are all very
telling.
Professionals or caregivers themselves should survey
a home three times, progressing in security at each
inspection. Look for safe, safer and safest.
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Safe
involves detecting basic dangers and fixing or
removing those items, such as movable furniture
that people wrongly rely on for support, chairs
that blend in with the walls behind them, and
loose extension cords and telephone wires;
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Safer
means locating ways to minimize injury in the
event of accidents, like replacing glass tables
with furniture that has blunt edges, and
locating a soft rubber mat by the bed in case of
a fall; and
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Safest
is maximizing access to help in an emergency,
such as installing a monitoring device.
Look at critical areas. Since those with
dementia need a quiet, orderly environment, it
is critical to address factors such as noise,
color and lighting. Modifying kitchens and
bathrooms, and taking steps to deter
wandering
are primary concerns. The key is to pay special
attention to lighting, furnishings, textures,
changes in elevation, handrails, and types of
flooring, and to remove hazardous clutter from
floors, stairways, etc. Often, small changes can
make big differences. For example, reducing the
level of light during meals can prompt better
eating habits; camouflaging an exit door with a
curtain can prevent wandering; and removing
clutter and unnecessary furniture can reduce
confusion.
Be creative. Products do not have to be
taken at face value; rather, consider a person's
specific condition and further adapt products
for an even greater sense of security. And
always keep in mind that, with this progressive
disease, what works one day may not the next.
Consider redundant strategies for
life-threatening situations. For example, to
prevent wandering, install multiple locks on a
door, each at varying heights out of direct
sight and requiring different skill sets to
open, and supplement them with an alarm. Or when
buying a personal response system that uses
pendants with a call button to alert a central
monitoring station, spring for extras. Use one
as a pendant, and cut off the strings from the
others and use double-sided tape to install the
help buttons to base moldings in key spots. This
way, if the individual falls while not wearing
the pendant, he could crawl to an emergency
button in, say, the foyer or shower.
Walk gently. While many changes sound
easy enough, convincing the at-home caregiver
and/or their loved one to alter their
environment can be the hard part. Often, their
reluctance boils down to a sense of shame or the
feeling that many assistive devices are
unattractive.
Look for designs and assistive devices that give
people independent functioning while maintaining
privacy and dignity. One example of a perfect
solution: grab bars so individuals can get on
and off the toilet by themselves. Manufacturers
are increasingly designing products without a
medical-type appearance, addressing the "shame"
issue for both caregivers and those with
dementia. Products are nicer looking, boasting
decorative colors and style.
In presenting home safety features to those with
dementia, be delicate. Since most people do not
welcome change, caregivers may need to broach
the subject on several occasions and make gentle
suggestions. Also, try to include the person
with dementia in the decision-making process.
And use language that empowers the person to
agree to the safety features for someone else's
sake, such as, "It's not for you; it's for me so
I don't worry so much." Another effective
strategy is to call solutions by another
name—gifts.
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