When faced with a diagnosis of dementia, one of the most immediate concerns people have is that confusion and memory loss will prevent them from continuing to live safely in their own home. Yet, with the right support, and some basic design and lay-out alterations, much can be done to transform the physical space in the home into an environment that is both safety conscious AND fosters independence.
Where to start?
Knowing where to start is probably the hardest part. When assessing your home, the 2 key questions to ask are:
What hazards exist that can easily be removed?
What adaptations can be made that will foster independence?
Using research conducted by the University of Stirling, and the national housing charity, Care & Repair England, we’ve collected together some useful suggestions for considering possible changes. We’ve arranged them under 3 headings to get you started:
o General design and layout
o Lighting and heating
o Safety and security
Look at each room in turn and don’t get overwhelmed – remember even 1 or 2 small changes can have a significant impact.
The Design and Layout of your home:
Consider the layout of each room. Simply eliminating clutter and unneeded furniture can make route-ways to and from the door, or across the room, more readily recognisable, and ensure movement is easier and safer.
Mirrors can cause confusion, particularly as the dementia progresses, so covering or moving them may help.
Closed doors, particularly in a confined space such as a hallway or landing, may be disorientating. Although it may seem drastic, removing them to create a more open-plan layout can reduce confusion and distress.
Use of contrasting colours can assist with finding your way around the home and remembering what things are meant to be used for. For example, dark coloured bed linen against cream walls and pale carpet will really stand out, as would a dark coloured toilet seat or handrail against a white bathroom suite. Plain colours work better than patterns and you can use this idea to highlight any object you want easily noticed…light switches, cutlery on the table, door handles etc.
Rearranging chairs to make it possible to look out of the window or watch what other people in the house are doing, can provide stimulation and help maintain social contact.
Put away infrequently used items and try to keep cupboards and surfaces uncluttered so that the important, much used objects are easier to spot.
Using see-through containers, glass fronted doors or open shelves will make things easier than having to remember where something is behind a closed cupboard door.
Lighting and Heating:
Shadows and dark areas can increase the incidence of hallucinations so ensuring good lighting (whether natural and electric) without excessive brightness or shadow is important.
Cookers and fires can become potential fire hazards as the dementia progresses. All fires should be fitted with a fire guard, and if possible, an isolation valve should be fitted to a gas fire or cooker to ensure it can only be turned on if a carer is there to supervise use.
Try to maximise natural daylight as this provides important information about the time of day.
Timers and motion-sensitive sensors can be useful to ensure adequate lighting at night.
Consider installing central heating with thermostatic controls that will automatically come on if the temperature drops below a certain level rather than having to rely on manual controls.
Safety and Security:
Minimize the risk of falls by installing handrails on stairs, grab rails on steps, and remove rugs or loose carpets that could prove a tripping danger.
Fitting a KeySafe on to an outside wall enables the front door to be kept locked at all times. Relatives, friends and carers who know the KeySafe code can access the keys and still enter the property when needed.
Make sure a smoke alarm is fitted – preferably mains operated so you don’t need to worry about replacing batteries.
Bathrooms can become a high accident risk area and hygiene needs to be a priority.Colour coding important equipment such as grab rails, toothbrush, and even soap can help as a memory aid, and grab rails and a toilet riser can provide physical support. Many older people find using a bath difficult so it is worth considering fitting a level access shower or wet room.
Getting this done as early as possible enables you to learn how to use it, helping maintain independence as long as possible, and then makes it easier for carers later on. Sensors can be fitted to the skirting boards so that if the taps are left running and cause a flood, the system will shut off the water and raise the alarm. Specially designed plugs are also available that drain water should a tap be left running.
There is an ever growing range of equipment and gadgets, including pressure-pad and motion sensors linked by a telephone line to a nominated person or call centre that can alert a carer to a potential problem. Useful sources of information on the latest aids available, (which can be accessed by clicking in the link below) are:
The Disabled Living Foundation’s website www.asksara.dlf.org.uk
Assist UK www.assist-uk.org