Alzheimer’s disease affects about 5.4 million Americans, about 5.2 million of which are 65 and older. It can be your grandparent, your cousin, your sibling or even your parent who faces the diagnosis. Eventually, those with Alzheimer’s require round-the-clock care, and for many families, that means taking the loved one into their own home.
Alzheimer’s disease has unique symptoms and traits, so it’s likely that your home will need some modifications in order to create the best environment for your loved one. This guide will cover all the adjustments you should consider making room by room, with tips on creating both the safest surroundings and the most secure environment. Many of them are simple enough to complete on your own, but others may require the skills of a trained professional to ensure the safest result. Keep in mind that every home and instance of Alzheimer’s disease is different, and needs will vary from family to family. Always consult your doctor about your loved one’s specific needs and challenges.
It’s best to opt for a ramp instead of steps whenever possible. Even if your loved one isn’t in a wheelchair, steps are often more difficult to navigate as we age and pose a significant tripping hazard to someone with Alzheimer’s. If you’re particularly handy you may opt to build a ramp yourself, or you can have it installed by a professional. There should be landings at both the top and bottom of the ramp, railing on both sides, and the ramp itself should be textured (especially if you live somewhere prone to icy winters or rainy summers) and reflective.
If you aren’t immediately able to create a ramp in place of outdoor stairs, check to make sure the steps are sturdy and even. There should be a handrail on at least one side. The steps should be textured, and the edges can be easily marked with reflective tape to increase visibility.
Trim back any shrubs or plants that may be intruding upon the walkway or porch, especially those that are prickly. Make sure walkways are level enough that they don’t present a tripping hazard to someone with unsure footing, but with enough traction to prevent slipping. You may also want to post a “No Soliciting” sign somewhere on the exterior of your home to reduce the likelihood of your loved one becoming the victim of a scam.
Those diagnosed with Alzheimer’s are often prone to wandering, so you may need to take some additional measures in securing your home. Exterior door locks should be placed somewhere somewhat uncommon or out of reach — that way, if he or she has a particularly rough day and attempts to flee out of confusion, it won’t be simple to just walk out the front door. You may even want to install alarms on all exterior doors and windows so that you’ll immediately know if your loved one does manage to make it out the door. At the very least, windows should all have locks, and often those normally used for child-proofing are sufficient.
Your Loved One’s Bedroom
In addition to any daily challenges associated with Alzheimer’s, your loved one is facing a major life change by relocating to your house. This can be especially tough for those with very progressed cases, who may have trouble knowing where or when they are, or even who you are. It can get overwhelming, and he or she needs to have a comforting place to retreat to, so it’s important to provide a bedroom that is private but secure. It should be on the first floor if possible, and with easy access to a bathroom. If you don’t have any spare bedrooms, you can convert an unused office or formal dining room. Give your loved one the courtesy of a working door — avoid curtains, removable screens, or other placeholders — but skip the lock. If this detail upsets your loved one, assure him or her you’ve spoken to the entire family about respecting privacy and that no one will barge in uninvited or unannounced unless it’s an emergency.
It’s best if the bedroom has wall-to-wall, low-pile carpeting because this will be the easiest surface for your loved one to walk on without issue. Ideally there shouldn’t be any throw rugs, but if perhaps he or she has brought one from home that gives a sense of comfort, ensure it is securely fastened to the floor. Wood floors should only be treated with non-slip wax and cleaners, and tested for slip risk before allowing your loved one to return after cleaning.
Avoid low furniture like coffee tables and footrests in the bedroom so that there is always a clear, obstacle-free path. Opt for dressers and bed frames with no sharp corners, or cover them with plastic bumpers. Shelving should be low enough that it’s easily accessible, but not jutting out into the walkway. Be sure that nothing on shelves could fall and pose a hazard, be it a heavy book that could injure someone or a knickknack that could shatter into a million sharp shards.
Bring in what furniture you can of your loved one’s, especially when it comes to the bedroom. Moving into a new place is likely going to be an emotional and confusing event, so making it really look and feel like home can make a world of difference. You may decide to replace his or her bed with a hospital bed or one with safety rails to help with transport, but keep the old pillows, blankets, and comforter to make it feel like less of a shock.
The bedroom should be well-lit, including night lights. Often, switching to higher wattage bulbs is enough to lift the lighting, but if you do need to add sources, opt for wall fixtures over floor lamps to keep pathways clear. There should be a well-functioning smoke detector as well as a carbon monoxide detector.
In general, make sure the room is free of clutter simplified as much as possible. As Alzheimer’s progresses, those afflicted find it increasingly difficult to process their environment. With less around to distract, and potentially overwhelm, the person can feel more at ease and focus better.
Like the bedroom, your loved one’s primary bathroom should also be on the first floor. Be sure the path from their room to the bathroom is well-lit with night lights, and put one inside the bathroom near the door to make it easier to spot. Again, try to keep this path relatively simplified to reduce the chances of confusion and clear of tripping hazards.
It may be necessary to install a heightened seat or safety railing with grippers to the toilet and adjacent walls. Keep extra rolls of toilet paper within easy reach. You might want to consider adding non-slip tiling to the area around your toilet, tub, and shower, but be sure that any mats you use have secure, slip-resistant bottoms. Safety rails with textured grips, shower seats, transfer seats, and roll-in showers are also valuable options to make bathing safer and easier for your loved one. A single lever for the faucet is usually easier to turn and operate than two separate knobs, so consider a new faucet head if necessary.
If they’re not already, switch to simple prints or solid colors for your towels, shower curtain, bath mat, and other decorative items. If possible, it’s best to give your loved one his or her own bathroom so there’s limited clutter as well as no confusion over which items belong to whom. Mark the faucets with clear “H” and “C” labels, and keep the sink clear of all but the necessary supplies. Any supplemental products like makeup and aftershave should be organized in a nearby cabinet or bin — somewhere accessible but out of sight at first glance. You can label cabinets and drawers with the corresponding items, and often large, color photos make the clearest tags.
Be sure to store items like bathroom cleaners, toilet bowl tablets, and other chemicals are stowed either in a locked cabinet or somewhere separate. Razors and any other sharp or potentially dangerous items should never be stored somewhere accessible; it’s also best to switch to electric razors for better safety and easier shaving.
Kitchen and Dining Area
Do your best to arrange your kitchen so that it has clear pathways all around it. Keep counters cleared off, and drawers and cabinets as organized as possible. Avoid hanging too many things on the refrigerator that could make it difficult to identify or process for your loved one.
As with the bathroom, it may be helpful to label drawers and cabinets with photos of what they contain. Keep knives and other sharp utensils in a locked drawer (again, a child safety proof lock may be sufficient) and cleaning supplies out of reach. It may even be helpful to set aside separate plates, cups, bowls, and utensils especially for your loved one. That way, he or she only has to go to one area for everything, and it will stay better-stocked since no one else will use them. Even the smallest ways you can cut down on the potential for confusion can make the biggest difference.
Take the opportunity to be sure your fire extinguisher is in good working order, then store it somewhere easily accessible to you, but not to your loved one. Check the smoke detector and keep up with fresh batteries as needed. If your loved one is prone to unsupervised cooking, there are safety covers you can place over power knobs. You may even want to add a security device to the refrigerator if there’s a risk he or she may rummage through it.
When it comes to your dining space, make sure your chairs are sturdy and don’t tip easily. If your chairs have wheels, find a non-rolling seat for your loved one that will be easier to lower into. Having a designated seat could even make dining a smoother process: if your loved one always sits in the same chair, he or she may not need as much guidance getting from the kitchen to the dinner table.
It isn’t necessary to sacrifice your entire sense of décor, but the simpler you can make the main living area, the less overwhelming it will feel to your loved one. The living room is also a great opportunity to incorporate more of his or her own belongings, especially if there are special photos that will make the place feel especially like home. Even if it’s just a familiar blanket by the couch, some personal touches can make the transition a little easier.
Eliminating clutter in the common area may be especially tough if you have children, so embrace easy storage like toy chests and bins. You may even want to keep a “cleanup” bin to quickly gather up floor debris, which could be especially helpful if your loved one wanders independently.
Avoid throw rugs if you can, or fasten them securely to the floor. If your loved one has a special chair or spot on the sofa that he or she always sits in, be sure there’s a clear path to it. Keep remote controls stored somewhere out of reach so they don’t get lost, and wires completely out of the walkways.
If yours is a multi-story home, block the stairs with a secure safety gate. There should be railing on at least one side of the stairs, and marking the edges of each step with brightly-colored tape can make them easier to navigate. If they aren’t carpeted, install secure non-skid strips to the steps.
Because Alzheimer’s can affect a person’s perception, you’ll want to make sure any sliding glass doors are clearly identified with decals at your loved one’s eye-level. Reduce glare in glass doors and windows, and try to take down decorative mirrors — an unexpected reflection can sometimes be misunderstood or even frightening.
The entire house should be well-lit, though if you want to have dimmer lights in your own bedroom, you can keep it locked. Store all medications, cleaning supplies, alcohol, tobacco products, firearms, lighters, and any other potentially hazardous objects in secure, locked locations.
You may even want to consider installing a home security system to avoid the dangers of wandering. Though not every person afflicted with Alzheimer’s will wander, it’s better to get ahead of the problem. However, if a high-tech system is simply out of the question, get creative. A strategically-placed wind chime can be an easy accent to a window (or easily hidden behind a curtain) and act as an alarm in case your loved one gets overzealous trying to get out. Placing some sort of decoration over the front door lock or moving it up high can make it difficult for your loved one to identify and thus unable to unlock the door.
Make your loved one a part of the conversation about home modifications as much as possible. Keep following up after he or she has moved in to make sure there aren’t any new or unforeseen issues that need addressing. However, it’s important to keep in mind that your loved one may not be able to express the problem, so you and your family will need to constantly keep an eye out.
The move will probably be a little overwhelming for your loved one, so give him or her time to adjust. Before long, your loved one will truly feel at home and adapt to the new routine.