How to Alzheimer’s-Proof Your House

Part Five: Indoors and Outdoors

Five-Part Complete Guide to Alzheimer’s Proofing Your House

Part 1 | Part 2 | Part 3 | Part 4 | Part 5

Alzheimer’sProofing Indoors

Attics / Basements / Garages / Sheds / Storage Lockers

Attics, basements, garages, sheds, storage lockers are especially dangerous because, in general, they are repositories for chemicals, machinery, tools, and other items that often require special safe-handling protocols. If you permit your Alzheimer’s-afflicted loved one to enter these areas, it should be only under your careful supervision. Moreover, all of AlzheimersProof’s general safety tips are applicable. To be specific, you need to ensure that walking paths are clutter-free, the accessible areas are appropriately lit, and that dangerous items are beyond your loved one’s reach.

Attic fans. See Fans.

Bicycles. Bicycles should be secured – preferably out of sight. A stationary bike might be a good way for the Alzheimer’s-afflicted individual to exercise, but it must be used only under careful supervision. Regular bicycles are likely to prompt your loved one to leave the premises.

Fans. Fans should be secured. As mentioned for other items, I favor electrical-plug locks that prevent appliances from being plugged into outlets. However, if the fan is functional (or hardwired – as are attic, or whole-house, fans) then access to it must be restricted. At the least, the fan blades need to be inaccessible so that they cannot be touched or bumped into (whether accidentally or on purpose).

House fans. See Fans.

Lawnmowers. Lawnmowers and other lawncare equipment – such as edgers (“weed eaters”), hoes, pickaxes, post-hole diggers, rakes, shears, shovels, spades, etc. – should be placed out of reach. Additionally, mowers (and other machines with engines) should be properly stored. This might involve having to drain them of fuel (e.g., gasoline) and oil. When in doubt, call in a lawn-and-garden specialist or handyman.

Locks, garage. The garage needs to be locked. Actually, it should be secured in several ways. Firstly, if there is an access door from the house, this should be locked with a double-keyed deadbolt. Secondly, I recommend installing a Guardian latch high up on the door for additional security. Thirdly, the motorized garage door should be restricted. You may need to confiscate and control access to remote controls. Additionally, it may be necessary to recode or replace them if confiscation is not an option. Consider purchasing a “dummy” opener to give to your loved one, so that your loved one will not continue to look for the operational remote.

Paints. Enamels, latexes, and oil-based liquid paints should either be properly discarded or else locked securely in cabinets. The same goes for aerosol spray paints except, in this case, there is an additional and more pronounced danger of fire or explosion. Paints must be stored according to manufacturers’ warnings about temperature and pressure.

Sporting equipment. Keep sporting goods locked away. Baseballs and bats, gold clubs, and the like should be put away. In the first place, these items could be used – whether innocently or not – to cause damage indoors. In the second place, they can give rise to desires to “elope.” For instance, my dad would look at his golf clubs and then try to leave the house to get to a golf course. It’s good to give Alzheimer’s sufferers physical activities to do. However, these need to be carefully arranged and scheduled and should not involve pieces of equipment that might put the patient or others at risk.

Tools, garage. Restrict access to electrical tools and hand tools. Locking tool boxes and storage chests are available from hardware and home-improvement stores.

Weight equipment. This equipment needs to be gotten rid of or else kept well out of reach. Like other Sporting equipment, barbells, dumbbells, free weights, and other weight equipment can be dangerous for a person with dementia. Number one, safe-lifting practices may be neglected. Number two, the individual may no longer have any clear idea of his or her own strengths (or weaknesses).

Whole-house fans. See Fans.

RETURN TO PART ONE: THE MASTER LIST.

Bathrooms

SEE PART FOUR: KITCHENS AND BATHROOMS

RETURN TO PART ONE: THE MASTER LIST.

Bedrooms

Assist bars. Remember that one of the “Activities of Daily Living” is being able to transfer (e.g., in and out of bed) by oneself. If this is getting to be difficult, you can place “assist” bars or rails next to the bed. These devices provide the afflicted person with something to grab onto for greater leverage.

Baby monitors. This is highly effective for keeping track of a napping or sleeping dementia patient. It can also be used in other rooms of the house, and for other occasions.

Bed monitors. This pressure-sensitive device can be placed under the mattress. It will alert you whenever a person’s bodyweight is removed.

Bed rails. If your loved one frequently falls out of bed, install bed rails along the sides. Mats or pillows can also be placed on the floor. However, if left in place, these can create a tripping hazard.

Fans. Some people like fans to sleep. However, as electrical appliance, a fan is not without danger. For one thing, you need to make sure the cover is secure so that fingers and objects cannot come into contact with the blades. For another thing, you want to see that the fan is placed somewhere well clear or any water (especially if your loved one likes to sleep with a glass of water on the night table).

Furniture. Ensure that furniture is “anchored” so that it cannot be knocked or tipped over easily. Heavy furniture can cause severe injury or death if it falls on a person.

Lighting, bedroom. Install a low-light detecting nightlight.

Medicines. See Specific Tips for middle-stage Alzheimer’s: Pharmaceuticals.

Prescriptions. See Specific Tips for middle-stage Alzheimer’s: Pharmaceuticals.

Rugs, bedroom. As previously discussed, and just like in other applications, rugs should be removed from the bedroom floor, or tacked down. Properly installed carpeting is superior, since it is less likely to bunch up, slide, or otherwise contribute to a person tripping.

Space heaters. These are dangerous since they must be placed correctly, operated carefully, and switched off while not being monitored. A space heater constitutes a burn and fire hazard. Similar warnings extend to things like electric blankets and heating pads. Central heating and cooling – properly controlled – is a better option.

RETURN TO PART ONE: THE MASTER LIST.

Entrances & Miscellaneous

Chair lifts. Install as needed, if affordable. Also called “stair lifts,” these are basically chairs that run on motorized rails and can transport physically impaired individuals up and down staircases without their having to walk.

Mats. Nonslip mats can be placed in on hardwood or linoleum entry areas in order to minimize the danger of slipping. However, as with rugs, mats can slide. Ensure that mats are stable (e.g., glued, tacked, or otherwise secured affixed to the floor) before relying upon them.

Stair lifts. See Chair lifts.

RETURN TO PART ONE: THE MASTER LIST.

Kitchens

SEE PART FOUR: KITCHENS AND BATHROOMS

RETURN TO PART ONE: THE MASTER LIST.

Laundry Rooms

Bleach. Exposure to bleach (sodium hypochlorite) mainly causes irritation. This can occur in the eyes or skin through topical contact, in the eyes or lungs from inhalation of bleach fumes, or in the mouth or digestive system from ingestion. Keep bleach locked in a cabinet or otherwise secured.

Detergents. See Laundry Room: Laundry detergents.

Laundry detergents. As you did with Bleach, keep all detergents under lock and key. In June of 2017, in an article titled “Laundry Pods Can Be Fatal for Adults With Dementia,” NBC News reported that, “…according to the Consumer Product Safety Commission …six adults with cognitive impairment died over the past five years as a result of ingesting the pods.”[1]

Locks. Because of the many hazards, the laundry-room door should be kept locked. Note: If a forced-air furnace is located in the laundry area, then the door needs to be outfitted with a vent, to allow for the free movement of air into the room.

Clothes Dryers. See Laundry: Dryer, clothes.

Dryers, clothes. Secure the door with childproof latches. Place childproof knob covers over the controls.

Washing machines. Securely latch the door or lid with childproof locks. Use childproof knob covers to restrict access to the control dials.

RETURN TO PART ONE: THE MASTER LIST.

Living Rooms

Bookshelves. Be sure that shelving is anchored to the wall so that it cannot easily topple over if it is bumped, climbed on, pulled, or otherwise mishandled.

Decals. To prevent facial and other injuries, mark glass panes on doors and windows with decals or stickers.

Electrical cords. Ensure that electrical cords are not damaged or frayed and be sure that the plugs are securely plugged into outlets to prevent sparking. See also General Safety Items: Extension cords and Seniors: Trip Hazards.

Fireplaces. For obvious safety reasons, it’s probably best to close up and secure the fireplace. At the least, however, an Alzheimer’s-afflicted person should never be left unattended with fires, fire pokers, lighters, matches, or the like of those.

Rugs. Remove scatter rugs or throw rugs. Repair or replace torn carpet. See also General Safety Items: Tripping hazards and Bedroom: Rugs.

Shelving. See Bookshelves.

Televisions. Be sure that flat screens, tube television sets, etc. are firmly secured and are incapable of being pulled or knocked over. Falling TVs can cause severe injury or death. See also Bedroom: Furniture.

RETURN TO PART ONE: THE MASTER LIST.

Alzheimer’s-Proofing Outdoors

BBQ equipment. Barbecue grills (whether charcoal or gas), fire pits, smokers, and other backyard accessories pose obvious fire risks in the best of times. If one factors in cognitive impairments, things could go from bad to worse in a hurry. Be sure that briquets, fire starters, matches, and the like are under lock and key. Additionally, ensure that gas cans are inaccessible. My dad once tried to scour a floor using sugar granules because I had restricted the chemical cleansers. It’s not outside the realm of the imaginable that an Alzheimer’s-afflicted person might try to start a fire using liquid hydrocarbons like gasoline, kerosene, and so forth.

Fencing. It is important to have definite boundaries around the perimeter of the patient’s “safe space.” An outdoor area can be calming and therapeutic, but it must also be bounded so as not to invite “elopement” (i.e., your loved one’s disappearing from or leaving your home or care area).

Hot tubs. See Pools.

Lighting, exterior. Make sure outside lighting is adequate. Motion sensors can switch on lights when a something moves through their fields. Mercury-vapor or sodium lamps are capable of lighting larger areas. Be sure to avoid irritating neighbors with badly placed fixtures. Keep the steps sufficiently lit to avoid falling at night. Additionally, you might want to light the perimeter of the driveway or walkway, to help guide reentry into the house.

Locks, outdoors. As has been stated elsewhere, entry/exit points need to be carefully controlled. Backyards can lead to “elopement” (or unauthorized departure from the care area), especially if they are unfenced. See Fencing.

Pools. Remove hot tubs, home spas, and swimming pools – or at least restrict access to them using sturdy covers and locking gates. As always, there is no replacement for careful supervision.

Ramps. At some point, it may be necessary to replace traditional steps with a wheelchair-accessible ramp. This should be professionally done. Plywood haphazardly placed on top on two-by-fours might collapse under the weight of a wheelchair, or otherwise pose the risk of serious injury to anyone who ventures on top of it.

Signage. Displaying some sort of alarm system or security signage can deter would-be thieves who may try to prey on the elderly or infirm. To further reduce the danger of the senior being “scammed,” hang a “No Soliciting” sign in a visible place at the main entry.

Spas. See Pools.

Steps. Maintain staircases and steps to prevent concrete deterioration or anything that might cause the surfaces to become falling or tripping hazards. In inclement weather, be sure that surfaces are properly treated with de-icer or salt compounds to prevent slipping and injury

Walking surfaces. Get rid of any items that might present falling or tripping hazards. Eliminate uneven surfaces or walkways, hoses, and other objects that may cause a person to trip. This may mean having to repair cracked or “heaving” concrete.

RETURN TO PART ONE: THE MASTER LIST.

How to Pay for Care Home Modifications

I have discussed long-term care in a separate post. Titled “Alzheimer’s-Proof Your Retirement Savings With Long-Term Care Insurance,” the article chronicles my own family’s financial struggle to get my dad nursing-home assistance. In that article, I point out that there are really only three ways to pay for long-term care.

Three (3) Ways That Anyone Can Pay for Long-Term Care

1. Private pay
2. Out of your own assets
3. Out of your own income
4. Spend your assets down and qualify for Medicaid
5. File a claim with your long-term care insurance

Now, of course, in order to be able to file a claim with long-term care insurance, you have to actually have a long-term care insurance policy in force. Since you will never be approved for such a policy if you wait until you have Alzheimer’s Disease (or some other form of dementia), if you are interested in protecting your retirement (and other assets) for your family/spouse, then you need to apply for long-term care insurance before you have any signs of cognitive impairment.

When it comes to paying for home modifications, the options dwindle down to two. As the website Caring.com explains: “Like Medicare, Medicaid doesn’t cover physical modifications to the home.”[2]

Two (2) Ways That Anyone Can Pay for Home Modifications[3]

1. Private pay
2. Long-term care insurance

Most people will therefore have to pay for their own home modifications, regardless of who they have perform the work. However, for those who have the right sort of long-term care insurance, some money might be available to subsidize various house alterations.

You have to check your contract or contact your insurance agent to discover whether these benefits are available to you and what limitations or restrictions, if any, may be placed upon them. For instance, some contracts might limit you to obtaining modifications of certain types, or from certain contractors, etc. And there may be maximums to the dollar amounts that insurance companies are willing to pay for such work.

Generally speaking, you may need to seek preapproval for any prospective, home-modification project.

But, here are a few sorts of installations/modifications that you might expect to receive approval – for those policies that offer these types of benefits.

• Addition of “knee holes” (to accommodate wheelchairs) in bathrooms, kitchens, studies, and work areas
• Installation of chair/stair “lifts” to enable people to traverse house levels without having to walk up stairs
• Mounting of grab bars and handrails
• Placement of wheelchair ramps over entryway steps
• Replacement of conventional bathtubs/showers with walk-in varieties
• Widening of doorways for wheelchair access

For More Information

See the following articles.

“How Do You Alzheimer’s Proof a Car?”

What do we mean by “Alzheimer’s Proofing?” see HERE.

What’s the Difference between Alzheimer’s Proofing and Baby Proofing or Childproofing? See HERE.

RETURN TO PART ONE: THE MASTER LIST.

Notes:

[1] Ben Popken, “Laundry Pods Can Be Fatal for Adults With Dementia,” NBC News, Jun. 16, 2017, <https://www.nbcnews.com/business/consumer/laundry-pods-can-be-fatal-adults-dementia-n773366>.

[2] Joseph Matthews, “FAQ: What Kinds of Home Equipment and Modifications Are Covered by Medicare, Medicaid, or the VA?” Caring.com, Apr. 9, 2018, <>. The author adds, however: “However, some state Medicaid programs have special pilot programs that can help with home modifications. If you need home modification, check with the Medicaid worker who handles your file and ask if there might be special coverage that can help you,” ibid.

[3] Veterans have certain grants that they can apply for through the U.S. Department of Veterans Affairs (also known as the Veterans Administration), usually designated the “V.A.” See Matthews, loc. cit.

How to Alzheimer’s-Proof Your House:

Part Four: Kitchens & Bathrooms

Five-Part Complete Guide to Alzheimer’s Proofing Your House

Part 1 | Part 2 | Part 3 | Part 4 | Part 5

Kitchens

Kitchens are replete with dangers. In general, reduce countertop clutter (see also Specific Tips for Early-Stage Alzheimer’s: Clutter), secure blades and cutting instruments, control access to breakables like china and glassware, and ensure that electrical appliances are not near sources of water.

Appliances, electrical. Ensure that electrical appliances are not near sources of water in the kitchen and that their use does not lead to fire. Blenders, cellular phones and chargers, Microwaves, mixers, toasters, are among the potentially dangerous small kitchen appliances. Individual appliances can be secured with electric-plug locks. Appliances that cannot be locked, should be removed from sight, or removed from the house altogether.

Blenders. See Appliances, electrical.

Burners. See Stovetop.

Cabinets. Install “childproof” locks on any storage cabinets that you wish to make off limits. China, glassware, and so on should be secured in this way (if not removed). Additionally, appliances like blenders, mixers, and toasters should be removed from sight and locked away when not in (supervised) use.

Centerpieces. See Table centerpieces.

Cleaning products, kitchen. Household cleansers also need to be kept under lock and key. Glass cleaners often contain ammonia, and surface-cleaning products may utilize bleach. Chemicals like these pose huge risks for Alzheimer’s sufferers who are liable to mistakenly ingest or otherwise misuse these substances. Even if properly used, a dementia-afflicted person cannot be counted on to adequately wash up afterwards, increasing the likelihood that they might contaminate food or whatever they touch after cleaning. See also Cleaning products, bathroom.

Coffee pots. See Appliances, electrical. [Kitchens]

Disposals. See Garbage disposals.

Drains. Install a plastic, wire-mesh or other sort of disposal/drain strainer to stop objects from falling into the disposal or down into the drain.

Drawers, kitchen. Drawers can likewise be latched or locked. Cutlery should be so secured, along with miscellaneous items like candles, glues, lighters, matches, razor blades, scissors, and so forth. Special problems are raised with the so-called “junk drawer.” This drawer needs careful attention. It should be emptied, and the contents relocated, or else it should be securely locked. Batteries, chemicals, tools, utility knives, and so on all pose acute dangerous for the cognitively impaired. Even more common and seemingly innocuous items like pencils and pens can be dangerous if used incorrectly, or for inappropriate purposes. For example, my dad once tried to use the clip from a pen to try to unscrew the cover plate from a wall outlet. The metal clip could easily have slipped and enter the electrical socket, which was live.

Foods. See General Safety Items: Food stuffs.

Garbage disposals. Consider having the garbage disposal removed entirely, to eliminate the danger of fingers being placed into it. A handyman or plumber can replace the disposal with additional PVC piping. At the least, the disposal needs to have a cutoff switch that will ensure it cannot be operated when no one is around to supervise.

Lighting, kitchen. Make sure that kitchen lighting fixtures provide adequate illuminations and are in good working order. Install a nightlight that switches on when the light falls below a particular threshold.

Magnets. Magnets are extremely dangerous if they are ingested. It is probably best to clear the refrigerator.

Mats, kitchen. If nonskid mats are being used, they must be securely placed so as not to slip out of position when they are needed.

Medicines. See Specific Tips for middle-stage Alzheimer’s: Pharmaceuticals.

Microwaves. Access to microwaves should be curtailed and microwave usage ought to be carefully monitored. One option would be to remove the microwave altogether. This is not ideal, however, if it inconveniences the caretaker. Another possibility would be to put electric-plug locks on the microwave’s power cord. This is the route that I took with my dad. Some microwaves now come equipped with “childproofing” features. Usually, this means that the control panel can be “locked” (by a sequence of buttons acting as a passcode). So, a final suggestion would be to replace your microwave with one that has these capabilities. Then simply engage the microwave’s lock function to prevent unauthorized use.

Mixers. See Appliances, electrical.

Ovens. Dementia patients may forget how to properly use appliances. The over door can be latched shut to prevent the cooking chamber from being accessed. It is also (theoretically) possible to install “shut-off” switches on some appliances, to keep them from heating in the first place or from remaining switched on for extended periods of time. The fuse panel or circuit breaker could also be used to accomplish the same purpose. Even if they manage to use the appliance correctly, Alzheimer’s sufferers may forget to turn it off – creating an obvious fire danger. Again, there is seldom an alternative to vigilance. See also Stovetop.

Pharmaceuticals. See Specific Tips for middle-stage Alzheimer’s: Pharmaceuticals.

Prescriptions. See Specific Tips for middle-stage Alzheimer’s: Pharmaceuticals.

Refrigerator. Install a “childproof” latch to the door to restrict access. This is especially important if medications have to be refrigerated. (See also Specific Tips for Middle-Stage Alzheimer’s: Pharmaceuticals.) Ensure that perishable foods are not spoiled. (See also General Safety Items: Food stuffs.)

Stovetop. “Childproof” knobs can be used to frustrate attempts to operate the appliance. My dad shattered several glass bowls when he placed them atop burners. Circuit breaker switches can be used to disable electrical stoves. See also Microwave and Oven.

Table centerpieces. Flowers and other centerpieces can be cheery additions to the dining area or kitchen. However, if centerpieces include such things as plastic fruits, poisonous plants, or other things that could be mistaken for edibles, then they are best removed.

Toasters. See Appliances, electrical.

Vitamins. Pills of all sorts – whether prescription, nonprescription, or whatever – need to be stored securely out of reach. This includes vitamins, which can present choking and overdosing hazards, just like prescription medicines can.

Water temperature. See Specific Tips for middle-stage Alzheimer’s: Water temperature.

RETURN TO PART ONE: THE MASTER LIST.

Bathrooms

Bathrooms are filled with perils of many kinds. The New York Times reports that, according to the Centers for Disease Control and Prevention, “…every year about 235,000 people over age 15 visit emergency rooms because of injuries suffered in the bathroom… Injuries increase with age, peaking after 85…”.[1] Interestingly: “People over 85 suffer more than half of their injuries near the toilet.”[2]

Persons suffering from cognitive impairment should be treated as you would treat small children. Never leave an Alzheimer’s-afflicted person alone in the bathroom. This need not mean that you have to stand next to them as the use the toilet (although, depending upon their overall physical abilities, you may have to do exactly this). But it does mean that you should always be aware of the what the person is doing. Impaired persons, left unattended, could end up burning, electrocuting, or poisoning themselves, or else choking, drowning, slipping, or otherwise harming themselves in any of several other unfortunate ways. Be present and be alert!

Appliances, electrical. Ensure that electrical appliances are not near sources of water in the bathroom. Cellular phones and chargers, clothes irons, electric radios and TVs, electric razors, electric toothbrushes, hair-curling irons, hairdryers, space heaters, and tablets are among the potentially dangerous equipment that can find its way into the bathroom. Police the entry into the bathroom, particularly if water is going to be involved. Try to encourage afflicted persons to shave themselves and dry their hair (etc.) in locations far removed from sources of water. And, as usual, be sure to place childproof covers on exposed and unused outlets.

Cleaning products, bathroom. Get rid of, relocate, or otherwise secure any cleaning products that may be stored under the bathroom sink. See also Cleaning products, kitchen.

Cough medicine. See Specific Tips for middle-stage Alzheimer’s: Pharmaceuticals.

Curling irons. See Appliances, electrical.

Doors. Doors could be widened to accommodate wheelchairs or other equipment. See also Locks, bathroom.

Drain traps. Insert drain traps in sinks to catch small items that may be lost or flushed down the drain.

Electrical appliances. See Appliances, electrical.

Electric razors. See Appliances, electrical.

Faucets. If your loved one has a faucet with separate spouts for cold and hot water, consider replacing the assembly with a single-spout version. The reason is that with dual spouts, the hot water comes out at full strength, and touching the stream (intentionally or unintentionally) can result in burns. With a single-spout setup, by contrast, the hot and cold water mix before coming out, thus decreasing the chances of burns (if the cold-water faucet is properly turned on, of course). See also Water temperature. You might also consider replacing fixtures with ones that have clearly and colorfully labeled indicators for “Cold” and “Hot” water valves. See also Decals and Labels.

Flooring. For bathroom-flooring concerns, see Tile flooring.

Hair dryers. See Appliances, electrical.

Heat lamps. Heat lamps can be excellent alternatives to space heaters for bathrooms.

Grab bars. Grab bars can and should be added in numerous places in the bathroom. For instance, bars can be a helpful addition to the toilet seat or, at least, installed next to the toilet bowl. Grab bars or handrails should also be a fixture in the bathtub or shower basin. As with many of the contemplated home modifications, grab bars need to be installed correctly to be useful. Improperly anchored grab bars are a major hazard and can result in severe injury to the senior (or whomever) if they give way under pressure.

Lighting, bathroom. Use a night-light. It may even be worthwhile installing motion sensors that will automatically turn on lights without a person having to fumble for, or remember to turn on, switches.

Locks, bathroom. Many bathrooms are standardly outfitted with doors that can be locked from the inside. In order to prevent the dementia sufferer from locking him- or herself inside, it is probably best to remove this lock from the door. At the very least, hide a key outside – for example, on the molding ledge above the door – for ease of reentry if your loved one is locked inside. (Many bathroom locks can be opened with a small, flat-bladed screwdriver. Take time to examine your door so that you know ahead of time how to open it if an emergency arises.)

Medicines. See Specific Tips for middle-stage Alzheimer’s: Pharmaceuticals.

Prescriptions. See Specific Tips for middle-stage Alzheimer’s: Pharmaceuticals.

Shelving. Shelves need to be properly anchored to the walls. Because of the tightness of the space in the bathroom, shelving should perhaps be sturdy enough to double as Grab bars. Where that is impractical, shelving should probably be removed.

Shower benches. These are basically small, nonslip seats that permit a person to sit in the shower (without having to be on the floor), instead of having to stand. They should be used along with shower “wands,” or handheld showerheads.

Showerheads. For added versatility, not to mention increased safety, think about converting traditional, fixed showerheads into handheld versions. These replacements enable your loved one to thoroughly wash without having to stand.

Shower seats. See Shower benches.

Shower, walk-in. Cognitively impaired individuals, along with some seniors in general, may have difficulties entering conventional bathtubs and shower basins. One thing to consider would be to convert the existing bathing/showering facility into a “walk-in” that is more accessible to someone who is experiencing coordination or mobility problems.

Space heaters, bathroom. See Appliances, electrical. See also Bedrooms: Space heaters.

Spout covers. A safety faucet cover is another useful, do-it-yourself addition to the bathroom. Also called “soft” faucet covers, these protective shields are usually made of foam, rubber, or some equivalent material designed to cushion the shower hardware in the unhappy event that someone slips and strikes the exposed metal. These covers are often available wherever childproofing devices are sold.

Tile flooring. Most bathrooms of course have linoleum, vinyl, or other tile flooring. However, to reduce the risk of slipping, you could consider replacing this with specialized “bath” carpet or rubber tiling.

Toilets. To prevent slipping, place nonskid adhesives or safety mats around the toilet.

Tub mats. Secure nonslip mats or “stickers” in the bathtub or shower basin.

Toilet seat. Elevated toilet seats, also called toilet-seat “risers,” can be helpful for elderly people who experience decreased flexibility and mobility. The slightly raised seats provide an assist when transferring on and off the toilet.

Walk-in shower. See Shower, walk-in.

Water temperature. See Specific Tips for middle-stage Alzheimer’s: Water temperature.

RETURN TO PART ONE: THE MASTER LIST.

How to Pay for Care Home Modifications

I have discussed long-term care in a separate post. Titled “Alzheimer’s-Proof Your Retirement Savings With Long-Term Care Insurance,” the article chronicles my own family’s financial struggle to get my dad nursing-home assistance. In that article, I point out that there are really only three ways to pay for long-term care.

Three (3) Ways That Anyone Can Pay for Long-Term Care

1. Private pay
2. Out of your own assets
3. Out of your own income
4. Spend your assets down and qualify for Medicaid
5. File a claim with your long-term care insurance

Now, of course, in order to be able to file a claim with long-term care insurance, you have to actually have a long-term care insurance policy in force. Since you will never be approved for such a policy if you wait until you have Alzheimer’s Disease (or some other form of dementia), if you are interested in protecting your retirement (and other assets) for your family/spouse, then you need to apply for long-term care insurance before you have any signs of cognitive impairment.

When it comes to paying for home modifications, the options dwindle down to two. As the website Caring.com explains: “Like Medicare, Medicaid doesn’t cover physical modifications to the home.”[3]

Two (2) Ways That Anyone Can Pay for Home Modifications[4]

1. Private pay
2. Long-term care insurance

Most people will therefore have to pay for their own home modifications, regardless of who they have perform the work. However, for those who have the right sort of long-term care insurance, some money might be available to subsidize various house alterations.

You have to check your contract or contact your insurance agent to discover whether these benefits are available to you and what limitations or restrictions, if any, may be placed upon them. For instance, some contracts might limit you to obtaining modifications of certain types, or from certain contractors, etc. And there may be maximums to the dollar amounts that insurance companies are willing to pay for such work.

Generally speaking, you may need to seek preapproval for any prospective, home-modification project.

But, here are a few sorts of installations/modifications that you might expect to receive approval – for those policies that offer these types of benefits.

• Addition of “knee holes” (to accommodate wheelchairs) in bathrooms, kitchens, studies, and work areas
• Installation of chair/stair “lifts” to enable people to traverse house levels without having to walk up stairs
• Mounting of grab bars and handrails
• Placement of wheelchair ramps over entryway steps
• Replacement of conventional bathtubs/showers with walk-in varieties
• Widening of doorways for wheelchair access

For More Information

See the following articles.

“How Do You Alzheimer’s Proof a Car?”

What do we mean by “Alzheimer’s Proofing?” see HERE.

What’s the Difference between Alzheimer’s Proofing and Baby Proofing or Childproofing? See HERE.

RETURN TO PART ONE: THE MASTER LIST.

Notes:

[1] Nicholas Bakalaraug, “Watch Your Step While Washing Up,” New York Times, Aug. 15, 2011, <https://www.nytimes.com/2011/08/16/health/research/16stats.html>.

[2] Ibid.

[3] Joseph Matthews, “FAQ: What Kinds of Home Equipment and Modifications Are Covered by Medicare, Medicaid, or the VA?” Caring.com, Apr. 9, 2018, <>. The author adds, however: “However, some state Medicaid programs have special pilot programs that can help with home modifications. If you need home modification, check with the Medicaid worker who handles your file and ask if there might be special coverage that can help you,” ibid.

[4] Veterans have certain grants that they can apply for through the U.S. Department of Veterans Affairs (also known as the Veterans Administration), usually designated the “V.A.” See Matthews, loc. cit.

How to Alzheimer’s Proof Your House:

Part Three: Specific Alzheimer’s Tips

Five-Part Complete Guide to Alzheimer’s Proofing Your House

Part 1 | Part 2 | Part 3 | Part 4 | Part 5

Specific Tips for Early-Stage Alzheimer’s

Alzheimer’s, if it is anything, is a disease that affects a person’s cognition. An Alzheimer’s sufferer may not do well with changes to his or her living environment. This is a difficulty, since (in some cases) major changes may be necessary in order to care for and protect the patient.

It is always preferable to be proactive rather than reactive, since if you’re reacting, then something bad has already happened. Therefore, try to anticipate problems before they occur.

Perhaps the best piece of advice, therefore, is to start implementing changes as early as possible. I have mentioned this elsewhere. (See HERE.) In a nutshell, if you can get an Alzheimer’s-afflicted person to accept the needed changes, so much for the better. Hence, it is well to try to get them accustomed to, or conditioned/trained for, the changes before they are strictly necessary.

In a way, then, it might be best for all of us to partially arrange out living environments in such a way that it will not be traumatic for us if we are ever cognitively impaired.

Still, whenever you begin the modification process, the following are things to think about.

Clutter. Eliminate or reduce clutter, pick up loose objects, and be sure that electrical cords are well clear of walkways. Clutter is potentially hazardous for several reasons. Firstly, it is psychologically hazardous as it can give rise to anxiousness, Trigger unsafe behaviors, or worsen confusion. Secondly, it is physically hazardous, both personally, as it can increase dangers such as tripping, as well as structurally, as it can heighten the risks of fire, mold growth, pest infestation (bugs, rodents, etc.), etc. See also For Seniors: Tripping Hazards.

Gates. Installing gates at the top and bottom of staircases may be appropriate, if access to the stairs needs to be limited.

Keys. Spare keys can be strategically placed outside of the house, in case the person with Alzheimer’s disease becomes locked out of his or her house. Of course, this must be done with care, since hidden keys – if discovered – pose home-security problems. See also General Safety Items: Keys.

Labels. Persons with cognitive impairments may be meaningfully assisted by labels or signs that help them to navigate their living space. Labels and signs should be large-print or visually based and can assist Alzheimer’s sufferers in finding bathrooms, light switches, television remote controls, and so on. In effect, these function as positive Triggers (which entry see for the negative sort).

Plants. Plants like European Mistletoe (Viscum album), Heart of Jesus (Caladium bicolor), Mother-in-law’s Tongue (Sansevieria trifasciata), and Nerium (Nerium oleander), though often kept as decorative, are actually poisonous (to one degree or other) and should be kept out of reach or removed altogether.

Thermostat. Carefully regulate ambient temperature. Consider camouflaging or relocating the thermostat. Another option is to install a thermostat lock box. In the case of my dad, he frequently fiddled with the controls. For example, if he felt chilly, he might set the temperature on 90 degrees. However, once the furnace was engaged, he might become distracted and allow the house to heat to an uncomfortable (or even dangerous) extent. Leaving open access to the thermostat can also be a recipe for higher-than-necessary electric or natural-gas bills.

RETURN TO PART ONE: THE MASTER LIST.

Specific Tips for middle-stage Alzheimer’s

Alcohol. Similarly, alcohol (both ethyl and methyl) should be discarded or locked away and stored out of sight. In addition to the dangers that drinking poses normally, a cognitively impaired individual may be more susceptible to alcohol poisoning. Moreover, drinking may be contraindicated for some prescriptions. Furthermore, alcohol can exacerbate certain dementia symptoms – such as decreased coordination, mental confusion, poor decision-making, and so on.

Answering machines. Use an answering machine when you cannot answer phone calls on behalf of your loved one. Be sure to set the machine to turn on after the fewest number of rings possible and turn the telephone ringers down. A person with Alzheimer’s disease often may be unable to take messages or could become a victim of telephone exploitation. Turn ringers on low to avoid distraction and confusion. Put all portable and cell phones and equipment in a safe place so they will not be easily lost. See also General Safety Items: For Seniors: Telephones.

Camouflage. In some cases, Triggers can be controlled through camouflage. If your loved one frequently “elopes” (i.e., leaves without permission) you might try to camouflage the door to make it look like it is merely part of the surrounding wall. Or again, you might cover the door knobs with pieces of fabric that are the same color as the surrounding paint. Camouflage works (when it does work) because people with dementia often experience perceptual and visual-discrimination difficulties.

Cigarettes, cigars, etc. Relatedly, smokers need to be watched carefully, as cigarettes, cigars, lighters, matches, pipes, and the like are fire hazards.

Doorknob covers. Covers, similar or even identical to ones used in “childproofing” expeditions, can help to secure entryways and exits. Covers work because Alzheimer’s sufferers often experience marked reductions in manual dexterity, making it difficult or practically impossible for them to perform the motion sequences required to bypass the knob covers.

Electric tools. See Tools.

Firearms. See Specific Tips for middle-stage Alzheimer’s: Guns.

Gates. Safety gates – like ones available for childproofing – could be positioned at the tops and bottoms of stairs as well as across door openings that lead to restricted areas. Additionally, yard gates should be locked to help ensure that your loved one does not leave the yard unsupervised.

Guns. Remove or secure any firearms (handguns, pistols, rifles, and the like). Because of the high-level of danger presented by these instruments, it is advisable to have redundant measures in place. For example, you could attach trigger locks onto guns and then, additionally, place them into gun safes or locked cabinets. Hide ammunition as well as any accessories that might prompt the patient to think about locating the firearm. Your local police department may be able to assist your family. Don’t hesitate to reach out to them with questions.

Handguns. See Guns.

Hand tools. See Tools.

Knives. As you would with Guns, you should secure or get rid of knives and other sharp objects (e.g., boxcutters, razors, scissors, shears, etc.).

Locks. Install locks on all exits and windows. Personally, I had a lot of success with double-keyed deadbolts – that is, deadbolts that must be opened with keys on both sides of the door. Some online authorities have also suggested installing “hotel-style” swing-bar locks. I also recommend reinforcement locks, but I prefer those that can be installed higher up (and out of sight) on the door. One household “hack” that can save you a bit of money is to reverse the lock on your screen or storm door to prevent “elopement.” Solicitors might think that you’re a bit loopy when they see the thumb-turn mechanism facing them when they approach the entryway. But this may be an agreeable price for servicing the ambition of frustrating your loved one’s attempts to leave the home unsupervised.

Motion sensors. Install magnetic or motion-sensitive alarms so that the caretaker will be alerted if an off-limits door or window is opened. Motion sensors throughout the living space can also alert you to instances of “wandering.” You might also consider Trackers.

Outlet covers. Cover exposed electrical outlets with childproof plugs. [See article on Childproofing vs. Alzheimer’s-Proofing]

Pets. Pets can be calming for persons with Alzheimer’s. However, they do not come without challenges of their own. Birds, cats, dogs, fish, and other pets need attention and caring. A person with impaired memory and reasoning faculties could accidentally injure, neglect, overfeed, or poison a pet through inattention or mistake. Some pets – like fish, hamsters, and such – need enclosures that must be kept clean and regulated. Consider fish. Large, water-filled tanks in close proximity to electricity (for filtration systems) can be dangerous for those with dementia. As difficult as it may be, fish should probably be relocated off premises. If pets are part of your loved one’s care plan, then just ensure that a caretaker is well apprised of everything the pet requires and has time enough to spend attending to it.

Pharmaceuticals. Secure medications (whether over-the-counter or prescription) and vitamins, possibly in locked cabinets. Do not leave them on bathroom or kitchen countertops or on bedroom night tables. Risks included choking, overdosing, and poisoning. Childproof caps may be advisable. [See article on Childproofing vs. Alzheimer’s-Proofing] Ensure that your loved one’s caretaker understands the dosage amount and frequency for each prescribed, or otherwise necessary, medication. Periodically check expiration dates and discard or renew expired prescriptions or over-the-counter medications. See also General Safety Items: Prescriptions.

Pistols. See Guns.

Plastic bags. Just as you would do with a small child, keep plastic bags well out of reach. Cognitive impairment can increase risks such as suffocation.

Power tools. See Tools.

Rifles. See Guns.

Shotguns. See Guns.

Tools. Hand tools, ladders, power tools, and so forth need to be fully secured in basement utility rooms, garages, or workshops. Again, redundancy is advised. For example, I locked away tools in cases and kept them in a double-locked garage. I placed ladders in the rafters and literally tied them to the ceiling joists using bicycle locks. Although it was unlikely that my dad would have been able to get into the garage in the first place (to my knowledge, he never did), if he managed it, his tools would still have been inaccessible. Or again, I put socket locks on the electric cord for the table, but I also removed and secured the blade.

Trackers. Various companies manufacture devices that can help you to locate a loved one who has left his or her care setting without authorization. Among other options, there is something called Project Lifesaver; the Alzheimer’s Association also has its Safe-Return Program.

Triggers. Ideally, these need to be eliminated or minimized. In the context of Alzheimer’s Disease, a “trigger” is something that prompts a sufferer to embark on a course of action that is unsafe for him or her. (For more helpful and positive “triggers,” see Labels.) For instance, an Alzheimer’s-afflicted person who is no longer competent to drive may still wish and try to do so after seeing the car keys hanging by the door. Or again, an open door might trigger a dementia patient to “elope” (i.e., to leave the care area without supervision). See also Trackers.

Water temperature. Just as should parents with young children, dial down the temperature on your water heater. You will need to adjust the setting to a temperature that is appropriate for your loved one’s context. Generally, the safe range falls somewhere in between about 105°F and 125°F, with most people opting for something around 115°F. Consult with your family physician or other advisers to determine what would be right for your situation.

Weapons. See the separate entries on Guns and Knives.

RETURN TO PART ONE: THE MASTER LIST.

How to Pay for Care Home Modifications

I have discussed long-term care in a separate post. Titled “Alzheimer’s-Proof Your Retirement Savings With Long-Term Care Insurance,” the article chronicles my own family’s financial struggle to get my dad nursing-home assistance. In that article, I point out that there are really only three ways to pay for long-term care.

Three (3) Ways That Anyone Can Pay for Long-Term Care

1. Private pay
2. Out of your own assets
3. Out of your own income
4. Spend your assets down and qualify for Medicaid
5. File a claim with your long-term care insurance

Now, of course, in order to be able to file a claim with long-term care insurance, you have to actually have a long-term care insurance policy in force. Since you will never be approved for such a policy if you wait until you have Alzheimer’s Disease (or some other form of dementia), if you are interested in protecting your retirement (and other assets) for your family/spouse, then you need to apply for long-term care insurance before you have any signs of cognitive impairment.

When it comes to paying for home modifications, the options dwindle down to two. As the website Caring.com explains: “Like Medicare, Medicaid doesn’t cover physical modifications to the home.”[1]

Two (2) Ways That Anyone Can Pay for Home Modifications[2]

1. Private pay
2. Long-term care insurance

Most people will therefore have to pay for their own home modifications, regardless of who they have perform the work. However, for those who have the right sort of long-term care insurance, some money might be available to subsidize various house alterations.

You have to check your contract or contact your insurance agent to discover whether these benefits are available to you and what limitations or restrictions, if any, may be placed upon them. For instance, some contracts might limit you to obtaining modifications of certain types, or from certain contractors, etc. And there may be maximums to the dollar amounts that insurance companies are willing to pay for such work.

Generally speaking, you may need to seek preapproval for any prospective, home-modification project.

But, here are a few sorts of installations/modifications that you might expect to receive approval – for those policies that offer these types of benefits.

• Addition of “knee holes” (to accommodate wheelchairs) in bathrooms, kitchens, studies, and work areas
• Installation of chair/stair “lifts” to enable people to traverse house levels without having to walk up stairs
• Mounting of grab bars and handrails
• Placement of wheelchair ramps over entryway steps
• Replacement of conventional bathtubs/showers with walk-in varieties
• Widening of doorways for wheelchair access

For More Information

See the following articles.

“How Do You Alzheimer’s Proof a Car?”

What do we mean by “Alzheimer’s Proofing?” see HERE.

What’s the Difference between Alzheimer’s Proofing and Baby Proofing or Childproofing? See HERE.

RETURN TO PART ONE: THE MASTER LIST.

Notes:

[1] Joseph Matthews, “FAQ: What Kinds of Home Equipment and Modifications Are Covered by Medicare, Medicaid, or the VA?” Caring.com, Apr. 9, 2018, <>. The author adds, however: “However, some state Medicaid programs have special pilot programs that can help with home modifications. If you need home modification, check with the Medicaid worker who handles your file and ask if there might be special coverage that can help you,” ibid.

[2] Veterans have certain grants that they can apply for through the U.S. Department of Veterans Affairs (also known as the Veterans Administration), usually designated the “V.A.” See Matthews, loc. cit.

How to Alzheimer’s-Proof Your House

Part Two: General and Senior-Safety Tips

Five-Part Complete Guide to Alzheimer’s Proofing Your House

Part 1 | Part 2 | Part 3 | Part 4 | Part 5

General Safety Items

As I was preparing the Master List with Alzheimer’s in mind, it occurred to me that many commonsense suggestions could be more widely applicable. Some things are just good practices for anyone, regardless of whether or not they are dealing with (someone who has) dementia. Here are a few examples.

For Everyone

Batteries. Store and discard batteries correctly. Exposed battery terminals can pose a fire hazard. Nine-volt (9V) batteries are especially dangerous. To be safe, cover battery terminals with electrical tape being throwing them away.

Break-in Deterrence. Cutting back bushes, foliage, and shrubbery can deprive would-be thieves of hiding places or staging areas. Adequate lighting is an essential component of home security. Obviously, doors and windows need to be kept locked. Alarm systems and other more exotic products are secondary to these foundational elements.

Chemicals, flammable. Keep inflammable chemicals (especially, but not limited to, aerosol paints, gasoline, lighter fluids, turpentine, and so on) far clear of kitchens, utility rooms, and anywhere there are sparking appliances such as furnaces and water heaters. Be mindful that: (a.) sometimes electrical switches can arc or spark and ignite chemicals; and (b.) the vapor or gas of certain chemicals can be just as dangerous – if not more dangerous – than the liquid.

Detectors. Ensure that working carbon-monoxide, natural-gas, and traditional smoke detectors are installed throughout the living space. (Click HERE if you would like to read about ALZHEIMERSPROOF’s detector recommendations.) Bedrooms, garages, hallways, and kitchens are hotspots – sometimes literally. Since the detector is only effective if its batteries are good, you need to schedule periodic battery checks and battery replacements. One person reported to me that replacing batteries is part of her family’s New-Year’s ritual.

Extension cords. Extension cords can present many dangers in the home. Damaged or frayed cords, for instance, pose the risk of electric shock or electrocution. Cords that are incorrectly gauged can pose fire hazards. Short circuits can blow fuses or trip circuit breakers, leaving seniors in the dark. Cords carelessly or haphazardly strewn about may cause seniors to trip and fall. See also Living Room: Electrical cords.

Food stuffs. Food – both canned goods and refrigerated items – should be checked regularly for expiration or spoilage. This becomes important in the case of a person whose eyesight or reasoning abilities are dwindling, but it is a good practice for anybody.

Lighting. Besides decreasing the risk of tripping at night, adequate lighting (especially on the exterior of the home) can also deter robbers.

Prescriptions. Many people keep prescription medications in the bathroom “medicine cabinet.” However, the fluctuating-temperature and high-humidity environment is generally not ideal for the storage of prescriptions or vitamins. Check the prescription for care instructions. Many bottles will indicate where and in what manner they should be stored (e.g., a label might read: “store in a cool, dry place,” or “refrigerate after opening,” etc.).

Telephones. Clearly record the home number as well as any emergency phone numbers and important contacts (e.g., family members or caretakers). For example: Poison control (1-800-222-1222); Alzheimer’s Association (1-800-272-3900); etc.

RETURN TO PART ONE: THE MASTER LIST.

For Seniors

The two keys for seniors are functionality and simplicity.

For seniors, activities of daily living become increasingly challenging. “Functionality,” then, has to do with thinking of changes that can help make day-to-tasks more manageable.

On the flipside, however, homes can become excessively cluttered with assistance apparatuses and “time-saving” devices. The extra clutter can jam up walking paths and present Tripping hazards (on which, see elsewhere). Beyond that, though, collections of stuff – when they get out of control – can exacerbate claustrophobia and become mentally oppressive. For those with some form of dementia, clutter can lead to cognitive overstimulation, which in turn can manifest in negative or anxious behaviors.

Yes, we want useful aids, but we also want organization. So, find a happy medium that works for your family. Here are some suggestions.

Benches. Sometimes little modifications can go a long way. For example, seniors may have difficulty entering their apartments or homes while carrying groceries or shopping bags. However, strategically locating a bench or shelf can provide a resting place for the packages while the senior unlocks the door.

Computers. The computer presents several challenges. Number one, seniors can fall victim to predators via nefarious “spam” email-message tactics. In “phishing” or “spoofing” emails, sending misrepresent themselves as being from reputable companies (such as the senior’s bank) or the government (e.g., the Internal Revenue Service) and seek to scare or otherwise cajole seniors into divulging personal information. Possible measures you can implement include installing Internet-restriction software, personally monitoring your loved one’s screen time, or limiting access to the computer through password protection. Number two, on the other side of things, seniors could accidentally delete documents or information that ought to be saved. Ensure that caretakers (or interested family members, what have you) keep local backups (e.g., on removal media like compact discs, DVDs, external hard drives, flash drives, and so on) or save the files to the “cloud.” Number three, the computer desk itself can present dangers in terms of tangles and tripping hazards. Due to their plethora of accessories, personal-computers (PC) workstations often rely on power strips to accommodate all the electrical cabling needed to make the operation work. Take some time and ensure that the various pieces of equipment – as well as their connecting and power cords – are safely stowed in out-of-the-way places. I have made good use of nylon (“zip”) ties and other cable accessories, to keep the setup tidy and off the floor. If valuable documents or materials are stored on a home computer, protect the files with passwords and back up the files.

Handrails. See Staircases.

Keys. Spare keys can be hidden outside and used as backups in case of emergency or inadvertent lockout. Be forewarned, however, that having a key outdoors may leave you vulnerable to certain home-security risks, if a thief were to discover and exploit the hidden key. So, think about ways to disguise the hiding place so that it will be useful, but will not leave the house as open to break in. See also, Specific Tips for Early-Stage Alzheimer’s: Keys.

Lighting, interior. Check to be sure that all rooms and walkways are sufficiently lit – especially during the nighttime hours.

Light switches. Additionally, try to ensure that light switches are located at the top and the bottom of staircases.

Rails. See Staircases.

Staircases. Stairways can be dangerous. Minimally, handrails should be installed on both sides of the staircase. The rail should extend farther out than the stairs, so that seniors can get a firm grip before venturing up or down. Additionally, the handrail should be professionally installed – and properly anchored to the wall. Some handrails are more decorative than functional, and one doesn’t discover until it’s too late that they are unable to support a person’s full body weight. Moreover, stairs ought to have nonslip surfaces – whether appropriate carpeting or with friction strips.

Telephones. Install flashing light in lieu of ringer for the hearing impaired. Set up an answering machine or voice mailbox to intercept – and screen – calls. See also Answering Machines.

Tripping hazards. Be sure that electrical cords are not stretched across walkways. Seniors can also trip on bunched-up rugs. Ensure that rugs are removed or are at least carefully affixed to the floor. Consider having carpeting put in instead of relying upon rugs.

RETURN TO PART ONE: THE MASTER LIST.

For More Information

See the following articles.

“How Do You Alzheimer’s Proof a Car?”

What do we mean by “Alzheimer’s Proofing?” see HERE.

What’s the Difference between Alzheimer’s Proofing and Baby Proofing or Childproofing? See HERE.

RETURN TO PART ONE: THE MASTER LIST.

Ultimate Guide to Alzheimer’s-Proofing A Home

Part One: The Master List

Five-Part Complete Guide to Alzheimer’s Proofing Your House

Part 1 | Part 2 | Part 3 | Part 4 | Part 5

Introductory Comments

As readers of this blog may already know, it fell to me to care for my dad, Jim, when he developed Alzheimer’s dementia. (Read “Jim’s Story.”) Among all the many challenges that I had to face initially was that of trying to make the home environment safe for Jim’s care.

As I told numerous individuals, if you are going to care for your loved one at home – whether your home or theirs – then you must treat the living space as a care environment. For some families, this might mean that the residence begins to look more like a hospital, complete with hospital beds, oxygen equipment, intravenous fluid-delivery systems, and so on. For others, however, the house will take on characteristics more reminiscent of a retirement community or a nursing home.

Whatever the look or “feel” of the home, the main idea is that it is up to the caretaker to adjust, alter or otherwise modify the living environment to maximize the ability to care for the loved one and keep him or her safe. In a word, you have to AlzheimersProof your living space. (“What Do We Mean By ‘Alzheimer’s Proofing’?”) In some respects, it is similar to babyproofing or childproofing a home. But in other respects, it differs notably.

The following is a work in progress. But it constitutes a sort of “master list” for home modifications that may be necessary or suitable for those suffering from dementia. Your feedback and suggestions are welcomed. As with many of my other posts, simply put, this is the list that I wish I had had at my disposal when I had to undertake the challenge of AlzheimersProofing my dad’s house.

The Usual Disclaimers

I am neither a lawyer nor a doctor. And I am not a home-improvement specialist or contractor. My articles are based on my own personal experience and research and they are provided on an as-is basis for informational purposes only. Not all listed or suggested modifications may be necessary in every situation. Contrariwise, some modifications may be necessary for you that are not listed.

Every situation is different. Readers are invited to create their own, personalized lists gleaning ideas from the master list and mixing in observations of their own. It is advisable, then, that readers carefully survey their area and walk through their (or their loved one’s) home environment, looking for and noting those items that might be hazardous. If you have background childproofing a house, then you have a bit of a head start (as some modifications translate easily from one application to the other).

Additionally, I make no promises about the feasibility of performing the needed modifications. To put it differently, not everyone is capable of executing the contemplated modifications on a do-it-yourself basis. You may want to seek profession advice or professional installation. When in doubt, consult an expert near you.

Also, keep in mind that no amount of modifications can or should replace caretaker diligence. Never leave a cognitively impaired person alone. Obviously, this is more important the more severe the impairment. And, since dementias are progressive diseases, the expectation is that your oversight will have to increase as your loved one’s condition worsens.

Some areas of the home – for example, the bathroom, garage, and kitchen – are especially dangerous (see below for safety tips). But, in truth, every room has its own dangers and risks.

Try to AlzheimersProof in as thorough a way as you can, given your energy, money, time, and other resources. The idea is to make a good-faith effort to protect your loved one. Try to anticipate or foresee your loved one’s needs and to meet them proactively. For example, if you are trying to prevent dad’s or grandma’s late-night kitchen raid, you might consider putting a judiciously stocked minifridge in his or her bedroom.

As difficult as the prospect might, though, you should be ready to entertain the possibility that the home may be unsuitable for your loved one’s care. I cannot give personalized advice. This website is merely for informational purposes. However, you should consult with attorneys, doctors, family members, financial planners, and others who can help you make the best decisions possible and to plan well for your loved one’s care.

Be safe and good luck to you and your family!

Master List

How to Use the Master List

The master list is an alphabetized directory of things that may need attention in or around the home.

You might find that simply reading the name of the item sparks your own ideas about how to sufficiently modify, protect, remove, secure, or otherwise “deal with” the item in question.

If not, then you can locate the follow-up, companion articles (as they are written!) to obtain more details and tips for the relevant action steps or items.

Click the bracketed links for more details on the selected entry.

Alcohol. Remove or restrict access to. [Specific Tips for middle-stage Alzheimer’s]

Answering machines. Use for call-screening purposes. [Specific Tips for middle-stage Alzheimer’s]

Appliances, electrical. Keep away from water. [Kitchens and Bathrooms]

Assist bars. Add next to bed. [Indoors and Outdoors]

Attic fans. See Fans. [Indoors and Outdoors]

Baby monitors. Use for monitoring patients. [Indoors and Outdoors]

Batteries. Store and discard batteries correctly. [General- and Senior-Safety Tips]

BBQ equipment. Remove or restrict access to. [Indoors and Outdoors]

Bed monitors. Use to alert to falls or movement. [Indoors and Outdoors]

Bed rails. Use to prevent falls. [Indoors and Outdoors]

Benches. Place in entryway to help with carrying packages. [General- and Senior-Safety Tips]

Bicycles. Secure. [Indoors and Outdoors]

Bleach. Restrict access to. [Indoors and Outdoors]

Blenders. See Appliances, electrical. [Kitchens and Bathrooms]

Bookshelves. Anchor. [Indoors and Outdoors]

Break-in Deterrence. Cut back bushes, foliage, and shrubbery; install motion-sensing lighting. [General- and Senior-Safety Tips]

Burners. See Stovetop. [Kitchens and Bathrooms]

Cabinets. Install “childproof” locks on. [Kitchens and Bathrooms]

Camouflage. Use to distract from door knobs and danger areas. See also Triggers. [Specific Tips for middle-stage Alzheimer’s]

Centerpieces. See Table centerpieces. [Kitchens and Bathrooms]

Chair lifts. Install as needed, if affordable. [Indoors and Outdoors]

Chemicals, flammable. Store correctly; restrict access to. [General- and Senior-Safety Tips]

Cigarettes, cigars, etc. Remove; control; monitor. [Specific Tips for middle-stage Alzheimer’s]

Cleaning products, bathroom. Get rid of, relocate, or otherwise secure. See also Cleaning products, kitchen. [Kitchens and Bathrooms]

Cleaning products, kitchen. Restrict access to. See also Cleaning products, bathroom. [Kitchens and Bathrooms]

Clothes Dryers. See Laundry: Dryer, clothes. [Indoors and Outdoors]

Clutter. Eliminate or reduce clutter. See also For Seniors: Tripping Hazards. [Specific Tips for Early-Stage Alzheimer’s]

Coffee pots. See Appliances, electrical. [Kitchens and Bathrooms]

Computers. Keep work area tidy; monitor usage; restrict access to. [General- and Senior-Safety Tips]

Cough medicine. See Specific Tips for middle-stage Alzheimer’s: Pharmaceuticals. [Kitchens and Bathrooms]

Curling irons. See Appliances, electrical. [Kitchens and Bathrooms]

Decals. Use on doors and windows. [Indoors and Outdoors]

Detectors. Install carbon-monoxide, natural-gas, and traditional smoke detectors. [General- and Senior-Safety Tips] (Click HERE for product recommendations for detectors.)

Detergents. See Laundry Room: Laundry detergents. [Indoors and Outdoors]

Disposals. See Garbage disposals. [Kitchens and Bathrooms]

Doorknob covers. Use like in “childproofing” scenarios to secure entryways and exits. [Specific Tips for middle-stage Alzheimer’s]

Doors. Widened (if needed); remove locks. See also Locks, bathroom. [Kitchens and Bathrooms]

Drains. Install strainers. [Kitchens and Bathrooms]

Drain traps. Insert in sinks to catch small items. [Kitchens and Bathrooms]

Drawers, kitchen. Latch or lock. [Kitchens and Bathrooms]

Dryers, clothes. Use “childproof” knob covers and latches. [Indoors and Outdoors]

Electrical appliances. See Appliances, electrical. [Kitchens and Bathrooms]

Electrical cords. Check for damage; keep out of walkways. See also General Safety Items: Extension cords and Seniors: Trip Hazards. [Indoors and Outdoors]

Electric razors. See Appliances, electrical. [Kitchens and Bathrooms]

Electric tools. See Tools. [Specific Tips for middle-stage Alzheimer’s]

Extension cords. Keep in working condition and out of walkways. See also Living Room: Electrical cords. [General]

Fans (Attic). Cover; secure. [Indoors and Outdoors]

Fans (Bedroom). Cover blades. [Indoors and Outdoors]

Faucets. Replace with single-spout; mark “cold” and “hot” clearly. See also Decals and Labels. See also Water temperature. [Kitchens and Bathrooms]

Fencing. Secure yard perimeter. [Indoors and Outdoors]

Firearms. See Specific Tips for middle-stage Alzheimer’s: Guns. [Specific Tips for middle-stage Alzheimer’s]

Fireplaces. Restrict access to. [Indoors and Outdoors]

Flooring. See Tile flooring. [Kitchens and Bathrooms]

Foods. See General Safety Items: Food stuffs. [Kitchens and Bathrooms]

Food stuffs. Checked for spoilage; store correctly. [General- and Senior-Safety Tips]

Furniture. Anchor. [Indoors and Outdoors]

Garbage disposals. Disable or remove. [Kitchens and Bathrooms]

Gates (Specific Tips for Early-Stage Alzheimer’s). Installing at the top and bottom of Staircases. [Specific Tips for Early-Stage Alzheimer’s]

Gates (Specific Tips for Middle-Stage Alzheimer’s). Control access to yards; keep gates locked. [Specific Tips for middle-stage Alzheimer’s]

Grab bars. Install (securely and correctly) to assist with mobility. [Kitchens and Bathrooms]

Guns. Remove or secure. [Specific Tips for middle-stage Alzheimer’s]

Hair dryers. See Appliances, electrical. [Kitchens and Bathrooms]

Handguns. See Guns. [Specific Tips for middle-stage Alzheimer’s]

Handrails. See Staircases.

Hand tools. See Tools. [Specific Tips for middle-stage Alzheimer’s]

Heat lamps. Install in lieu of space heaters. [Kitchens and Bathrooms]

Hot tubs. See Pools. [Indoors and Outdoors]

House fans. See Fans. [Indoors and Outdoors]

Keys (General Safety Items). Control access to; hide spare outside. [General- and Senior-Safety Tips]

Keys (Specific Tips for Early-Stage Alzheimer’s). Spare keys can be strategically placed outside of the house, in case the person with Alzheimer’s disease becomes locked out of his or her house. Of course, this must be done with care, since hidden keys – if discovered – pose home-security problems. [Specific Tips for Early-Stage Alzheimer’s]

Knives. Remove or secure. [Specific Tips for middle-stage Alzheimer’s]

Labels. Utilize labeling and signage. See also Triggers. [Specific Tips for Early-Stage Alzheimer’s]

Laundry detergents. Restrict access to. [Indoors and Outdoors]

Lawnmowers. Restrict access to; store correctly. [Indoors and Outdoors]

Lighting, bathroom. Use night-light or motion sensors. [Kitchens and Bathrooms]

Lighting, bedroom. Install a low-light detecting nightlight. [Indoors and Outdoors]

Lighting, exterior. Ensure adequacy. [Indoors and Outdoors]

Lighting, interior. Check for adequacy. [General- and Senior-Safety Tips]

Lighting, kitchen. Check for adequacy. [Kitchens and Bathrooms]

Lighting. Ensure adequacy for robbery-deterrence. [General- and Senior-Safety Tips]

Light switches. Check for accessibility and functionality. [General- and Senior-Safety Tips]

Locks (Laundry). Secure room. [Indoors and Outdoors]

Locks, bathroom. Remove locks or hide keys elsewhere in house. [Kitchens and Bathrooms]

Locks, garage. Use double-keyed deadbolt or reinforcement locks. [Indoors and Outdoors]

Locks, outdoors. Control entry/exit points. See Fencing. [Indoors and Outdoors]

Locks. Install locks on all exits and windows. [Specific Tips for middle-stage Alzheimer’s]

Magnets. Discard or remove. [Kitchens and Bathrooms]

Mats, kitchen. Use nonskid versions; secure to floor. [Kitchens and Bathrooms]

Mats. Add to entryways. [Indoors and Outdoors]

Medicines. See Specific Tips for middle-stage Alzheimer’s: Pharmaceuticals.

Microwaves. Disable or restrict access to. [Kitchens and Bathrooms]

Mixers. See Appliances, electrical. [Kitchens and Bathrooms]

Motion sensors. Use to control “elopement” and “wandering.” See also Trackers. [Specific Tips for middle-stage Alzheimer’s]

Outlet covers. Use covers to block access to live electrical outlets. [Specific Tips for middle-stage Alzheimer’s]

Ovens. Disable or lock. See also Stovetop. [Kitchens and Bathrooms]

Paints. Discard or restrict access to. [Indoors and Outdoors]

Pets. Add or remove as needed. [Specific Tips for middle-stage Alzheimer’s]

Pharmaceuticals. Secure medications; control dosages. See also General Safety Items: Prescriptions. [Specific Tips for middle-stage Alzheimer’s]

Pistols. See Guns. [Specific Tips for middle-stage Alzheimer’s]

Plants. Keep well-maintained; remove if poisonous. [Specific Tips for Early-Stage Alzheimer’s]

Plastic bags. Keep out of reach. [Specific Tips for middle-stage Alzheimer’s]

Pools. Remove or restrict access to; supervise use of. [Indoors and Outdoors]

Power tools. See Tools. [Specific Tips for middle-stage Alzheimer’s]

Prescriptions. See Specific Tips for middle-stage Alzheimer’s: Pharmaceuticals.

Prescriptions. Store correctly; restrict access to. [General- and Senior-Safety Tips]

Rails. See Staircases. [General- and Senior-Safety Tips]

Ramps. Install as needed. [Indoors and Outdoors]

Refrigerator. Install a “childproof” latch on. See also Specific Tips for Middle-Stage Alzheimer’s: Pharmaceuticals. See also General Safety Items: Food stuffs. [Kitchens and Bathrooms]

Rifles. See Guns. [Specific Tips for middle-stage Alzheimer’s]

Rugs, bedroom. Remove or secure to floor. [Indoors and Outdoors]

Rugs. Remove or secure to floor. See also General Safety Items: Tripping hazards and Bedroom: Rugs. [Indoors and Outdoors]

Shelving (Bathrooms). Ensure proper anchoring or remove. See also Grab bars. [Kitchens and Bathrooms]

Shelving (Living rooms). See Bookshelves. [Indoors and Outdoors]

Shotguns. See Guns. [Specific Tips for middle-stage Alzheimer’s]

Shower, walk-in. Replace conventional with walk-in varieties. [Kitchens and Bathrooms]

Shower benches. Insert to allow seated showering. [Kitchens and Bathrooms]

Showerheads. Replace conventional with hand-held wands. [Kitchens and Bathrooms]

Shower seats. See Shower benches. [Kitchens and Bathrooms]

Signage. Display to avoid scam artists and solicitors. [Indoors and Outdoors]

Space heaters, bathroom. See Appliances, electrical. See also Bedrooms: Space heaters. [Kitchens and Bathrooms]

Space heaters. Remove. [Indoors and Outdoors]

Spas. See Pools. [Indoors and Outdoors]

Sporting equipment. Keep sporting goods locked away. [Indoors and Outdoors]

Spout covers. Cover metal to prevent (further) injury during slips. [Kitchens and Bathrooms]

Staircases. Keep clear; install handrails and nonslip surfaces. [General- and Senior-Safety Tips]

Stair lifts. See Chair lifts. [Indoors and Outdoors]

Steps. Maintain de-ice (as needed), maintain, and mark clearly. [Indoors and Outdoors]

Stovetop. Install “childproof” knob covers on. See also Microwave and Oven. [Kitchens and Bathrooms]

Table centerpieces. Remove if poisonous or inedible. [Kitchens and Bathrooms]

Telephone (Seniors). Set up an answering machine or voice mailbox to intercept – and screen – calls. [General- and Senior-Safety Tips]

Telephones (General). Display emergency numbers. [General- and Senior-Safety Tips]

Televisions. Anchor. See also Bedroom: Furniture. [Indoors and Outdoors]

Thermostats. Carefully regulate; control access to. [Specific Tips for Early-Stage Alzheimer’s]

Tile flooring. Cover with nonslip mats; replace with bath carpeting. [Kitchens and Bathrooms]

Toasters. See Appliances, electrical. [Kitchens and Bathrooms]

Toilets. Surround with nonskid adhesives. [Kitchens and Bathrooms]

Toilet seat. Replace conventional with raised seats as a mobility aid for ease of transferring. [Kitchens and Bathrooms]

Tools, garage. Restrict access to electrical tools and hand tools. [Indoors and Outdoors]

Tools. Secure or remove. [Specific Tips for middle-stage Alzheimer’s]

Trackers. Use to monitor whereabouts off premises. [Specific Tips for middle-stage Alzheimer’s]

“Triggers.” Eliminated or minimize. See also Labels and Trackers. [Specific Tips for middle-stage Alzheimer’s]

Tripping hazards. Clear paths; remove Clutter; and tack down carpet/rugs. [General- and Senior-Safety Tips]

Tub mats. Use to prevent slipping. [Kitchens and Bathrooms]

Vitamins. Restrict access to; control dosages. [Kitchens and Bathrooms]

Walk-in shower. See Shower, walk-in. [Kitchens and Bathrooms]

Walking surfaces. Keep cleared and treated. [Indoors and Outdoors]

Washing machines. Use “childproof” knob covers and latches. [Indoors and Outdoors]

Water temperature. Keep between 105°F and 125°F. [Specific Tips for middle-stage Alzheimer’s]

Weapons. See the separate entries on Guns and Knives. [Specific Tips for middle-stage Alzheimer’s]

Weight equipment. Remove or restrict access to. See also Sporting equipment. [Indoors and Outdoors]

Whole-house fans. See Fans. [Indoors and Outdoors]

How to Pay for Care Home Modifications

I have discussed long-term care in a separate post. Titled “Alzheimer’s-Proof Your Retirement Savings With Long-Term Care Insurance,” the article chronicles my own family’s financial struggle to get my dad nursing-home assistance. In that article, I point out that there are really only three ways to pay for long-term care.

Three (3) Ways That Anyone Can Pay for Long-Term Care

1. Private pay…
   A. Out of your own assets
   B. Out of your own income
2. Spend your assets down and qualify for Medicaid
3. File a claim with your long-term care insurance

Now, of course, in order to be able to file a claim with long-term care insurance, you have to actually have a long-term care insurance policy in force. Since you will never be approved for such a policy if you wait until you have Alzheimer’s Disease (or some other form of dementia), if you are interested in protecting your retirement (and other assets) for your family/spouse, then you need to apply for long-term care insurance before you have any signs of cognitive impairment.

When it comes to paying for home modifications, the options dwindle down to two. As the website Caring.com explains: “Like Medicare, Medicaid doesn’t cover physical modifications to the home.”[1]

Two (2) Ways That Anyone Can Pay for Home Modifications[2]

1. Private pay
2. Long-term care insurance

Most people will therefore have to pay for their own home modifications, regardless of who they have perform the work. However, for those who have the right sort of long-term care insurance, some money might be available to subsidize various house alterations.

You have to check your contract or contact your insurance agent to discover whether these benefits are available to you and what limitations or restrictions, if any, may be placed upon them. For instance, some contracts might limit you to obtaining modifications of certain types, or from certain contractors, etc. And there may be maximums to the dollar amounts that insurance companies are willing to pay for such work.

Generally speaking, you may need to seek preapproval for any prospective, home-modification project.

But, here are a few sorts of installations/modifications that you might expect to receive approval – for those policies that offer these types of benefits.

• Addition of “knee holes” (to accommodate wheelchairs) in bathrooms, kitchens, studies, and work areas
• Installation of chair/stair “lifts” to enable people to traverse house levels without having to walk up stairs
• Mounting of grab bars and handrails
• Placement of wheelchair ramps over entryway steps
• Replacement of conventional bathtubs/showers with walk-in varieties
• Widening of doorways for wheelchair access

For More Information

See the following articles.

“How Do You Alzheimer’s Proof a Car?”

What do we mean by “Alzheimer’s Proofing?” see HERE.

What’s the Difference between Alzheimer’s Proofing and Baby Proofing or Childproofing? See HERE.

Notes:

[1] Joseph Matthews, “FAQ: What Kinds of Home Equipment and Modifications Are Covered by Medicare, Medicaid, or the VA?” Caring.com, Apr. 9, 2018, <>. The author adds, however: “However, some state Medicaid programs have special pilot programs that can help with home modifications. If you need home modification, check with the Medicaid worker who handles your file and ask if there might be special coverage that can help you,” ibid.

[2] Veterans have certain grants that they can apply for through the U.S. Department of Veterans Affairs (also known as the Veterans Administration), usually designated the “V.A.” See Matthews, loc. cit.