Alzheimer’s Proofing Vs. Baby Proofing: An Overview

I have had the experience of having to make alterations around the house to better accommodate my Alzheimer’s-afflicted dad. As I reflect on these changes, and prepare to summarize them for web consumers, I am mindful that I have also been in the position of baby proofing a home for new arrivals.

I started thinking about some of the ways these two experiences were similar, and about other respects in which they were quite different. I offer a few thoughts as a sort of primer to my upcoming series on Alzheimer’s proofing your home.

When should you start baby proofing?

Most babies start crawling around eight months, however, many of them start crawling considerably earlier than this. A crawling infant will soon start pulling him- or herself up onto his or her feet, which means various surfaces will never again be out of reach. One recommendation for new parents would be to begin baby proofing as soon as the pregnancy test comes back positive! However, for those who found themselves in the position of having a newborn, but of not having a baby-proofed “pad,” all hope would by no means be lost at this point. Still, such parents would be highly encouraged to get started right away with their baby-proofing efforts.

Although it might strike first-time moms and dad as odd to baby proof a home when their little Bitsy Boo can’t really move much, veteran parents know all too well the surprising rapidity with which Munchkin will be “getting into” things. The moral of this story is obvious: it’s never too early to start taking precautions against Sweet’ums injuring him- or herself.

When should you start Alzheimer’s proofing?

Of course, the same logic can be applied to those at immanent risk of, or recently diagnosed with, Alzheimer’s or it’s precursor, mild cognitive impairment. In some respects, it might behoove people at various stages of life to begin making small changes around the house, just to lessen the extremity of any adjustments that are needed later in life. In other words, maybe we should all start Alzheimer’s proofing our digs for that unhappy day in the future when someone we care about becomes someone that we must care for in a house that is not up to the challenges dementia.

Let’s look at some of the similarities between baby proofing and Alzheimer’s proofing one’s living quarters.

Differences, Similarities, and Other Odds and Ends

Making the Environment Safer and More Controlled

Unfortunately, one thing that babies and (advanced) Alzheimer’s sufferers have in common is a low level of cognitive function.[1] For present purposes, this means that both classes of individual are unable to correctly and reliably avoid environmental perils. It is therefore necessary for caregivers to rearrange the environment to minimize particular risks.

Here are some tips to save both children and the elderly (or otherwise impaired) from damage and danger.

Manage cords

Power cords present a problem for both babies and Alzheimer’s victims. For both, there is a danger of electrical shock. But they are also a tripping hazard.[2] Use nylon (“zip”) ties to keep electrical and other cables well-maintained and out of eyesight (as much as feasible).

In a similar vein, running connecting cords through conduit can keep entertainment centers and personal-computer workstations better-managed and less likely to be messed with. (Split-loom tubing is also quite effective.)

Cover outlets

Speaking of electrical shock, put outlet caps into all accessible electrical sockets to shield little ones – and not-so-little ones – from possible electrocution.[3] More protection may be afforded by screw-in outlet cover plates or self-closing outlets. (For an additional layer (literally) of security, position furniture so that it obscures access to outlets.[4]) On the flip side, dementia sufferers periodically attempt to do things (like plugging in vacuums or rewiring outlets) that, when they were compos mentis, they were accustomed to doing.

I once discovered my dad, Jim (read his story HERE), “scouring the floor” (according to his explanation) with sugar granules – because he thought the floor ought to be cleaned, but I had hidden all the chemicals. Who’s to say that he wouldn’t have gotten the notion to try to perform the duties of an electrician using only a ballpoint pen clip or a spoon?

Consider further: sockets are presumably going to be at eye level for most youngsters, and Punkin’ might be tempted to put items like forks, etc., into them. Therefore, both parents and Alzheimer’s caregivers ought to endeavor to keep flatware secured in a (high?) cabinet where neither Lil’ Bit nor grandma can reach.

Lock knives away

While on the subject of eating utensils, tableware and the like, be sure to keep cutlery safely tucked away from curious youths as well as confused seniors. Magnetic locks can serve that purpose.

Cushion sharp or dangerous edges

There will undoubtedly be a couple of bumps and hits as little ones figure out how to walk. However, you can do a few of things to stop inevitable spills from becoming major disasters. Adding soft spreads to hard surfaces on floors and furniture shields your children from getting badly bruised or cut in the event that they take a tumble. Introducing child-safe gates at the top or bottom (or both) of stairs means they can’t get up or down without an adult. Keeping your staircase sufficiently well-lit (and free of toys) helps ensure that there will be fewer falls.

Some of these suggestions are equally advisable for older adults. Putting some “corner guards” (also known as “bumper” cushions) or foam edging on coffee tables and the like can pull double duty saving baby noggins and adult legs/shins from hard knocks. After a certain level of disability is reached, well-secured handrails become nearly essential features for staircases.

Guard entry ways

This has a dual aspect. On the one hand, parents and dementia-sufferer supervisors alike might wish to invest in “finger protectors,” so that their charges digits don’t get crushed in a door-closing mishap. On the other hand, “elopement” is an ever-present factor in some contexts. For containment purposes, it is therefore advisable to install some sort of childproof or “Alzheimer”-proof lock mechanisms on exits.

Our home has three entryways. We employed a Guardian door brace on the passage into the garage, installed too high up for my dad to reach without causing a commotion. On the front door, I actually resorted to reversing the storm-door lock, so that you needed a key to exit the house. The back door was similarly controlled. Except, there, I put on a double-keyed deadbolt.

Have working CO and smoke detectors

Of course, with everyone locked up safe and sound, it is imperative to keep watch over fire (and related) hazards. Minimally, smoke and CO detectors should be placed throughout the living space, with special attention on sleeping areas.[5] (As an aside, readily available battery-powered CO detectors – like THIS and THIS – typically detect levels of CO in concentrations of 60 parts per million or greater. THIS ONE mentions 400 ppm on the bottom – which is a lot! For maximum peace of mind, obtain a low-level CO detector. Kidde makes the KN-COU-B and Defender makes its LL6070. We purchased an NSI model 3000 from our local heating and cooling company.) I also obtained a plug-in natural-gas detector and placed it outside of the laundry area (where we have the furnace and the gas-fueled water heater). Smoke detectors are widely available.

Secure medicines and chemicals

Store all pharmaceuticals securely, such as in a high-bolted cabinet. Never remove anything from its unique childproof holder unless you have need of it, and then be sure to return it. Bear in mind that “childproof” caps can prevent dementia patients from accessing drugs due to the loss of dexterity that accompanies their condition.

For children as well as Alzheimer’s-afflicted adults, do whatever it takes not to open medication in front of your youngster. For toddlers, the fear is that or he or she might attempt to mimic your actions.[6] For older adults suffering from cognitive impairment, one danger is that seeing the medication will prompt a recurring anxiety over whether or not it’s time to “take a pill.” This can cause all sorts of trouble.[7]

Shield both inquisitive and curious children as well as disoriented and restless seniors from cleaners and miscellaneous chemicals by putting those things away in locked or otherwise secured cupboards or by installing magnetized security latches (or THIS) that “catch” automatically when you close cabinet doors. Other devices are available for drawers as well.

Take precautions in the car

Just as you would protect your child[8] in your automobile by activating the now ubiquitous “child safety locks” on passenger doors, the same technology can likewise prevent older adults from exiting the vehicle in an untimely (and possibly dangerous) manner.[9]

Ensure that objects are age-suitable

At present, it may be easier to follow this principle as it concerns youngsters than as it pertains to “oldsters.” For instance, toys labeled “Infant” or “Ages 0 to 6 months” are probably safe for your baby.[10]   

Or, again, there are intuitive dangers to look out for. A good rule of thumb is to guarantee that your kids’ toys are significantly larger than their open mouths, to avoid choking. Additionally, verify that every one of the parts joined to a toy – like a doll’s button eyes or a teddy bear’s bows – are securely affixed and can’t become detached with reasonably minimal effort.

But what does one look for with aged adults? At the time of this writing, product labels like “Not Recommended for Those 75 Years Old or Older” or “Ages 18-75” are not commonplace. And one reason is apparent. With young children, it is plausible to think that age warnings will apply to (nearly) 100% of the relevant class. To put it differently, and for the most part, all two-month olds will be at risk of choking on small parts. But this does not seem to be the case with the elderly. Put another way, not all 80-year olds experience the sort of cognitive decline that might prompt a product warning aimed at them.

Still, there are a growing number of product lines that are geared specifically at the Alzheimer’s and dementia-suffer “market.” (See, for instance, THIS PUZZLE for an example of the phraseology I’m talking about.)

Minimize miscellaneous environmental risks

In the case of children, other choking and nonspecific perils are almost ever present.

Bedrooms

You should ensure, for example, that your infant’s playpen has fastened rails. Mobiles with little hanging parts should be removed when infants graduate to pulling themselves upright. As children age, they may require rails installed on conventional beds in order to reduce the risk of falling out of bed.

In a similar way, seniors can benefit from specialized mobility rails that both reduce the chance of tumbling out of bed, but also provide a means for older people to help pull themselves up when transferring in and out of bed.

Living rooms

Besides the tips like covering outlets and securing televisions, already mentioned above, you might consider corralling fledgling walkers inside of a “play yard” or equivalent. This worked for my family.

But what about for older adults? Unless the person is “non-ambulatory” or wheel-chair confined, it is probably useless to attempt to keep a dementia suffer cordoned off in a single room. The best that you can hope for is to enrich the environment with activities that absorb his or her attention.

However, when the allure of handicrafts wears off, as it inevitably will, it is best to have a contingency plan. The failsafe for my dad was to control the points of entry into the house so that he would be unable to wander off. (See, again, the section subtitled “Guard entry ways,” above.)

Bathrooms

For young ones, the risks of drowning and electrocution are preeminent. To stop your infant from burning him- or herself during shower time, set your water heater to a low temperature. In case you’re redesigning, install “anti-scald” valves on new pipes. Hold or secure the toilet seat in a downward position to prevent the infant from splashing around and falling in. Ensure all shower items, and cleaning supplies are in upper cupboards or cabinets that the child can’t reach. Never leave the baby in the bathroom alone particularly not in a filled bathtub. The point bears repeating: The bottom line for babies and toddlers is supervision. You simply cannot leave them unattended.

But seniors typically present somewhat different challenges. The constellation of hazards mainly centers around the risk of falling. Also relevant is the fact that many Alzheimer’s-afflicted persons retain their adult desire for privacy. You cannot easily supervise a dementia patient while toileting or bathing. Thus, bathrooms are of particular concern.

There are safety steps that can be taken, however. Think about converting a shower, especially if a person must step over a ledge to enter, into a walk-in bathtub. Lay non-slip mats on the ground. Ensure that the medicine cabinet is locked or relocated.[11] Restrict access to electrical appliances such as hair dryers. (Refer back up to the section on magnetic and other cabinet locks.)

Kitchens

Children may view stovetop controls as great fun to pull and twist. Thankfully, they are usually out of reach, unless you have a “climber” on your hands. Get some knob covers. An appliance lock helps ensure that your little one can’t pull the entire oven door onto him- or herself.

Have something percolating or boiling on the stove? Burns are very common; tea can singe fifteen minutes after it’s been made. Keep hot beverages away from the edge of surfaces and put your cups down when playing with the babies. Turn pot handles away from the front of the stove, to minimize accessibility (little children tend to grab them). Additionally, various “stove guards” are available that offer extra layers of protection.

There’s really no way around it: the kitchen is a dangerous appliance. For those, like Alzheimer’s sufferers, whose cognitive faculties are comprised or undermined, it may be best to steer clear of this room entirely. My dad caused several (small) fires with paper towels carelessly placed onto the stovetop. The toaster is likewise troublesome. But heat and fires are not the only perils. Mental impairment can fail to prevent a person from drinking expired milk or eating improperly prepared meat. And in many kitchens, cleaning (and other) chemicals are sometimes found in close proximity to food. Mix ups can occur. Less dramatically, grandpa’s failure to thoroughly wash his hands can lead to the contamination of the cookie jar with something merely distasteful – such as granules of dog food – or, God forbid, with something potentially deadly – like drain-clearing crystals or rat poison. Lock the stuff up!

As stated previously, magnetic cabinet latches are a cheap and effective way to protect the aged as well as the young. My dad once attempted to make soup (we think) by placing a glass vessel on a stove burner. As it heated, the glass shattered and made quite a dangerous mess of things. Store glassware under lock and key.

Waste Disposal

Inquisitive children will attempt to get into anything you leave lying around. Relatedly, dementia-afflicted persons may become convinced that they have lost something – whether real or imagined – and begin rummaging through the garbage, putting themselves in danger. In case you’re discarding anything hazardous (e.g., batteries, broken glass, jagged metal, or plastic bags and packing material) it’s prudent to take it outside immediately. Alternatively, put the recycling and trash containers someplace your charges can’t reach.

Hallways

Ensure that hallways and walkways are clear, to minimize trips and falls.

Concluding Remarks

Alzheimer’s and baby proofing doesn’t totally dispose of the danger of damage, yet it does fundamentally diminish many of the most prevalent dangers. It’s about risk mitigation. Regardless of whether you’re in a new or old home, parts of your living space will always be in need of Alzheimer’s and baby proofing. Realistically, you can’t fully secure your place but you can reduce risk. Even if you are confident that you’ve performed a comprehensive “proofing,” chances are you’ve missed something. And it’ll be your charge that finds and exploits the weakness. No amount of child- or dementia-proofing should substitute for diligent watchfulness.

[1] Still, there are differences. Babies have this low functionality because their brains have not developed and grown as they are expected to in the coming years. Alzheimer’s patients, on the other hand, have brains that are at various levels of degeneration.

[2] A related danger is that electrical cords, when tripping over or pulled, can cause (sometimes heavy) appliances to fall on little noggins or on brittle feet. Children are periodically crushed to death by accidentally tipping onto themselves televisions and other massive pieces of furniture. See HERE and HERE and HERE and HERE and HERE.

[3] Parents: be mindful of the fact that some types of outlet cover could be potential choking hazards if, perchance, a child manages to pry them out of the socket (or to find one that was removed by an adult, but never replaced). An alternative is to search for covers that require two hands to remove or that feature cover plates that screw on.

[4] Just be sure that the furniture does not itself present a tipping risk. See, again, footnote #2.

[5] It is fairly intuitive that there is a greater danger while people are sleeping, since their senses and response times may be dulled. Caution is needed, however. For reasons that are probably too obvious to readers of this blog, babies and Alzheimer’s patients cannot be relied upon to react appropriately to detector alarms. Diligent supervision is always required.

[6] An added suggestion: If your child does see you taking medication, never refer to it as “candy.”

[7] Anyone who has spent time caring for Alzheimer’s sufferers probably realizes that routine tasks often become obsessions or, at the least, sources of great consternation. Even if you have just administered a dose of medication, an Alzheimer-afflicted senior can forget this and become distressed.

[8] Of course, there are numerous other safety tips that pertain to small children only. Most prominently, babies and little kids require special seating – e.g., rear-facing car seats are usually recommended up to a certain age or up to a particular weight. I will not get into such things here, as many internet sites are dedicated to these issues. Suffice it to say that parents should not use car seats with which they are unfamiliar. This should not be understood as a reason to avoid car seats, but as a motivator to familiarize oneself with your own model. Nowadays there are features that may have been added to newer seats that are not present on older models. Additionally, hand-me-down seats might have structural or other issues (like missing parts or lost directions) that render them unsafe or unwise to use. When in doubt, have a professional (e.g., a fire-department official) inspect your car seat and your installation. It might have been engaged in a crash or it might be past its termination date.

[9] One drawback is that such security measures are commonly installed on rear doors only.

[10] Still, a label is not a substitute for attentiveness. Also, keep an eye out for manufacturer recalls.

[11] For other reasons, like the high-humidity environment, it is probably unwise for anyone to keep pharmaceuticals in the bathroom.