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
- Private pay
- Out of your own assets
- Out of your own income
- Spend your assets down and qualify for Medicaid
- 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]
- Private pay
- 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.