20: Environment Issues: Designing Safe Environments

This program will present principles and strategies for:

  • Improving home safety
  • Designing safe environments
  • There are no easy answer when its comes to the care of another
  • Our hope is to offer you useful information and guidelines for caring for someone with dementia
  • These guidelines will need to be adjusted to suit your own individual needs

Aging Changes and Dementia Factors Affecting Safe Environments Aging Factors

  • Decreased mobility and flexibility
  • Vision loss
  • Hearing loss

Dementia Factors

  • Recognition declines (agnosia)
  • Memory declines (amnesia)

What could be the reason for Robert’s yelling?

  • A. He fell down and is in pain.
  • B. He forgot the way back to his room.
  • C. He wanted to go outside and became frustrated when he could not unlock the door.
  • D. All of the above.

Choice A: He fell down and is in pain, is a possibility.

  • Make sure there are chairs, couches, or benches for sitting and resting
  • Arrange furniture to keep walkways unobstructed
  • Provide good lighting without glare

Choice B: He forgot the way back to his room, is another good choice.

  • Use signs to serve as cues for important places like the bathroom
  • Make sure that furniture remains in the same positions

Choice C: He wanted to go outside and became frustrated when he could not unlock the door, is another possibility.

  • All exterior doors should be under close surveillance and locked when the person should not be going outside

Choice D: All of the above, is the answer

  • Because it is very difficult to predict what a person with dementia might do, caregivers must consider all possible behaviors
  • Keep in mind that today’s modifications may work now but may not work as the illness progresses, or modifications that didn’t work today may work tomorrow
  • Install smoke alarms and carbon monoxide detectors
  • Cover electrical outlets
  • Remove hazardous materials and poisonous plants
  • Restrict access to dangerous areas (stairwells, decks, pools)
  • Reduce noise distractions inside and outside
  • Post “No Solicitation” signs
  • Use answering machines set to the lowest number of rings
  • Keep telephones, cell phones, and computers out of the way
  • Password protect computer files and screen for misuse of the Internet
  • Secure all doors and windows
  • Disguise doors
  • Hang signs that say, “STOP” or “Do Not Enter.”
  • Keep a spare key hidden outside
  • Disable or remove bathroom door locks
  • Cover windows

Click here to learn more about home modification and safety.

  • Install handrails
  • Carpet or apply safety grip strips on stairs
  • Avoid or tack down extension cords
  • Place furniture for sitting throughout the home
  • Keep walkways unobstructed
  • Provide good lighting without glare
  • Adjust water heater to 120 oF
  • Consider installing anti-scald devices
  • Install single-handle faucets
  • Avoid flammable/volatile compounds near heaters
  • Place red tape around objects that can cause burns
  • Remove fire hazards
  • Use electric blankets, pads, and sheets with caution

Why doesn’t Robert want to go into the bathroom?

  • A. He doesn’t want to leave the kitchen.
  • B. He has a fear of bathing.
  • C. He is afraid of slipping on the bathroom floor.
  • D. He doesn’t remember how to get to the bathroom.
  • E. All of above.

Choice A: He doesn’t want to leave the kitchen, is a good possibility.

Choice B: He has a fear of bathing, is also a good possibility.

Choice C: He is afraid of slipping on the bathroom floor, is another possibility.

Choice D: He doesn’t remember how to get to the bathroom, may also be a possibility. Choice E: All of the above, is the best answer.

  • Use color to contrast floors, walls, furniture, and different rooms
  • Use different lighting to separate rooms
  • Use familiar objects such as paintings to identify rooms
  • Use signs and photos on walls and doors
  • Use aromas to identify rooms
  • Use furniture as landmarks
  • Use different floor surfaces
  • Provide familiar objects
  • Label cupboards and drawers
  • Organize and remove clutter
  • Provide adequate lighting
  • Keep floors clean and dry
  • Keep a clear path to seating with sturdy furniture
  • Provide comfortable furniture and decor
  • Store dangerous tools and chemicals in locked cabinets
  • Remove potentially hazardous content or latch or lock cupboards and drawers
  • Remove knobs for the oven and stovetop
  • Cover the burners
  • Use shut-off timers on ovens and toasters
  • Install locks on the stove if necessary
  • Supply fire-resistant items
  • Consider locking refrigerators
  • Dismantle the garbage disposal
  • Remove choking hazards
  • Water temperature
  • Sharp knives and objects
  • Poisons
  • Lock away prescription drugs
  • Some people incorrectly believe that if one pill works, two may work better, without considering the dangerous side effects
  • Organize a pill caddy
  • Caregivers should control the medications
  • Clearly identify the bathrooms with signs and/or painted door
  • Install acoustic ceiling tiles
  • Provide good lighting without glare
  • Remove or disable bathrooms door locks
  • Bathtubs should be accessible on at least 2 sides
  • Install nonskid surfaces
  • Keep floors dry
  • Consider installing carpeting
  • Install water-resistant surfaces
  • Use color contrasts between the floor, walls, countertops, and sink
  • Install grab bars
  • Place rubber cover over bathtub faucet
  • keep toxic substances in locked cabinets
  • Remove clutter
  • Cover electrical outlets
  • Remove electric appliances from bathrooms
  • Toothbrushes
  • Try to have things that the person needs or wants close to the bed
  • Provide adequate lighting for getting to the bathroom or for wandering
  • Consider an intercom system
  • Remove any throw rugs and other tripping hazards
  • Remove any burn risks
  • Remove fans if objects can be placed in the blades
  • Place mats by the bed
  • Get a hospital-type bed with rails
    • Get a bed that can be raised and lowered
    • Keep the bed in it’s lowest position
    • Use a proper sized mattress or a mattress with raised foam edges
  • Unsafe zones
  • Restrict access to tools, fluids, sporting equipment found in garages
  • Restrict access to cars and car keys
  • Restrict access to laundry equipment, water softener, circuit breaker, and furnace found in basements
  • Outside activities can improve health and overall well-being
  • If a person is inclined to wander, and the yard is not enclosed, a caregiver should stay outside with the person
  • Install non-slip, glare-free walking paths
  • Repair uneven or damaged walkways/surfaces
  • Prune bushes and foliage
  • Mark stairs and uneven edges
  • Prevent confined spaces by using fencing and walls that do not completely obscure the view
  • Place landmarks for entrances and exits
  • Make sure all plants and materials are nontoxic
  • Create an area protected from harsh weather
  • Bring part of the outdoors inside
  • Basic home safety measures
  • Securing doors, windows, electrical outlets
  • Installing smoke and carbon monoxide detectors.
  • Restricting hazardous materials
  • Restricting access to dangerous areas
  • Reduce the risk of falls and burns, especially in kitchens and bathrooms

Written by:
Catherine M. Harris, PhD, RNCS.
Mindy J. Kim-Miller, MD, PhD

Edited by:
Sasha Asdourian


19: Early Stages: Family Intimacy & Sexuality

Select the best answers from the list of choices following each question.

Click here to open Certificate of Completion
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