Caregiving : Alzheimer's disease

by National Institute on Aging

(Page 5 of 7)

How can we make the house safer for my mother who has Alzheimer's disease? I'm worried about her safety.

You can take many precautions that will make the house safer, more accessible, and comfortable. Because you are not present, you may want to evaluate the safety of your mother's home during one of your visits (with the understanding that you must quickly correct any real dangers). On future visits, you should be alert for hazards and aware of things you can do to make the house safer.

If you are worried about your parent's safety, don't wait until the next visit. If you feel that your parent is unsafe alone, make note of which behaviors have become most worrisome and discuss these with the primary caregiver and the doctor. Behavior that is unsafe or unhealthy may have become familiar to the primary caregiver. The kitchen in particular presents many opportunities for accidents, especially when a parent misuses appliances or forgets that something is cooking. Discuss your concerns and offer to help adapt the environment to meet your parent's changing safety needs.

If you are concerned about home safety for a parent who has Alzheimer's disease, NIA's free pamphlet, Home Safety for People with Alzheimer's Disease has plenty of helpful suggestions.

Consider these principles about home safety for older people:

Think prevention. It is hard to predict or anticipate every problem, but you can go through the house room-by-room and evaluate safety problems. Checking the safety of your parent's home may prevent a hazardous situation. Some easy steps to take:

Remind the primary caregiver to lock all doors and windows on the inside and outside to prevent wandering.

Make sure all potentially harmful items, such as medications, weapons, machinery, or electrical cords are put away in a safe, preferably locked, place when they're not in use.

Use child-resistant caps on medicine bottles and childproof door latches on storage units as well.

Adapt the environment. Because it is easier to change a place than to change a person, consider the following:

• Install at least one stairway handrail that extends beyond the first and last steps.
• Place carpet or safety grip strips on stairs.
• Avoid clutter, which can cause disorientation and confusion.
• Keep all walk areas free of furniture, and extension and electrical cords.
• Cover unused outlets with childproof plugs.
• Make sure all rooms have adequate lighting.

How can I help lighten the load for my mother? Over the years Dad's condition has worsened, and now when we talk Mom sounds exhausted.

Your mother may be hesitant to ask for help, or to say that she needs a break. Be sure to acknowledge how important her care has been for your father. Also discuss the physical and emotional effects caregiving can have on people. True, caregiving can be satisfying, but it also can be very hard work. Offer to help arrange for respite care.

Respite care will give your mother a break from her caregiving responsibilities. Respite care can be for an afternoon or for several days. Care can be provided in the family home, or your dad may spend the time in an adult day services program or at a skilled nursing facility. The ARCH National Respite Locator Service can help you to find services in your parent's community. You might suggest your mother contact the Well Spouse Association - it offers support to the wives, husbands, and partners of chronically ill or disabled people and has a nationwide listing of local groups.

Your parents may need more help from home-based care to continue to live in their own home. Some people find it hard to have paid caregivers in the house but most also say that the help is invaluable. If your mother is reluctant, point out that with in-home help she may have more energy to devote to your father's care and some time for herself.

Over time, your father may need to move to assisted living or a nursing home. If that happens, try to support your mother. You can help her select a facility. She may need help adjusting to his absence or to living alone in their home. Just listening may not sound like much help, but often it is.

How can I help my folks decide if it's time for them to move? I don't think they can stay in their own home much longer. Should I suggest that they move to my home? Move to assisted living? I'm at a loss.

The decision about whether your parents should move is often tricky and emotional. Each family will have its own reasons for wanting (or not wanting) to take such a step. One family may decide a move is right because the parents no longer need so much space or cannot manage the home. For another family the need for hands-on care in a long-term care facility motivates a change. In some cases, a move frees up cash so that the parent can afford a more suitable situation.

In the case of long-distance caregivers, the notion of moving can seem like a solution to the problem of not being close enough to help. For some caregivers, moving a sick or aging parent to their own home or community can be a viable alternative. In some cases, an adult child moves back to the parent's home to become the primary caregiver. Keep in mind that leaving a home, community, and familiar medical care can be very disruptive and difficult.

Older adults and their families have some choices when it comes to deciding where to live, but these choices can be limited by factors such as illness, financial resources, and personal preferences. Making a decision that is best for your parent - and making that decision with your parent - can be difficult. Try to learn as much as you can about possible housing options.

Older adults, or those with serious illness, can:

• stay in their own home, or move to a smaller one,
• move to an assisted living facility or retirement community,
• move to a long-term care facility, or
• move in with another family member.

Experts advise families to think carefully before moving an aging adult into an adult child's home. In its fact sheet Home Away From Home, the Family Caregiver Alliance suggests considering the following issues before deciding whether or not to move your parent to your home:

• Evaluate whether your parent needs constant supervision or assistance throughout the day, and consider how this will be provided.
• Identify which activities of daily living (eating, bathing, toileting) your parent can perform independently.
• Determine your comfort level for providing personal care such as bathing or changing an adult diaper.
• Take an honest look at your health and physical abilities, and decide if you are able to provide care for your parent.
• Expect changes in your parent's medical or cognitive condition.
• Explore the availability of services such as a friendly visitor, in-home care, or adult day services.
• Investigate back-up options if living with your parent does not work or is not your choice.
• Consider the type of medical care your parent needs and find out if appropriate doctors and services are available in your community.

About the Author

www.nia.nih.gov
NIA, one of the 27 Institutes and Centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.