Caring for a Person with Alzheimer's Disease : Safety Issues

by National Institute on Aging

(Page 4 of 5)

Safety is an important issue in caring for a person with Alzheimer's disease. Even with the best-laid plans, accidents can happen. Checking the safety of your home, keeping the person from wandering and preventing him or her from driving when driving skills decline are some ways you can minimize hazardous situations.

Safety Issues - Home Safety

Caregivers of people with Alzheimer's often have to look at their homes through new eyes to identify and correct safety risks. Creating a safe environment can prevent many stressful and dangerous situations.

Install secure locks on all outside windows and doors, especially if the person is prone to wandering. Remove the locks on bathroom doors to prevent the person from accidentally locking himself or herself in.

Use childproof latches on kitchen cabinets and any place where cleaning supplies or other chemicals are kept.

Label medications and keep them locked up. Also make sure knives, lighters and matches, and guns are secured out of reach.

Keep the house free from clutter. Remove scatter rugs and anything else that might contribute to a fall. Make sure lighting is good both inside and out.

Consider installing an automatic shut-off switch on the stove to prevent burns or fire.

Home Safety and Wandering

Keeping the person safe is one of the most important aspects of caregiving. Some people with Alzheimer's have a tendency to wander away from their home or their caregiver. Knowing what to do to limit wandering can protect a person from becoming lost.

Make sure that the person carries some kind of identification or wears a medical bracelet. If he or she gets lost and is unable to communicate adequately, this will alert others to his or her identity and medical condition. Keep a recent photograph or videotape of the person to assist police if the person becomes lost.

Keep doors locked. Consider a keyed deadbolt or an additional lock up high or down low on the door. If the person can open a lock because it is familiar, a new latch or lock may help.

Secure or put away anything that could cause danger, both inside and outside the house.

Quiz

1. Keeping a person with Alzheimer's disease safe is

A. a minor aspect of caregiving.
B. impossible to accomplish at home.
C. one of the most important aspects of caregiving.

C is the correct answer. Because people with Alzheimer's disease may be confused and forgetful and may tend to wander, it is important to create a safe environment for them wherever possible. This may mean identifying and correcting safety risks in the home, placing some form of ID on the person with Alzheimer's disease, and installing locks on doors.

2. To create a safe home environment, caregivers should

A. install locks on outside windows and doors.
B. remove locks on outside windows and doors.
C. install locks on outside windows but not on outside doors.

A is the correct answer. Secure locks should be placed on all outside windows and doors. There should also be chimes on the doors and windows to let caregivers know when the person is trying to leave the house.

3. If wandering becomes a problem with a person with Alzheimer's disease, it is a good idea to

A. place bells on doors.
B. make sure that the person carries some type of identification.
C. keep a recent photograph or videotape of the person in case he or she gets lost.
D. all of the above

D is the correct answer. Some caregivers find it helpful to use nightlights, bells on doors, or locks placed at the bottom of doors. Having the person wear an identification bracelet and placing identification on shoes, eyeglasses, purses, keys, and wallets may be helpful. The Alzheimer's Association's Safe Return program assists in identifying and finding persons with Alzheimer's disease and related dementias who wander off or get lost.

4. In the home, medications should be

A. labeled and kept locked up.
B. labeled and placed in the possession of the person with Alzheimer's.
C. labeled and located in a place where the person with Alzheimer's can easily get them.

A is the correct answer. The caregiver should be in charge of the medications and should keep them locked in a secure place. The caregiver should know how many doctors the person has and what medicine has been prescribed, and should be in charge of dispensing it to the person.

Safety Issues - Driving

Making the decision that a person with Alzheimer's is no longer safe to drive is difficult, and it needs to be communicated carefully and sensitively. Even though the person may be upset by the loss of independence, safety must be the priority.

How Long Should Driving Continue? Look for clues that safe driving is no longer possible, including getting lost in familiar places, driving too fast or too slow, disregarding traffic signs, or getting angry or confused.

Be sensitive to the person's feelings about losing the ability to drive, but be firm in your request that he or she no longer do so. Be consistent - don't let the person drive on "good days" but forbid it on "bad days."

Ask the doctor to help. The person may view the doctor as an "authority" and be willing to stop driving. The doctor also can contact the Department of Motor Vehicles and request that the person be re-evaluated.

If necessary, take the car keys. If just having keys is important to the person, substitute a different set of keys.

If all else fails, disable the car or move it to a location where the person cannot see it or gain access to it.

Quiz

1. If the caregiver sees clear signs that the person with Alzheimer's disease is no longer a safe driver, the caregiver should

A. insist that the person not drive.
B. let the person decide whether or not he or she wants to drive.
C. let the person drive on his or her "good days" but not on his or her "bad days."

A is the correct answer. As their symptoms become more severe, people with Alzheimer's disease may become less able to evaluate accurately their own skills and capabilities. If you observe incidents of poor judgment, risk-taking, and/or dangerous behavior at the wheel, take steps to stop the person from driving.

2. If it is difficult to get the person with Alzheimer's to stop driving, the caregiver can

A. hide the car keys.
B. enlist the help of the doctor.
C. move the car to a place where the person cannot see it or gain access to it. D. all of the above

D is the correct answer. A variety of options are available to stop someone from driving. The caregiver can hide the car keys, ask for a doctor's help, hide or even disable the car, or use a combination of these approaches to ensure that the person stops driving. Safety must be the first priority.

3. One way to evaluate whether someone is still competent to drive is to

A. check the expiration date on the person's driver's license.
B. ask the person whether he or she feels competent to drive.
C. have the doctor contact the Department of Motor Vehicles and request that the person be evaluated.

C is the correct answer. The Department of Motor Vehicles can test an individual at the request of a physician. Persons with Alzheimer's may not be the best judge of their own driving abilities and are not likely to want to give up the independence and mobility that driving brings. The expiration date on a driver's license is not an indication of a person's competence to drive.

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.