- Dementia Care Notes - https://dementiacarenotes.in -

Adapt the home for persons with dementia

The person with dementia finds it difficult to understand where he/ she is, or walk around the home. The person finds doing normal tasks more difficult.

What caregivers can do: Make changes in the home to keep it safe for persons with dementia. Look for changes that can make it easier for them to do their tasks independently, or with very little support. Help them feel more capable and happier by suitable changes at home. Keep adjusting the home as their abilities get worse.

The surroundings affect how persons with dementia do their daily activities and how they feel and respond to situations. But though their abilities get worse over time, the home and objects around them do not change much. This makes it even more difficult for them to do their tasks. Home adaptations help to make them safer, happier, and more independent. This reduces chances of their withdrawing or feeling agitated, and also reduces the overall stress for other family members.

Approaches while considering home adaptations

Changes have to be selected based on the current abilities of the person with dementia. These abilities change over time, and so the home may need to be changed again and again accordingly. For example, in early stages, the person may seem confused because there are too many objects in the room, or apparently forget where the bathroom is. Removing unnecessary objects and adding signs may help. Later, when the person starts facing problems in walking, you can add grab rails. If the person finds it difficult to get up from a chair, you can use a chair that has arms.

An important part of home adaptations is observing the person’s problems to see which home adaptations can be useful. You have to select what suits the person as well as and the rest of the family. Changes require effort and money. Remember that you may need to keep making more changes. Be creative and look for practical ideas and materials. In addition to the suggestions and resources listed on this page, talk to friends and get ideas. Visit online or in-person support groups; other caregivers may have faced similar problems and may have good, practical tips. They may also know where you can buy special equipment and materials.

While looking at which adaptations can help the person, be clear of your reason. Some possible reasons to make changes:

Make it easier for the person to know the place and time (Reality orientation): People with dementia are often confused about where they are or what the time or date is. Reality orientation is the term for trying to help them know where they are. Changes may include adding prominent clocks and calendars, having windows that allow them to see the sunlight, etc. Clearing the room of clutter and simplifying the layout can help, because then they can recognize the purpose of the room more clearly–is it a bedroom? a dining room? etc. Consider using better lighting. You can also add signs (words or pictures or both), especially for the bathroom.

Simplify daily tasks: People with dementia may start having difficulties finding what they need if the room has too many things. Or they may not recognize an object. They may have forgotten how to use it. Some objects may require a lot of physical control to use and they may not have that much hand control any more. If there are too many objects in a cupboard, they may have problems selecting which one they want. They may also have problems walking around in a room. Look at changes that can reduce such difficulties so that they can do their tasks more easily, and be more independent.

Encourage some behaviors and discourage others: Use changes in the home to make some things more visible and make some other things less visible. This can be used to remind persons with dementia to do some things, and discourage them from doing other things.

Ensure safety: Given the several problems that persons with dementia face, think how the home can be made safer even if they are confused and have poor coordination.

Most home adaptations involve removing things, adding things, and re-arranging things. A prominent, easy to read clock may be added to improve reality orientation, as may signs and night lights. Rooms may be simplified by removing or hiding unnecessary objects. Contents of shelves and wardrobes can be re-arranged so that useful objects are more visible and things that are not required are removed.

Before making changes, consider how the someone with dementia will adjust to the change. You may think that it is a good thing to replace a complicated phone with a modern model that has only a few buttons. But the person may be used to the old phone. The new phone may be too difficult to learn. Similarly, you may think that a digital clock is an easy way to know the date and time. But the person may be used to clocks with hands, and may not be able to read a digital clock. Similarly, re-arranging the kitchen may make the person unsure about how to cook because everything seems different. It is important to think of the person’s difficulties in adjusting before you make changes to something the person is used to.

Teepa Snow, dementia care and training expert, has explained in a video how the area that persons with dementia can see clearly reduces. They they have problems figuring out the depth of objects they see, or even knowing what is “real” and what is not. This understanding is very useful for adapting the home for people with dementia. View video “Aging vision and Alzheimer’s” on Youtube Opens in new window [9].)

Another problem is that, even if their sight is alright, many persons with dementia start having problems reading things. They are not able to make sense of the letters and words. They may have balance and walking problems. They may have problems holding and manipulating objects. They may withdraw or get frustrated, and not realize that some small changes can make things easier for them. You can remain alert on the problems they are facing, and how these change over time, and can keep adjusting the home accordingly.

While making home adaptations, remember the cognitive problems that persons with dementia may be facing. For example, dementia often affects the way they see and interpret things. Objects that seem perfectly commonplace to you may seem odd and even frightening to them.

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Possible ways to improve reality orientation

Some minor changes in the house may help remind persons with dementtia where they are and what the time is:

reality orientation with clocks calendars labels pads whiteboards
If the person is still able to read and understand, it may help to use large clocks and calendars, have pads and pencils conveniently located, and use labels and notes.

For helping them understand which part of the house they are in and what the room is meant for, the following may help:

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Possible ways to make it easier to perform tasks

[Also see the discussion on Helping with Activities of Daily Living [11]]

Reminders: In the earlier stages, persons with dementia are able to read and use various types of reminders:

Charts on how to do activities: In the earlier stages, persons with dementia are able to read and use charts and instructions for tasks such as making tea.

Make things easier to locate: Simplify rooms to make things easier to locate

Make objects easier to use: Make it easier for the person to hold and manipulate objects. For example,

Make it easy to move around for familiar tasks: Make it easier for the person to walk around for normal activities. /p>

Make it easier for them to ask for help/ contact persons:

Many of these tips will not work if the person with dementia start calling up people so often that it is a problem for others. If that happens, you may have to keep only one or two very important numbers accessible, like your number.

Reduce need to move when confused:

Also remember that persons with dementia may not remember to call out for help. At night, when they are sleepy and confused, they may try to walk to the bathroom without putting on the light, and may fall down. Place a bedside commode at nighttime for their use if they are able to use it. Note that not all persons feel comfortable using a bedside commode.

Adaptations to help persons with dementia cope with problems in getting up and in walking Here are some possibilities:

Adaptations to make things easier for providing care:

Most discussions on home adaptations look at ways to make life easier and safer for the person with dementia. But home adaptations must also be considered to make it easier and more comfortable for you.

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Encourage or discourage actions by adjusting the environment

Use colors and placement to make some objects prominent and hide some objects:

Encourage persons with dementia to engage in activities (to the extent suitable for the person)

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Ensure safety at home

Reduce chances of tripping/ hurting

Reduce chances of confused interpretation of objects/ reduce things that frighten the person

Lighting: A dark place can be frightening to the person with dementia, but a very bright light can also be confusing.

Reduce chances of wandering by making minor changes to the room

Wandering is a very common behavior observed in dementia, and puts the person at risk. A more complete discussion on wandering–why persons with dementia may wander and what can be done to reduce their chances of wandering–can be seen at this link (which includes video explanations): Special Tips: Wandering [12]

Grab rails in a corridor and in a toilet

grab rail in corridor-1grab rail in toilet-1grab rail in toilet 2

(Photographs taken at Nightingales Centre for Ageing and Alzheimer’s, Bangalore)

Special tips for the bathroom

The bathroom is one of the most common areas for accidents like falls and burning. Some tips:

General Safety

Persons with dementia sometimes close the door of the bathroom/ bedroom. Then they get agitated or fall down. They do not open the door even when family members keep knocking. door hook for safetyConsider replacing door bolts with simple latches and hooks that you can force open from outside.

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Special concern areas

Some activities of the person with dementia become problematic when the person is no longer able to notice mistakes or understand the danger. Take special caution for these, and remain alert about when to reduce the need for the person to do these activities.

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Assistive devices

Assistive devices can be used by persons with dementia (or caregivers) to make some daily tasks easier. Devices are available for mobility, self-care, dressing, drug management, safety, housework, and many other aspects of daily living. Examples of devices are bedroom accessories, bathroom accessories, daily living aids, hearing, visual, mobility aids, adjustable Indian commode, economy commode, toilet safety railings, adjustable back rests, wheelchairs, bed raisers, bent forks, and many other such products.

Some organizations are now making such devices in India and have agents in various cities. Information on available devices is also often visible in stalls in fairs and events aimed at seniors. Products may also be available from online stores. Shops that sell orthopedic supplies may also have such products or know vendors/ agents who have them.

Even if a product is not available in India, you may be able to look at the product description and think of how to get similar products made. Of course, whether you buy a product or whether you get it made yourself, please be very careful of its safety and sturdiness, and its suitability for the person who will be using it.

For devices not available in India yet, some families order them from suppliers outside India, or ask friends and relatives to get them when coming for a trip to India.

Some specific data on sources of assistive devices is given in the resources section below (See Also…)

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See also….

Resources/ references from Dementia Care Notes and related sites

Two resource listings are available on the site, at: Caregiver resources in India [13] and Other dementia/ caregiving resources [14]. Both of these list various organizations and online resources, and many of these have tips on how to adapt the home for persons with dementia.

Some relevant interviews on this site:

The full list of interviews is here: Voices: Interviews with dementia caregivers, volunteers, and experts [17]

Assistive living devices in India

The Govt. of India’s Old Age Solutions portal has a section: Assistive devices Opens in new window [18]. This discusses various types of devices.

Pedder Johnson Opens in new window [19]: They manufacture and market several products for dignified living of elders and disabled persons. Their site contains pictures that make it easy for visitors to decide whether the product would be useful.

Information on such products and agents who sell them may also be seen in newspaper articles. For example, for Bangalore, two possible organizations where information was available online are shared here. Please satisfy yourself about their suitability and reliability before ordering anything.
Devised Care India is an organization set up by two ladies: (articles on it at newsreport on Devised Care in Hindu Opens in new window [20] and on the Silver Talkies portal: Devising Ways to Help the Elderly Opens in new window [21]) Contact details (as of November 2015): Phones: +91-9886393874, +919972817654, Email: devisedcare@gmail.com
Geriose: An online retail outlet offering products for the geriatric community in India. Contact and website: www.geriose.com, www.facebook.com/geriose, and email: info@geriose.com

External links with discussions/ suggestions on home adaptation

And here is a general discussion on the principles for adapting the environment around the person to make it more enabling: Dementia Enabling Environment Principles Opens in new window [26].

Soem books also have tips and illustrations on how the home can be made safe and empowering for persons with dementia. The suggestions may need to be adapted for your context depending on the availability of materials. Check out the suggestions below, or surf Amazon.com Opens in new window [27] or Amazon.in Opens in new window [28] for your specific needs.

comfort of home AD book cover and link [29]
The Comfort of Home for Alzheimers Disease: A Guide for Caregivers (The Comfort of Home) (Maria M Myers, Paula Derr): This book has many tips on how to adapt the home for safety and comfort of care receivers. It describes various equipments to help persons with dementia stay mobile. For the paperback version, see Amazon.comOpens in new window [30], or, if you are in India, see Amazon.inOpens in new window [31] or FlipkartOpens in new window [32] or any other vendor.

This book is also available as a Kindle eBook. Read the book or sample right away on your laptop, tablet, or Kindle by checking it at Amazon.comOpens in new window [29] or Amazon.inOpens in new window [33].

book home proof cover and link [34]
The Complete Guide to Alzheimer’s-Proofing Your Home (Revised Edition) (Mike Warner): This book has been suggested by some readers and is part of some recommended book lists, but has not been reviewed/ evaluated by us yet. You can see the book description and reviews and decide if it is of interest to you to get your house ready for the person with dementia. For the paperback version, see Amazon.comOpens in new window [34], or, if you are in India, see Amazon.inOpens in new window [35] or any other vendor.

(You can also see our full list of suggested books at: Books on dementia and care [36]

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Page/ post last updated on: March 17, 2019

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