Let’s be honest: few of us will want to leave our homes when we grow older, despite some possible safety issues. Our home is not just a house – it is a place that is full of memories and one that symbolizes our independence. The comfort and security that our home gives us is not measurable, yet it is something we all understand.
But when a relative shows signs of memory loss or is diagnosed with Alzheimer’s disease or another form of dementia, and her condition worsens, family members often have to determine if their relative is safe living alone at home. A person with dementia may not be aware of the safety and health issues that her living situation presents.
So, what is safe? The answer can vary from family to family and even among family members. Some of us will tolerate risky or uncertain situations longer than others. To help you make the determination if your relative is safe, here are some questions for you and your family to think about:
Can your relative call for help in an emergency situation? Programming one of the phone buttons to call 911 may help people in the early stages, but not when the person’s memory and judgment deteriorate. This may be the time to bring some help into the home or start talking about community and residential care options.
Does your relative have a tendency to leave the house or wander away? Many families say, “Yes, but she always comes home”. Be prepared in case one day she cannot find her way home. Have a photo available in case she gets lost. Contact the Alzheimer’s Association about their Safe Return® program. Ask neighbors to call you if they observe any unusually behavior or excessive wandering. Notify your local police department that your relative is living alone and has some memory loss.
Is your relative vulnerable to mail, phone or door-to-door solicitors? People with dementia often respond to phone and mail solicitations repeatedly. With impaired judgment and memory, it is easy to understand how a person can be caught in the web of giving beyond their means. Watch for large piles of mail solicitations in the mail, especially opened envelopes. Is your relative sending in cash or check donations? Monitor credit card and banks account activity regularly. If your relative is having difficulty managing finances, but is reluctant to give up control, try to do it together, providing oversight and support but involving the person with dementia as much as possible. When all else fails, activate your Durable Power of Attorney.
Does your relative use the stove? Unplugging the stove, removing the knobs or only having a microwave in the house reduces the hazards in the kitchen.
What’s in your relative’s refrigerator? Food may be purchased and forgotten, posing the risk of food poisoning. Check the refrigerator for expired foods. Leave reminder notes about what is in the refrigerator and in the cupboard. Monitor your relative’s weight. Leaving non-perishable snacks out in sight can also remind the person with memory loss to eat.
Is the home a good, comfortable and healthy temperature? Complaints about the temperature or the thermostat not working might be a clue that controlling the temperature may be a problem. Program the thermostat for day and night time temperatures. If your relative has too little or too much clothing on for the inside (or outside) temperature, it may indicate problems in judgment about what to wear.
Does your relative smoke? Smokers who have dementia can be safe with cigarettes one day and pose a real risk the next. Caregivers should be very observant of their relative when smoking. Taking control of their cigarettes and allowing them to smoke only under supervision is one way to reduce the risk of fire. Often the person forgets about smoking as their dementia progresses.
Is your relative talking about not sleeping because of nighttime noises or activities? This could mean that she is not sleeping well because she is afraid to be alone.
Is your relative calling you persistently or more often when you are away? This is often a sign that a person with dementia is afraid of being alone and is feeling unsafe or insecure. Keeping track of how often your relative calls and if the calls are at the same or similar time of day may help you identify when she is feeling vulnerable or in need of re-assurance.
Expecting a person with dementia,who does not recognize or remember safety risks, to understand our concerns isn’t always a reasonable expectation. It is up to us to take action, and make decisions about their emotional, physical and financial safety.