A home safety checklist for dementia

A safe-enough home for someone with dementia comes down to a handful of small, nearly invisible changes: a nightlight on the path from the bed to the bathroom, throw rugs and clutter cleared off the floor, grab bars by the toilet and in the tub, and a lock placed high or low on exit doors if the person has started to wander. Use an exit lock only while someone is present, never to leave a person with dementia locked in alone or unsupervised in new or changed surroundings. You do not have to turn a home into a hospital. A few quiet changes, done one room at a time, can lower everyday hazards. Start tonight with the one at the top of the list: a light on the nighttime trip to the bathroom. A nightlight makes that route easier to see; keep cords, clutter, and loose rugs out of the path too.

Where should I start?#

Start with the path from the bed to the bathroom. Add a nightlight the whole way, and clear the floor of rugs, cords, and anything a foot can catch. That is ten minutes, tonight. Then work through the house one room at a time; you don't have to finish it all today.

The room-by-room checklist#

Do one area at a time. Ten minutes each is plenty.

Bathroom

• Grab bars for the toilet, tub, and shower, bolted into the wall, never the towel rail, which pulls loose under weight.
• A non-slip mat in and out of the tub.
• Consider a device that limits how hot the tap water gets, so a confused hand can't be scalded.

Kitchen

• Stove knob covers, removable knobs, or the gas shut off when the stove isn't in use. Appliances with an automatic shut-off help.
• Move the genuinely dangerous cleaners and sharp tools out of sight.

Stairs and floors

• A handrail on both sides of the stairs where you can manage it.
• Take up throw rugs; they are pure trip hazard. Tape down anything that has to stay.
• Good, even light in every room and hallway.

Doors and wandering

• A deadbolt or latch placed high or low on exit doors, out of the usual line of sight, can buy a few seconds while you are there. Never use one to leave the person locked in alone, and never leave someone with dementia unsupervised in new or changed surroundings.
• A bell or chime on exit doors, so you hear one open.
• Remove locks on interior doors, so your person can't lock themselves in.

The Alzheimer's Association's home safety guidance walks through these room by room and offers a printable checklist.

The room-by-room walk-through, in one card.

How common is wandering, and how do I prepare?#

Common enough to plan for before it ever happens. The Alzheimer's Association reports that about 6 in 10 people with dementia will wander at least once, and many do so more than once. It can begin surprisingly early in the disease, often triggered by feeling lost, searching for someone, or trying to "go home" or "go to work."

A plan is calm, not alarm. Before there's ever an incident: know the places your person tends to head for, keep a recent photo where you can grab it, tell a neighbor or two what's going on, and look at door chimes now rather than after a frightening afternoon. If it does happen, start looking right away (many people are found within about a mile and a half), and call 911 if you haven't found them within 15 minutes, telling responders the person has dementia. A wandering-response and ID enrollment service can help a person who walks off be identified and returned quickly. The Alzheimer's Association's guidance on wandering covers both prevention and what to do in the moment.

Do I need to buy special equipment?#

Mostly no. Most of this is a nightlight, some tape, a couple of grab bars, and rearranging what you already own. One free change that helps a lot: put the everyday things where the eye already looks, out in plain sight rather than tucked away neat. A dementia brain often can't remember to search a drawer, but it can still respond to what's right in front of it. The remote, the glasses, the phone, left out where they live.

When should I call the doctor?#

Tell the doctor about any fall, even if there was no pain. NIA explains that a fall can flag a medical problem or an issue with medicines or vision, and that a doctor may suggest physical therapy, a walking aid, or other steps. For a professional home-safety evaluation, NIA says an occupational therapist, nurse, or physical therapist can help.

Be gentle with yourself#

Doing this walk-through can stir a quiet grief, because each grab bar is also an admission of how much has changed. Let that feeling be there, and do the task anyway. Preparing for the hard parts is not giving up on the person. It is one of the deepest kinds of love there is: making the world a little safer for someone who can no longer do it for themselves.

When the late-day hours bring their own restlessness and risk, the same steady thinking helps: What helps with sundowning.

If steady, practical help like this would be welcome, this guide grew out of Again, With Love, our free Sunday-morning newsletter for people caring for someone with dementia.

Again, With Love is a caregiving aid, not medical advice. For medical questions, please talk with your loved one's doctor.