I’ve often stated that the goal of giving good care to someone living with Alzheimer’s disease or another dementia is to provide just two things—safety and contentment. (I used to say that we should try to keep our loved ones safe and happy, but contentment is the more realistic goal.)
I want to talk about safety today. This is a huge topic. So many symptoms attributable to dementia play a role: loss of visual-spatial function, poor judgement, auditory and visual memory loss, inability to read and comprehend, worsening motor skills and coordination.
I’ve already written about driving safety here. And wandering here. And money issues here.
In a booklet issued by the National Institute on Aging, I found a novel way to discuss safety by dividing up the topic under the five senses. I’m borrowing their approach, not their content.
Sight: There is a lot that can fall into this category. A person living with dementia at some point will have diminished visual-spatial capabilities. This may manifest itself with balance issues. Imagine not being able to judge the height of a curb, or stumbling when you misjudge something as small as a throw rug. Stairs can become hazardous. Eventually, peripheral vision is impaired. This can lead to difficulty perceiving clutter, small animals, or even furniture. Visual misperception may lead to an inability to see objects for what they are—a black door mat becomes a hole—and loss of visual memory may lead to seeing the face in the mirror as a threatening stranger.
Sound: A loved one with dementia doesn’t lose the ability to hear, but if they can’t interpret what they are hearing, a disaster may arise. I’m thinking here of various warning sirens, or a kettle whistle, or alarm systems. If your loved one doesn’t understand what the weather alarm means, they may rush outdoors to escape the intrusive sound.
Touch: Again, not that Alzheimer’s disease diminishes the sense of touch, but rather, if the loved one has poor judgement, they may touch a hot stove, or pull something out of the oven without a mitt. Poor judgement in clothing choices may lead to hypo- or hyperthermia. Dangerous plants and wildlife might pose a threat if they lack the ability to perceive them as such. Not being able to regulate the water temperature for a bath or shower may be dangerous.
Taste: The sense of taste does diminish with age as well as with advancing dementia. A loss of this discrimination may lead to a loved one ingesting poisonous or harmful substances. Or too much of something they enjoy, like salt or other spices. Because some household items smell enticing, the loved one may not realize that they are not meant to be eaten—toothpaste, soap, lotions, etc.
Smell: The sense of smell also decreases with age and progressive dementia. This may be a safety issue if the loved one cannot detect the smell smoke or that food has gone bad.
There are other areas of safety that need to be considered that require specific action on the caregiver’s part. Try looking at the home where your loved one lives with their safety in mind. It’s akin to looking at a home with a baby or toddler’s safety in mind. You should remove or lock up medications, alcohol, chemicals, guns and other weapons, and other hazardous items. Consider placing childproof measures to certain door handles, stove knobs, electrical outlets.
Keeping our loved ones safe takes a great deal of vigilance, and even if you think that you have thought of everything, they may still find ways to put themselves in unwitting danger.