One of the first things to keep in mind when creating a safe space for a loved one living with dementia, is that modifications will differ per individual because the disease affects everyone differently.

There are general challenges to look out for, but each person’s situation is different and will change as the disease progresses over time, said Julie McMurray, senior manager of Central Massachusetts Region, Alzheimer’s Association in a May 11 webinar on home safety for those living with dementia.

“If you’ve met one person with Alzheimer’s and dementia,” McMurray said, “you’ve truly met one person with Alzheimer’s and dementia.”
Safety modifications need to be tailored to a person’s specific needs and updated as the disease progresses.

In the early stages of the disease, for example, McMurray said strategies might focus on supporting autonomy for the individual with dementia. While in later stages, the focus might shift to supporting the caregiver in keeping the individual safe.

In the webinar, McMurray recommended planning for broad changes including differences in a person’s balance or gait; vision accommodations for reduced depth perception and a decreased ability to see contrast; altered sensory perception changes such as reduced temperature sensitivity; increased confusion; difficulty navigating the home environment; and forgetting how to operate household appliances.

A dementia-friendly environment, she said, can promote a feeling of safety, security, and happiness, help a person to think and understand more easily, and promote independence by making needed items easier to find and use.

McMurray was joined by Amy Finke, vice president of business development for Lifeway Mobility, in discussing how caregivers can modify home spaces. Lifeway provides accessibility solutions and has a showroom in Westborough.

Key areas to consider, according to both women, include entryways, bathrooms, and stairways with a goal toward reducing the risk of falling and creating supports for confusion and difficulty navigating spaces.

One concern faced by more than half of families living with dementia is wandering, McMurray said, citing research that shows six in 10 people experiencing dementia will wander.

“Consider enrolling (the person with dementia) in a wanderer response service, ask neighbors to call if they see the person wandering lost or dressed inappropriately, have a photo on hand to give to police if needed, and also let police know (in advance) that they have the diagnosis and may be at risk for wandering,” she said.

Painting a section of the floor black in front of an exit can also help as the paint will appear like a hole to those with reduced depth perception and could keep them from crossing it. Alternatively, not being able to perceive depth can become a problem when stairs, carpeting, or other areas are black in color.

Additional modifications include adding railings and ramps on stairs to get in and out of the home. In the bathroom, grab bars for toilets and showers are useful with one multi-use option being a floor-to-ceiling pole with an adjustable bar allowing for multi-directional uses.

To help increase contrast, especially in all-white bathrooms, brightly-colored toilet seat covers and nightlights can be added to toilets. Cutouts can also be made to existing tubs to help individuals get in and out more easily.

Finke has been helping clients for more than 15 years and has seen a variety of solutions work. Finding the right ones for an individual’s circumstances is a process, she said. In some cases, modifications can make navigation easier, but they can also be disruptive to an individual with dementia.

The best starting point is a home evaluation, she said, advising families to ask for references from the Alzheimer’s Assocation and to read reviews before choosing someone.