You can do a lot to keep your ward safe and comfortable at home. Perhaps in the past, when your loved one was younger, it did not matter. But if now he is unsteady on his feet, it is important to consider all the risks. Then you will be calm - because you will be sure that he is safe and you have done everything possible for this.
The level of security at home should be increased if your ward:
- hardly moves without assistance,
- has difficulty maintaining balance and coordination,
- has vision problems
- suffers from dementia, confusion, or has other mental disorders.
Make the lighting brighter
- Be sure to check that there is good lighting at home everywhere.
- Install additional lamps on the stairs, in the corridors, and in bends in the aisles.
- Install a lamp next to your loved one's bed.
- Install a nightlight to make it easier to get to the toilet at night.
- Move objects to make them easier to reach.
- Put the furniture so that the room has enough space for movement.
- Check the floors in all rooms and make sure they are not slippery. Bathroom rugs and carpets should be flat without corners and edges that you can trip over. If necessary:
- cover the mats with anti-slip tape and discard uneven carpets with loose edges,
- lay out non-slip mats in rooms where slippery floors are often (for example, in the bathroom and in the kitchen),
- Apply a non-slip coating to the stairs.
- Check that all furniture is stable, fasten or replace all unstable items.
- Install protection on the sharp corners of glass tables or countertops.
- Always remember the risk of fire at home: install fire and smoke detectors, regularly check the batteries inside.
- Consider installing a hob and oven with an automatic shut-off function.
- When replacing household appliances, select those that have the auto-off feature.
- Check the organization of space in the kitchen. For convenience and safety, store utensils, glass and other frequently used items in drawers or in the closet, where it is convenient to get them from.
- Consider using a medical call device: you can buy an alarm that your loved one will carry. And if necessary, simply press a button on the device to call the corresponding service.
- Install the handrails wherever your loved one needs them - in the shower, in the bathroom, or next to the toilet.
- Put anti-slip mats around the shower and sink. If you think it necessary, install a chair in the shower.
- Consider installing the nozzle on the toilet seat - it will be easier for older people to sit on the toilet and get up from it. Very comfortable is a seat with an electric lift.
- Make a simple, easy-to-read list with important numbers for you and your loved one and keep it handy.
- Include the numbers of other relatives, neighbors and emergency services.
Rule number 1: security
At different stages of dementia (initial, medium, severe), an elderly person faces many risks and can harm both himself and others. Forewarned is forearmed. The way to minimize risks is to pre-localize problem areas and hazards.
What risks can be identified:
- Risk of injuries and falls.
This factor is relevant in principle for many elderly people, because with age, vision, motor skills deteriorate. Cluttered spaces, sills, bumps, slippery floors, slippery surfaces on the street - all this can cause a fall. With age, there is a risk of a fracture due to a simple fall at home or on the street (due to leaching of calcium and subsequent osteoporosis). Eliminate the clutter, make it possible to move around the house without hindrance, glue the carpet to the floor with double-sided tape so that its edges do not bulge, even the thresholds.
- Leaving home and losing orientation.
In terms of prevalence, this risk factor is second only to falls. The fact is that, memory loss in Alzheimer's disease leads the patient to a state of disorientation. He can go to the store and get lost on the way back (forget where he lives), or, being inside his apartment, suddenly forget what he is doing here and what is his house and go outside (in search of the house in which he lived, for example, 30 years ago). An elderly person with Alzheimer's disease can get lost inside the apartment and not find the toilet (if, for example, the door to the toilet is the same color as the wall). To improve navigation, you can hang signs (toilet, light, kitchen, bedroom, etc.). To limit access to the street, you can, on the contrary, “camouflage” the door outward to match the color of the wall, or put a “STOP!” Sign on it and so on.
And another good idea is GPS trackers. Here is a small review.
- Chemicals and poisons.
Household chemicals (such as "domestos", "mole", etc.), household poisons (such as concentrated vinegar) can be deadly if taken orally. It is recommended to put them in a separate box, sign it “DANGER!” And hide it away
- Incorrect medication.
Very often, by the age of 75+, a substantial list of medicines is accumulated that must be taken daily, following the recommendations for admission (time of administration, dosage). Often these drugs can be 5 or more. Getting confused is easy. You can take the same medicine twice, and forget some other. And you also need to buy these medicines in advance. A weekly pill box may be a good way out of this situation. The caregiver puts the tablets in cells once a week. But keep in mind that this only works with mild dementia. In the later stages (starting from the middle), you will have to give medication every time.
- Injury to yourself and others from sharp objects.
Knives, scissors, forks and other piercing and cutting objects are best removed at the later stages of dementia. If at home some other weapon (for example, a firearm) is stored, it is better to hide it too. The fact is that a demented person at some point can forget who you are and what he is doing here. And decide that you are a thief or an attacker. What consequences can this lead to? To anyone. And do not forget about the basic “hit / run” reflexes: in moments of agitation and panic, the elderly dementia can be very strong.
- Fire and burns.
Stove, oven, microwave may pose a fire hazard and burns.
What precautions can be taken: 1. put a fire alarm (departmental or non-departmental) with different types of sensors (smoke / fire), 2. replace the gas stove with a safer electric induction, 3. replace the cookware for cooking with one that would minimize risk of burns from handle / surface. In the end, you will need to limit cooking.
- Vulnerability to financial fraud.
Elderly people (and not only dementia ones) are especially vulnerable to all kinds of scammers who use credulity and kindness. At a minimum, this may be the purchase / installation of unnecessary things and devices, which are positioned by the fraudulent seller as a mandatory measure. As a maximum, you should remember about black realtors and other representatives of the fauna of large cities.
In general, in principle, admission to a house of strangers is a separate risk that must be taken into account.
- Poor food and drink.
Just like taking pills, eating and drinking can get out of hand. Food needs to be bought and cooked. There may not be the strength to do something, you can simply forget about eating. Malnutrition and dehydration are frequent companions of older people living alone.
Smoking is not only unhealthy, but can potentially lead to fires and burns.
With the progression of dementia, it is better to exclude lighters from the everyday life of the patient. If he / she wants to smoke, then do it only under supervision.
- Driving a car.
Perhaps this is not so relevant for our country, however, if an elderly person drives a car, then it is worth following his maneuvers and promptly forbid him to drive.
- Inadequacy in critical situations.
Sometimes the risk factors themselves (falls / injuries / burns, etc.) are not so dangerous as an inadequate reaction to them and subsequent additional problems.
Who is at risk
The age threshold, according to geriatricians, is 65 years old. With age, a person accumulates many diseases that provoke an imbalance, muscle strength decreases. For a young and flexible person, an accidental fall most often ends successfully, but at an older age, falling is extremely dangerous, often fatal.
We treat falls as inevitable: they say, well, what can you do if both the strength of the muscles and the coordination of movements are not the same. But experts insist: falls are a medical and social problem in many respects, since the environment - from the way of living in an apartment to the urban environment - is often not adapted to the needs and capabilities of the elderly. And this is wrong.
What can be done
“First and foremost, we must change our attitude to falls as an unpredictable event. We must understand that this is not happening by chance, and this can be prevented,” says Olga Tkacheva.
It is for this that the RSCSC developed a program, a special technique aimed at reducing the risk of falls.
In health facilities that host elderly patients, an assessment of the individual risk of falling is to be introduced and taken into account in treatment. "This is not difficult to do, there are appropriate tests, you just need to introduce them into mandatory practice," says Professor Tkacheva.
And then it will become clear what the approach to the patient should be: whether he needs to be accompanied on a walk, maybe he will need a cane or a walker. Even medicines for such patients need to be selected especially carefully, since there are drugs that increase the risk of falls.
The second point: medical and social institutions will have to be converted - you need reliable furniture, handrails on the walls, "anti-slip" floors.
Thirdly, on the basis of the Ambulance, together with gerontological centers and trauma departments, it is necessary to create services for responding to the fall of the elderly. The fact is that with a fracture of the femoral neck, surgery should be done as quickly as possible. Otherwise, the patient remains bedridden. The purpose of creating a response service is that if an accident has happened, the elderly person should get help immediately.
- Clutter elimination.
A mess is a lot of things with different purposes in one space. In this space it’s not immediately clear what to do. In the conditions of several rooms, each room should fulfill its function: a kitchen - for cooking and eating, a bedroom - for sleeping, a hall - for watching TV and spending leisure time, an entrance hall - for dressing, a bathroom - for putting oneself in order. In the case of one room, you need her to zonso that one zone acts as a bedroom, the other is a leisure part. This may seem obvious, but the disorder causes a state of agitation (in the case of dementia, this can lead to subsequent behavioral manifestations).
The general recommendation is to get rid of the trash and bring the state of things in space to the expected and logical.
- Clear the way of movement.
Moving around the house should be comfortable. You can get rid of unnecessary furniture and home decoration if they interfere with walking. Wires, sills, broken floors, broken steps, a rug or piece of linoleum can be dangerous.
- Equip a bathroom.
See a separate section of this article about this.
- Simplification of access to the bathroom.
The recommendation may be relevant for suburban residential buildings. The bathroom should be close to the bedroom. And in the house. If it is impossible to equip the bathroom near the bedroom, you need to purchase a night dressing chair.
- Strong chairs with armrests.
Generally speaking, not every chair is suitable for use by older people.
In my opinion, the chairs should be:
- strong and reliable
- heavy (when planting and rising they should not be easily moved away), therefore wooden is better than metal and plastic
– necessarily with armrests (moreover, the armrests should be as long as possible so that it is more convenient to lean on them when standing up)
- Finish - leather, eco-leather or leatherette (especially true for the later stages, when problems with incontinence of stool and urine begin)
- Dangerous items.
Medicines, knives, cleaning products and other dangerous items must be organized in an inaccessible place away from sight. On faucets (in the bathroom and kitchen), it is recommended to limit the temperature of hot water using the built-in thermostat (available on most new models of faucets). Electric blankets and heating pads are best removed.
- Strong handrails.
It is better to put contrasting handrails in the bathroom (next to the toilet, next to the sink, next to the shower / bathtub), all stairs, if they are in the house, should be equipped with handrails.
- Bedside table.
Next to the bed, it is desirable to have a bedside table in the head area. And a night light. It would be a good idea to put a motion-sensitive nightlight (with a volume sensor), they are inexpensive, but very convenient.
There are many useful gadgets:
- GPS trackers that can determine the location of a lost elderly person,
- Phones for the elderly with large buttons and / or shortcut buttons (to which you can even add photos of relatives / doctor)
- fire detectors
- video surveillance with online access (there are a lot of services now, including free ones)
- volume sensors that turn on the light
- Availability of information.
Important information can be printed out and fixed in a conspicuous place: the names and phone numbers of relatives and friends, the doctor’s name / phone number, a list of medicines and prescriptions, clinic contact information, and a list of allergies.
- Security outside the house.
If an elderly person lives in a country house, then the gates and gates should be with locks, the paths of movement along the site should not be cluttered, poisonous and prickly plants must be removed, preferably a “circular” route.
- Reduced chance of wandering.
To reduce wandering and awkward searches, you need to make sure that the basic needs are resolved and easily accessible (toilet, food, drink). It is recommended to involve a person in activity and do something useful (with what he can still do, of course), for example, fold ironed clothes, help with cooking dinner, etc.
Kids take care of parents
A lot depends on how the life of an elderly person is arranged. “Falls are possible not only in a medical institution,” says Yulia Kotovskaya. “It can fall both at home and on the street. Therefore, creating a safe environment is extremely important.To take care of this, to make the reconstruction of the apartment where an elderly person lives, is the concern of his relatives and children. "
Adequate lighting is needed, and if an elderly person gets up regularly at night - and a nightlight, and the ability to easily turn on the light to the toilet.
Non-slip floor - this is especially true for the bathroom and toilet. By the way, it is better to replace the bathtub with high sides with a convenient shower cabin.
There are special convenient toilets from which it is easy to get up, in addition, in the toilet, on the route to the room and in the kitchen, it is good to make handrails on which the elderly person can lean.
Smooth surface. If there are thresholds, it is better to remove them, as well as carpets (or fix their edges so as not to stumble). Check for wires that prevent you from walking around the apartment.
Comfortable home shoes. Slippers are easy to put on and take off, but from a safety point of view these are not the best shoes. We need slippers or slippers that would “hold” the foot, with a strong back.
In many cases, a cane helps. An even more convenient device that insures against falls when walking is a walker on wheels. In Europe, America, people quietly walk with them through the streets. Unfortunately, we rarely see them anywhere in our country.
Senility can be pushed back
Experts call this condition differently - senile asthenia and sarcopenia. To begin to fight its onset, as well as to engage in the prevention of osteoporosis (it is because of it that an elderly person’s fall often ends in a fracture), it is necessary long before a person feels a deterioration in physical condition. And here there is one secret - physical activity and proper nutrition.
“In the geriatric departments, physical therapy and balance training are mandatory,” said Olga Tkacheva. “But, of course, you need to start such prevention long before you reach old age. The sooner the better.”
Professor Julia Kotovskaya recommends adding simple exercises to daily exercise to balance, strengthen muscles and ligaments of the legs and foot. The WHO recommendations refer to oriental practices: qigong, tai chi gymnastics is very suitable for the elderly, since it does not require much physical effort, but it perfectly strengthens muscles and trains the ability to maintain balance.
The bathroom and the toilet are areas of particular danger, because it is there that falls and injuries occur most often (the most common of them is a hip fracture, which in most cases leads to disability of the victim).
General bathroom tips are as follows:
How to eat
A sufficient amount of calcium in food and vitamin D are important for the elderly, a deficiency of which in our northern country is observed in the majority of the population, Yulia Kotovskaya notes. Therefore, calcium-rich dairy products are a must.
Be sure to need protein. The norm for an elderly person is 1-1.5 grams of protein per 1 kg of weight. Elderly often do not want meat, and they begin to lean on carbohydrates - rolls, white bread, pasta. It is not right. I do not want meat - let there be chicken, fish. Protein can also be obtained from legumes - beans, lentils. Well, of course, good sources of protein are eggs, cottage cheese, cheese and other dairy products.
Salt-free diets can be unsafe. “You need to accustom yourself to a small amount of salt from a young age,” Professor Kotovskaya explained. “And in the elderly, we recommend limiting it only in extreme cases, when we see that the patient is very abusing salty. But it is really better to refuse sugar and rolls."
It is important to drink enough fluids. A day, taking into account liquid foods (soups, milk, etc.) should be about 1.8 liters. Of these, 700-800 milliliters of water or unsweetened drinks.
- If possible, replace the tile on the floor with a non-slip tile (with small "pimples"), or lay a rubber mat, but in the case of a rug, make sure that the edges of the mat do not bend or puff,
- In good mixers, there is the possibility of limiting the thermostat, a good idea is to physically limit the maximum temperature of hot water in order to avoid burns,
- If the bathroom is combined, highlight one wall with a color, for example, the one next to which the toilet is located, it will be easier to navigate in space,
- The door should be contrasted (on both sides)
- Set color handrails next to the toilet, next to the shower, for example, if the toilet is next to the side wall, then on the side of the wall you can put a stationary handrail, and on the other hand - folding,
- Using a bathtub in old age is not as convenient as a shower. If possible, replace the bath with a shower, or better yet equip the gangway and put there highchair, even if it is not possible to make global repairs and install a gangway, then a seat or a bathing chair is a good idea. If you leave the bath, then consider replacing the bath with a special bath for the elderly and disabled (it has a door open and you can go into it), or purchase steps for the bath (but remember that this unsafe),
- Towel hooks should be large and contrasting,
- Towels - contrasting and colored,
- Personal hygiene items (brush, brush glass, toothpaste, liquid soap) should be different in color from the background,
- Put the colored toilet lid on,
- A curtain on a mirror is needed in those moments when an elderly person may be afraid of his reflection in the mirror (read our article about how dementia is arranged from the inside),
- The handle on the door should be contrasted. For the elderly with arthritis, there are special door handles that are convenient to open with the forearm, and for arthritis patients it is better to replace the faucet with the elbow (as those used in operating rooms and some doctors' offices).
- If medicines are stored in the bathroom, it will be good to organize and hide them from view.
Tip # 1: contrasting colors
The simplest modification that can be done in any home is to designate all objects that are used in everyday life with contrasting (relative to the background) colors.
For example, you can make the following changes:
- Change the light switch from white to color so that it can be easily seen on the wall even in the dark, it is advisable to additionally put a switch with night illumination. Above the switch, you can even stick the “Light” plate, even if it seems ridiculous, obvious or funny to you.
- Color the handrails and railings in the house in a contrasting color, for example, bright red, bright blue or bright yellow. If you still do not have handrails in critical places (bathroom, toilet, stairs), then it's time to put them. Choose vibrant colors and a non-slip antibacterial coating.
- Change tableware and appliances to bright and contrast in order to simplify the process of eating. Choose cutlery for the elderly, they are similar to their similar sets for children: with thick colored handles.
Tip number 2: "help" for memory
Another simple life hack for carers is marking up things used in everyday life with pictures and notes for memory. An example of such a markup is to attach stickers with pictures of what is inside to the cabinet and drawers of the chest of drawers. Depending on the severity and stage of the disease, pictures can also be pasted in all constantly used rooms as needed. For example, auxiliary pictures in the bathroom can serve as a detailed reminder of the need for regular household activities, such as washing hands or washing.
“Help” for memory, in addition to pictures and photographs, may include several whiteboards for recording in strategically important places at home. On these boards, you can use a marker to apply items such as schedules and plans for the patient and for the caregiver. And there you can specify the necessary contacts (for example, relatives, friends, doctors, etc.) and emergency phones.
In addition, caregivers must ensure that the premises are generally well-groomed and not cluttered, as well as well-lit. Chaos and disorder can put a lot of pressure on an Alzheimer's patient, so try to tidy up and simplify the whole space.
All these tips can be implemented with a minimum budget, with virtually no professional help, so we can assume that this is a “project for a cloudy weekend”, DIY (“crazy hands”). At the same time, modernization in the house can be extremely important for a patient with dementia, because these changes can allow the patient to stay at home longer and not to move to a specialized boarding house longer. At the same time, for caring relatives, it can be especially valuable to realize that the patient’s house is adapted for living with dementia, and it is easy for the patient to navigate and independently satisfy basic household needs. And do not feel at the same time endless frustration and embarrassment from their own forgetfulness.
Don't forget about yourself
Caregivers for dementia patients are also vulnerable and at risk:
- Sprains of the back and injuries of the musculoskeletal system / pain due to physical exertion due to the movement of patients
- Danger of being hit, scratched, bitten, etc.
- Danger of being attacked by dangerous objects (piercing-cutting, firearms, sometimes, even trite hot soup)
- Risk of injury from falls
- Neglect of personal care and the appointment of doctors
- Overeating and malnutrition from stress
- Improper self-medication
- Social isolation, depression.
Think in advance about your health and your safety.
Take care of yourself!