Because of the way dementia affects the brain, people with the disease are at greater risk for self-injury than the general population. Not only does dementia cause memory loss, but it also impacts the parts of the brain that control reasoning and problem-solving. People don’t just forget they’ve turned on the stove; they may also be unable to react to the fire they start in a rational way, and they may be unable to figure out how to escape a life-threatening situation. If you have a loved one with dementia, here are some considerations to help them live more safely and reduce the risk of starting a fire in the home.
Does the person live alone?
Many people in the early to moderate stages of dementia live alone in the community or are left alone for several hours during the day. They may be physically capable of their normal daily activities. But family members should be aware that the functions of the person’s brain are changing and must learn to address potential risks before they turn into crisis situations. One way to minimize risk is to hire in-home caregivers so that the person is never left completely alone. They can still have the freedom to roam around inside and outside the home, but the caregiver can keep a watchful eye on their activities and step in when needed to make sure they don’t injure themselves.
Have you covered the basics?
Check the smoke detectors to make sure they have fresh batteries. Test them to ensure the alarms are functioning. Come up with an escape plan in case of emergency and discuss strategies for helping your loved one with dementia exit the home. If the person is living alone, you might post the escape plan in two or three prominent places in the home so that they can see and follow it in the event of a fire.
What appliances does the person use? What activities did they do in the past?
Think about the activities the person does now and the activities they did in the past. At the same time, think about what appliances are involved in those activities. Were they a homemaker, spending most of their days at the stove cooking meals or ironing clothes for their spouse? Did they make handcrafts using tools in the garage? Did they spend time out in the garden, pruning back overgrowth and burning brush piles? Many types of dementia have a regressive effect: the person “goes back in time” and falls into routines they may have followed in their youth. It may no longer be safe for them to use the tools and appliances they did then without careful supervision. They may also forget how newer appliances function and may try to do things the “old way” – for instance, putting an electric kettle on the stovetop. It may be necessary to disable such devices, keep them locked away when a caregiver isn’t available to supervise, or remove them from the home altogether.
Does the person smoke?
A smoker with dementia might leave their cigarette lying on a surface that is not fireproof or may not react appropriately if they notice their cigarette has caused another object to smolder. Covering furniture and other surfaces with fireproof material can help reduce the risk of starting a fire in the home.
Does the person use a fireplace, space heater, or candles?
It’s easy to see how any one of these could lead to a fire incident. Sources of open flames should be removed or disabled; for instance, if the person has a gas fireplace, disconnect the gas. If they get cold and need a space heater, look for an option that will automatically shut off after a certain time, once it reaches a certain temperature, or if it is tipped over. Older heat sources, such as radiators, should be removed or disabled if possible and replaced with “smarter” devices that have built-in safety features.
Can you identify a helpful neighbor?
If the person with dementia lives alone or is frequently unsupervised, informing nearby neighbors of their condition can help expand the safety net. Family caregivers can provide their phone numbers to the neighbor and also encourage them to call 911 if they suspect the person with dementia is unsafe. Neighbors might ordinarily be reluctant to interfere for fear of damaging relationships in their community, but if you invite their help, many will be glad to keep an eye on your loved one.
What if the person is frustrated by your “meddling”?
Few of us enjoy being told what to do, and a person with dementia is no different. When you start making changes to their home environment – replacing or disabling appliances or hiring a stranger to provide care – it’s likely they will be disagreeable. Caregivers often become frustrated because they carefully explain to the person all the reasons for making the changes, but the person just doesn’t “get it.” Remember, a reduced ability to be rational is an effect of the disease. Sometimes reasoning and explaining don’t work. Even so, it’s important to be respectful of the person and to avoid treating them like a child. They may not remember specifics, but they will remember the emotions they experience during your interactions.
One tactic you can use is “distract and divert.” If they keep asking where their tools went, start with, “That’s a good question. Do you remember when you gave Susan the cutting board you made at her wedding? That was such a nice day!” They may follow you into a pleasant conversation about the wedding day and forget their concerns about the tools. Another strategy is to use “white lies.” Many of us are uncomfortable doing this because we’ve been told all our lives that lying is wrong, but sometimes it is more important to protect the feelings of our loved one and maintain a good relationship. For example, if they question why the gas fireplace isn’t working, you might tell them it’s broken. When they insist you call a repair person, you can assure them you’ll do that soon, then change the topic to something enjoyable. When using this strategy, remember that your loved one’s well-being is at stake, and the most important thing is that they are safe, comfortable, and able to enjoy their interactions with their loved ones.
What community resources are available?
It’s always a good idea to get professional input on your efforts to make the home safer because there may be things that escape your notice. Check in with your local fire department and agencies serving people with dementia to start. They may recommend additional measures or might connect you with programs that help emergency service providers better serve people with dementia. You might also get in touch with a geriatric social worker or care manager who can do an in-home safety assessment. If you’d like help connecting with the right resources, give us a call. We’ll be happy to help.