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A C T I O N S E R I E S

S teps To
Enhancing Your
Home:

MODIFYING THE
ENVIRONMENT

Alzheimer’s Association
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W hen caring for an individual
with Alzheimer’s disease at
home, safety and accessibility can
be important concerns. The person
may experience changes in:
Judgment
(forgets how to use familiar household
appliances and equipment properly)
Orientation to time and place
(gets lost on her own street or is unable to
recognize or find areas in the home)
Behavior
(becomes easily confused, suspicious, or fearful)
Physical Ability
(has trouble with balance, or depends on a
walker or wheelchair for mobility)
Senses
(experiences changes in vision,
hearing, sensitivity to temperatures,
and depth perception)
With some creativity, flexibility
and problem-solving, the home
can be adapted to support these
changes. This brochure provides
simple steps to make the home safe
and supportive for the individual
with Alzheimer’s.
2 3
Before modifying your home,
consider the following:
Assess the environment.
Identify possible hazards by looking at your home
through the eyes of an individual with Alzheimer’s.
What objects could cause the person injury? Can
the person easily get outdoors or access dangerous
areas such as the kitchen, garage, or basement?
Focus on adapting rather than teaching.
Avoid reteaching the person with Alzheimer’s about
safety issues. Instead, identify potential risks and
take the appropriate precautions.
Simplify the activities.
Most accidents, especially in the area of personal
care, occur when the person with Alzheimer’s is
rushed. Break activities into simple, step-by-step
tasks, allowing her plenty of time to complete them.
Giving extra assistance, such as laying out clothes in
the order that they are put on, will also help her
with simple tasks that have become hard to do.
Support the person’s needs.
Try not to create an environment that is too restric-
tive. The home should encourage independence,
social interaction, and activities that are meaningful.
Be realistic about what you can do.
You will never be able to prevent every problem.
Rely on your common sense while paying close
attention to objects or activities that could
be dangerous.
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C R E AT I N G A SAFE ENVIRONMENT
Once you have identified potential safety problems,
take the following steps to modify your home.
M A K E P O T E N T I A L LY D A N G E R O U S
PLACES LESS ACCESSIBLE
The person with Alzheimer’s may be at risk if
she has access to certain areas of the home or the
outdoors. The following action steps will help to
make potentially dangerous areas more difficult
to access:
Lock or disguise hazardous areas.
Cover doors and locks with a painted mural or
cloth. Use “Dutch” doors, swinging doors, or
folding doors to hide entrances to the kitchen,
stairwell, workroom, and storage areas.
Install locks out of sight.
Place deadbolts either high or low on exterior
doors to make it difficult for the person with
Alzheimer’s to wander out of the house. Keep an
extra set of keys hidden near the door for easy
accessibility. Remove locks in bathrooms or bed-
rooms so she is not able to lock herself inside.
Use special safety devices.
Child-proof locks and door knobs can help
limit access to places where knives, appliances.
equipment, cleaning fluids, and other poisonous
products are stored. Use automatic shut-off
devices for appliances such as an iron, toaster
oven, and coffee maker.
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A C C O M M O D AT E V I S U A L C H A N G E S
As the disease progresses, changes in vision
may make it difficult for the person to distinguish
colors and understand what is being seen.
Consider the following:
Diffuse bright light.
Reduce glare by removing or covering mirrors
and glass tops or highly polished furniture. Cover
windows with blinds, shades, or sheer draperies
to block bright sunlight. Avoid using bare light
bulbs or clear "decorator" bulbs without shades.
Taking these action steps may help to reduce
agitation in the person with Alzheimer’s.
Create an even level of lighting.
Add extra lighting in entries, outside landings,
areas between rooms, stairways, and bathrooms
because changes in levels of light can be
disorienting to the individual with Alzheimer’s.
Use different colors.
Place contrasting colored rugs in front of doors
or steps to help the individual anticipate staircases
and room entrances. However, avoid using very
dark colored rugs since it may be perceived as a
hole. Apply colored decals to glass doors and large
windows because she may think they are open
doors.
Install special lighting.
Use night lights in hallways, bedrooms, and
bathrooms to prevent accidents and reduce
disorientation, especially if the person wanders.
Illuminated light switches and timers for lights in
these areas can also assist her at night.
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BEWARE OF HAZARDOUS OBJECTS
A N D S U B S TA N C E S
Even the most basic appliance or household
object can become dangerous to the person with
Alzheimer’s. To reduce risk of injury:
Limit the use of certain appliances and
equipment.
Remove electrical appliances, such as an electric
razor or a hairdryer, from the bathroom to reduce
the risk of electrical shock.
Put away kitchen appliances and equipment including
knives, mixers, grills, guns, lawn mowers, or power
tools because the person may not remember how to
use them safely. Also, consider removing the knobs
on the stove or installing a hidden gas valve or
circuit breaker so she can not turn on the stove.
Supervise smoking and alcohol
consumption.
Keep an eye on the person who uses cigarettes,
cigars, or pipes because she may not realize the
dangers related to smoking. Monitor consumption
of alcohol because it can have many negative
effects, especially when mixed with medication.
Be prepared for the unexpected.
Persons with Alzheimer’s have been known to eat
items such as small rocks, dirt plants, flowers,
and bulbs. Take precaution by removing toxic
plants and any decorative fruits (wax, plastic, etc.)
that the person may think are real. Also, remove
vitamins, prescription drugs, sugar substitutes, and
seasonings from the kitchen table and counters.
6 7
Keep the refrigerator safe.
The person with Alzheimer’s may not be able to
distinguish the difference between fresh and
rotten food. Clean out the refrigerator regularly
and discard inedible food. Keep foods that are
safe to eat in the front of the refrigerator and at
eye level where she can easily see them.
Keep walking areas clear.
Remove objects, such as magazine racks, coffee-
tables, and floor lamps to create safe wandering
areas and reduce the possibility of injury.
A V O I D I N J U R Y D U R I N G D A I LY
ACTIVITIES
Since a majority of accidents in the home occur
during daily activities such as bathing, toileting,
and eating, it is important to take special precautions.
Monitor temperatures.
As the disease progresses, the person may have
a decreased sensitivity to temperature. Consider
setting hot water heaters at 120 degrees and
installing automatic-mixing or anti-scalding
devices to the faucets. Meanwhile, help her mix
hot and cold water, and always turn off hot water
first when finished. Also, it is important to check
the temperatures of foods before serving to make
sure that they are not too hot or too cold to consume.
Prevent falls.
Install walk-in showers and grab bars in the shower
or tub and at the edge of the vanity to enable
the person to move around safely and indepen-
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dently. Shower seats and commode chairs are also
helpful if she has limited mobility. Add textured
decals to slippery surfaces and apply adhesives to
keep throw rugs and carpeting in place, or remove
them completely. Place padding on the edge of
counters and bathroom fixtures if they are sharp.
Supervise taking prescription and
over-the-counter medications.
The person may experience many difficulties related
to medication use, either forgetting to take them,
or taking too much. Consider using locked pill
dispensers operated on a self-timer to assist her.
Make medicine or kitchen cabinets less accessible
by installing locks.
C R E AT I N G A S U P P O R T I V E
ENVIRONMENT
While it is important to make the environment safe,
it is equally important to create an atmosphere that
supports the changing needs of the individual with
Alzheimer’s.
Encourage independent movement.
Eliminate hazardous objects, limit access to
danger-points such as stairwells, kitchens, and
outside doors so the person can move safely
and independently. If necessary, make room to
accommodate walkers and wheelchairs.
Involve the person in activities.
Let her participate in preparing meals, rinsing
the dishes, folding clothes, raking leaves, and other
activities with your supervision. These activities
enhance self-esteem and make her feel more
valued around the home.
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Use surroundings to initiate activities.
Leave out scrapbooks, photo albums, or old
magazines that help the person to reminisce and
encourage conversation. Try using music the
person once enjoyed in the past to prompt
activities such as dancing, clapping, or other types
of exercises. It is important, however, to keep the
noise level to a minimum since loud distracting
sounds may cause agitation.
Create access to the outdoors.
Encourage the person to enjoy supervised
outdoor activities such as gardening or walking.
A backyard with a fence allows her to safely
go outside on her own. If she is unable to go
outdoors, consider doing indoor activities in a
room with many windows or on an enclosed porch.
Be prepared for emergencies.
Keep a list of emergency phone numbers and
addresses for the local police and fire depart-
ments, hospitals and poison control help lines.
Check fire extinguishers and smoke alarms, and
conduct fire drills on a regular basis.
If the person has a tendency to wander, enroll
her in the Alzheimer’s Association's Safe Return
program. The program is a nationwide system
designed to identify, locate and return to safety
persons who are memory impaired. For more
information about the Safe Return program,
contact your local chapter of the Alzheimer’s
Association or call (800) 272-3900.
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Tips for Creating a Safe and
Supportive Environment
✓ Safety Checklist:
❑ ❑ Remove or tape down throw rugs and carpeting
Kitchen
❑ Lock up cleaning supplies
❑ Turn off electricity to the garbage disposal
❑ Hide knives and other utensils
❑ Put away the toaster, blender and any small appliances
❑ Unplug larger appliances such as the microwave
❑ Remove knobs from stove or hook up stove to a
hidden gas valve or electric switch
❑ Keep fire extinguisher nearby
❑ Clean out refrigerator regularly
Bathroom
❑ Set water temperature at 120 degrees
❑ Install grab bars
❑ Apply textured decals on slippery surfaces
❑ Supervise the use of hairdryers, electric and
hand razors, and curling irons
❑ Remove locks from the bathroom door
❑ Discard dangerous items from the medicine chest
Bedroom
❑ Avoid using electric blankets
❑ Monitor use of heating pads
❑ Install night lights between the bedroom
and bathroom
Garage
❑ Put away hand and power tools such as drills,
axes, saws, and picks
❑ Limit access to large equipment such as a
lawnmower, weedwacker, and snowblower
❑ Lock up poisonous products such as paints and
fertilizers
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Throughout the home
❑ Disguise outdoor locks or install deadbolts
❑ Apply colored decals to large windows and
sliding glass doors
❑ Remove poisonous plants
❑ Create an even level of lighting near doorways,
stairways, and between rooms
❑ Remove objects that block walking paths
Outdoors
❑ Disconnect gas
❑ Lock gates to fences
❑ Supervise the person in areas that are not enclosed
❑ Put away car keys
A L Z H E I M E R ’ S A S S O C I AT I O N
Through its nationwide network of chapters, the
Association offers a broad range of programs and
services for people with the disease, their families,
and caregivers. These services include support
groups, telephone helplines, educational seminars,
advocacy programs, and a variety of print and on-
line resources on the disease, caregiving
approaches, and current research.
For more information or to locate the chapter
nearest you, call:
(800) 272-3900
or visit our web site:
www.alz.org
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Alzheimer’s Association

National Office
225 North Michigan Avenue
Floor 17
Chicago, IL 60601-7633
(800) 272-3900
www.alz.org

ED313Z
@1999 Alzheimer’s Disease and Related Disorders Association, Inc.
All Rights Reserved Reprinted 2003