Your Dementia Home by Unforgettable.org

Your Dementia Home A step by step guide to creating a dementia-friendly home.

Weâ&#x20AC;&#x2122;ve don e the researc h for you.

Contents Introduction

Chapter 1: Living room

Chapter 2: Kitchen

Chapter 3: Bedroom

Chapter 4: Bathroom & toilet

Chapter 5: Stairs

Chapter 6: Doors

Chapter 7: Floors

Chapter 8: Signage

Chapter 9: Garden

Who are Unforgettable?

Introduction Home, sweet home: why creating a dementia-safe home is so important. If someone you love has just been diagnosed with dementia, you may think it’s a bit early to start making alterations to their home, especially if they’re still independent and only mildly affected. But as anyone who’s further along the dementia journey will tell you, it’s always a good idea to be a few steps ahead. A few small changes now, whilst your loved one is still fit and well enough to cope with a bit of upheaval, could ensure they continue to live safely and happily in their own home for years to come...which is exactly what everyone wants. If dementia is already affecting your loved one quite noticeably you might be worried about changing their home in case it confuses them even more. This is a very understandable concern, and you are right to think this isn’t the time to replace all their carpets and redecorate the whole house. But a few tweaks to the home can still make a huge difference to their safety and their quality of life. Best of all, they need not cost a fortune or cause any major disruption either. If you’re loved one has had an accident at home — or a near miss — you will be desperate to avoid it happening again. But try not to panic. Instead, consider it a warning sign that the time has come to look carefully at how they’re living now and make some changes so that they can continue living in the home they love. The good news is that we’ve got plenty of ideas and product suggestions to help you create a safe, yet comfortable home for your loved one with dementia. We’ve identified the different challenges that may occur for someone with dementia who wishes to remain living in their own home, and provided tips, suggestions and products to help solve these problems. Read on for more information… 3

Chapter 1: Living room It’s the room they’re likely to spend a great deal of time in, so it’s really important that the living room is a pleasant place, filled with photos and furniture that means a lot, as well as a practical space to get around easily. Challenge: Dim lighting Muted lighting in a living room is often considered restful, but elderly people generally need stronger, brighter lights to see properly. As you get older, your eyes take longer to adapt between areas of light and dark, so if the lights are low and produce dark patches or shadows, it can be disturbing and confusing.

Solve it: Ensure that the living room is well lit throughout and that windows let in as much natural daylight as possible. If the person you’re caring for suffers from depression or SAD (Seasonal Affective Disorder) a lightbox may be useful for helping to boost their mood. Studies have shown that bright light therapy (using these specially designed lights) can also help to reduce feelings of agitation and improve sleep patterns. It might also be worth buying a bright reading light that can be angled to help them focus on close-up activities such as knitting or reading. If you do put additional lighting in the room, make sure the lamps are easy to operate, especially if the person you care for has limited mobility and co-ordination, struggles to bend down to switch on plugs or lacks strength in their fingers to turn on lights. 4

Challenge: Using technology Fancy televisions and remote controls (not to mention the many associated DVD players and digital set top boxes) can be complex and confusing to operate for anyone, but if you have dementia they might be particularly daunting. Likewise, fiddly buttons on telephones (landlines and mobiles) can be tricky to use. Finding the right numbers and/or mis-dialing is also a common issue.

Solve it: Choose a remote control that has large, simple buttons — power, volume and channel — to reduce confusion when using the television. If the person with dementia gets confused by the sheer number of channels available on digital TV networks, you can often set up a list of favourites, or even delete unpopular channels so they don’t appear (and which can be restored if you rescan the TV). Consider buying a simplified phone, which has large, clear buttons, an amplified ringer and caller display, and a simple phone book that makes it easy to pick who they need to talk to. You can even get phones that let you use pictures of important family members or carers if they’re struggling to read names.

Challenge: Finding chairs that are easy to get out of It’s easy to become attached to a favourite armchair or sofa, especially if you’ve had it for years. But if the person you’re caring for struggles to get out of it, you might want to think carefully about replacing it. Having trouble getting out of a chair can mean they delay going to the bathroom as often as they need, or to the kitchen to make a drink or a meal. These sorts of difficulties can really affect their quality of life. 5

Solve it: Invest in chair raisers, which are small blocks that fit under the legs of chairs. They lift up furniture so the person with dementia doesn’t have to bend down as far to be seated. Special rise and recliner chairs are a bigger investment, but if it’s going to make their day-to-day life easier (and yours) it might be worth the money. If mobility is an issue, walking frames and sticks can help them navigate the room itself, but remember to think about floor coverings such as rugs or steps. They could prove a tripping hazard, so it’s worth removing them, or making it very clear if there’s a step down.

Challenge: Muted colour schemes People with dementia find it harder to see colour contrasts. For example, they might find it hard to tell the difference between cream and white. So if the living room is decorated in muted colours, from the floors to the furniture, it can become very difficult for them to see things clearly, and this can lead to trips and falls. As people get older, generally, their eyesight and ability to distinguish colours can deteriorate — it can seem like they’re looking at everything through a yellow filter.

Solve it: You don’t have to start redecorating or replacing all the furniture (that would be too confusing anyway). Instead, ensure that furniture contrasts with the floors and walls by using colourful soft furnishings. For example, a favourite armchair can have a brightly coloured cushion cover or throw tucked into the seat to make it easier to see.

Challenge: Confusing furnishings Highly patterned sofas, curtains and carpets can also be confusing and disturbing for someone with dementia. A loss in the connections within the brain can mean they see a floral pattern and think the flowers are actually real. Carpets with strong stripes can be seen as steps, which could cause them to try to step up or down, and fall. Mirrors can also cause confusion if they fail to recognise themselves in the reflection. Imagine how distressed and agitated you might become if you thought there a stranger was in your living room. This can also happen when someone with dementia catches sight of themselves in a reflection and doesn’t recognise the person staring back.

Solve it: Try to keep carpet the same colour throughout so it’s easy to see that the floor is level. Cover up mirrors or remove them and make sure that curtains are closed at night so that they can’t also see reflections in the windows when it’s dark outside. 6

Chapter 2: Kitchen It’s the heart of the home, a room they’ve spent a lifetime navigating easily, and a room which is filled with hazards — heat, water, sharp items... But whilst someone living with dementia might not be able to rustle up a three course meal for six any more, they can still enjoy doing daily activities for themselves in this room, providing you’ve taken a few simple precautions. Three fears in the kitchen...and how to face them: 1. Fires and floods 2. Falls 3. Food poisoning

1. Fires and floods: leaving an oven, tap or appliance on This is a very understandable worry. People with dementia may forget to turn off gas hobs, electric ovens or taps. Sometimes they won’t turn them off because they have forgotten how to use the switches and knobs. Install an electric cooker guard, which can be set with a specific time that the device can be left on for. If the appliance is left on longer than this, or if the temperature goes higher than it should, an alarm will sound. 7

It may be possible to fit an isolation valve to a gas cooker which can be switched off if the gas is on for too long. Make sure they also have a working smoke detector (and that you check the batteries regularly) and a carbon monoxide detector. If you’re worried about them leaving taps running, or being able to turn the taps on or off, there are a number of items that can help. Try using a special plug that will release water from a basin if it gets too full. If taps are stiff or fiddly, you can fix special tap turners, which are colour coded red and blue so it’s obvious which is hot or cold, and provide a long handle for plenty of leverage. Most kettles are fitted with an automatic switch-off to ensure they don’t boil dry. If the person with dementia doesn’t have one of these, you may have to buy a new kettle. Thankfully, many electric kettles are styled to have a ‘vintage’ look, so hopefully won’t be too much of a change for them.

2. Falls: They might trip while carrying hot food or drinks Kitchens tend to be small rooms which are packed with equipment and cupboards. So if the person you’re caring for needs help getting around — with a walking stick, frame or wheelchair — it’s easy to see how accidents can happen, especially if they’re trying to carry something or have to reach into low or high cupboards. Special tray trolleys will provide the same support as a walker, but with a surface to rest plates or cups so they don’t spill food as they move around or out of the kitchen. Sturdy kitchen steps can make reaching high cupboards easier, while low cupboards can be adapted so that items slide out on a separate runner base. Consider removing kitchen rugs or mats, especially if they’re a bit worn. Unforgettable currently sells a Falls Prevention Kit, with a wide variety of products to make every home safer.

3. Food poisoning: They’ll ignore use-by-dates and eat food that’s gone off It’s easy to forget about food in the fridge at the best of times. But when someone has dementia it’s even easier, especially since their appetite can fluctuate quite dramatically. A cream cake bought a week ago might have a tiny ‘use by date’ on the packaging so it’s hardly surprising they may not see it, or ignore it when they fancy something sweet... The same applies to other perishable food that’s been put in the fridge. Schedule in regular fridge ‘clear outs’ which will let you remove any out of date food before it gets eaten. If the person with dementia has bought the same item multiple times (often because they forgot they bought it the last time), put it in the freezer if it’s suitable and then it can be taken out when they need it. If you need to dispose of anything, take it to an outside bin and don’t draw attention to what you’re doing. The person you’re caring for might get very upset if they see you ‘wasting’ food from their fridge.

Challenges in the kitchen — and how to solve them Forgetting where you store things Kitchens are complicated places. Imagine going into a stranger’s kitchen and trying to put dishes away. Finding the right cupboard would be really difficult, right? So it’s easy to see why people with dementia may get confused about where everything might belong, or start putting them in the wrong place. Putting pots and pans in a food cupboard, or a pint of milk in the microwave, might not pose a major health risk, but it can be disruptive, and make life increasingly difficult for anyone else who might be sharing the home.

Solve it: Use labels or signage on cupboards so that it’s clear where everything belongs. If it’s possible, put everyday items in open-fronted cupboards or on shelves that are very easy to see. Group similar items together — for example, keep mugs, teaspoons, tea and coffee in one area of the kitchen so that making a hot drink can be relatively stress free. Also think about using see-through storage jars so that they don’t have to open lots of lids to find out what’s inside each one. Cleaning products should be kept in cupboards that are preferably out of sight, or even locked, to reduce the risk of accidents. 9

Did you know? Dementia can affect your visual abilities, particularly being able to spot knobs and handles on drawers if they’re the same colour as the drawer itself. Think about painting handles a contrasting colour or replacing them with ones that are brightly coloured and easier to see.

Forgetting how to use items Complicated kitchen gadgets can become tricky to operate if you’re living with dementia. Microwaves are often one of the biggest culprits, but coffee machines and blenders may also prove troublesome.

Solve it: It can be very upsetting for someone who used to love baking cakes, for example, to suddenly realise they can’t operate a food processor, so it might be kinder to remove or store items like this. Suggest baking cakes together instead. Better still, ask them to teach you how it’s done — they’re likely to remember the important bits and you can operate the gadgets and oven. Microwaves can be useful as they’re usually set on a timer so won’t stay on for a long length of time. However, if the person is struggling to remember how to use a microwave, type out clear instructions and put them near the device, (preferably stuck to a wall or cupboard so they can’t be moved) emphasising important safety aspects such as not putting any metal items or foil into the microwave.

Not being strong enough to lift or open things If the person you’re caring for struggles to open jars and tins, lift kettles or saucepans or use knives and scissors, the kitchen can be especially difficult. Losing strength and the ability to grip or twist things, is a common issue for many elderly people, not just those with dementia.

Solve it: There’s already a wide range of gadgets that can help someone with strength and dexterity problems to navigate their kitchen. For example, if you’re worried about them lifting a kettle full of boiling water, you can get a kettle tipper, which cradles the kettle and then allows them to pour water out without having to lift it. Jar and bottle openers are useful for stiff containers that are difficult to unscrew, particularly if grip is weakened. 10

Chapter 3: Bedroom Bedrooms are a sanctuary for us all, a place to rest and unwind. If you’re living with dementia, life can feel very stressful so getting a good night’s sleep is vital. It’s also really important that your loved one with dementia can get up during the night if they have to, without facing common problems such as tripping, falling or becoming disorientated.

Three challenges in the bedroom — and how to solve them Getting into or out of bed Age and mobility problems can make these seemingly simple tasks difficult. Pulling yourself up into a seated position may be harder than it used to be. It’s important to address these sorts of issues quite quickly because falling out of bed can cause serious injury. The good news is that there are already lots of products available to help. For example, mattress elevators which help push someone up into a sitting position, or bed support rails which can be used to lean on when sitting down or getting up from a bed.

Night time wandering People with dementia rarely wander about aimlessly as they’re usually trying to get somewhere but find themselves lost or disorientated. At night, they’re probably trying to find the bathroom, or get back to their bedroom. You can set up bed sensors, which are placed under a pillow or mattress and can tell if someone has left their bed. They then either trigger an alarm, or are linked up to a telecare system which can send a message to a carer or family member to let them know they’ve got out of bed and haven’t returned. You can also install a bedside motion detector which will send an alert if it detects someone getting out of bed.

Getting to the toilet Incontinence can be one of the most upsetting side effects of dementia. It’s traumatic for both the person affected and for the carer, but try not to panic, symptoms of incontinence can be managed.

Solve it: The good news is there are lots of products available to make life easier. Fit a waterproof mattress and duvet protector to ensure the bedding is protected. You can set up an incontinence alarm which will alert the sleeper or nearby carers if it detects moisture. You could also provide them with absorbent underwear or incontinence pads to sleep in. It might also be worth placing a commode next to the bed so they don’t have to go far if they need the toilet. 12

Did you know? Night time incontinence often has a simple cause. Perhaps the person with dementia can’t get to the toilet in time, struggles to see his way to the bathroom or no longer recognises the ‘urge’ to go. Occasionally, incontinence is a side effect of other problems including urinary tract infections (UTIs) and prostate gland problems. Working out the likely cause is the first step to tackling it.

Finding their way at night If the person you’re caring for needs to get up in the middle of the night, you don’t want them to be fumbling around in the dark trying to find a light switch, as this can easily cause accidents and increase their chances of tripping or falling.

Solve it: Set up night lights that are triggered when someone walks by or if a door is opened. Bedside lamps that can be easily turned on by simply tapping the base rather than having to find a fiddly switch can also be useful too.

Telling the time Struggling to know whether it is morning, evening or the middle of the night, is a very common problem for people living with dementia. In fact, forgetting how to tell the time is one of the ‘classic’ symptoms of early dementia (being able to tell the time properly is one of the tests carried out when diagnosing the condition), so it’s easy to see why it can cause so much confusion. Even if they do know the time, they might still get muddled about whether it’s am or pm. 13

Solve it: Simplified clocks and watches with clear numbers and hands can be very useful. You can also get radio controlled talking clocks or clocks that simply say it’s ‘Thursday morning’ or ‘Friday afternoon’, without providing any other potentially confusing details. When nights get lighter in summer time it could be worth investing in some blackout blinds to ensure their sleep doesn’t get interrupted.

Getting dressed in the morning Picking suitable clothes, and putting them on in the right order can be tricky for anyone living with dementia. If they also have mobility problems they might struggle with buttons, zips or laces, too, or have trouble bending down to put on tights or socks.

Solve it: Be prepared! Lay out clothes for them in a clear order so they can avoid having to look inside wardrobes and drawers and become overwhelmed by all the choice. Perhaps you could both decide on the outfit the night before, then attach each item to a numbered hanger so they know the order in which to put it on. Investigate dressing aids that will help them put on socks, tights and shoes, or elastic shoe laces so they don’t need to worry about tying laces up.

Chapter 4: Bathroom and toilet Bathrooms — like kitchens — can be filled with hazards for people with dementia. After all, hot water and wet floors are a dangerous combination if you’re frail and confused. But with a little forward planning, there are plenty of ways to improve safety and ensure bathing remains as stress-free as possible.

Three fears — and how to face them 1. Scalding water 2. Flooding 3. Falls

1. They’ll burn themselves with scalding water People with dementia may not notice when water has become too hot, or they might struggle to understand modern temperature controls on bathroom fittings. Similarly, if they reach out to grab a heated towel rail — understandable if they’re unsteady on their feet — they’re at risk of a nasty burn. Choose a thermostatic care shower, which makes it easier to control temperature. You can pick ones with simple, clear buttons that are easy to press. Avoid using showers that provide a heavy flow of water as it can be overwhelming for someone with dementia. Look into low surface temperature (LST) radiators and avoid leaving pipework exposed as it can get hot. 15

2. They’ll leave taps on and cause a flood Forgetting about running taps can be a common problem if you have dementia. Flooding doesn’t only lead to slips and falls, it can cause expensive damage and involve major upheaval to fix. Choose showers that automatically shut down after a certain amount of time to prevent flooding. You can also get flood-proof plugs for baths and basins. These open up when a certain pressure is reached, allowing the water to drain away until the pressure is reduced, at which point it will then close up again.

3. They’ll fall over and hurt themselves Sadly, it’s easy for people with dementia to fall in the bathroom. Slippery floors, bathmats, or baths that need to be stepped into, are the major culprits. Choose shower cubicle materials made from special plastic that won’t shatter if fallen against. Install anti-slip flooring within the shower and ensure that the bathroom floor is all one colour. Any change in colour can be seen as a step, which could then cause them to stumble. If bathroom floor tiles are very shiny, they can give the appearance of being wet, which again can confuse, cause hesitation and falls. Grab rails can be installed next to the toilet, in the shower and in the bath to help them pull themselves up or down.

Three challenges in the bathroom — and how to solve them 1. Difficulty washing Everyone wants to feel clean and fresh, but if you’re struggling to stand up in the shower, or get in and out of the bath this might not be easy. So if the person you’re caring for is finding bathing and washing, increasingly difficult, creating an environment which is calming and comfortable will make the whole process much easier.

Solve it: There’s a massive range of bath equipment available, from bath steps to help them get into the bath, to hoists, lifts or seats to help them lower themselves into the bath. Try installing a shower seat into shower cubicles as it can help to reduce the risk of falling while showering. Electronic bath seats will help to lower people up and down into the bath.

If they struggle to reach round to apply shampoo or wash themselves, there are long-handled bathing aids which can help. People with dementia may find mixer taps confusing. More traditional taps, that have clear colour cues to demonstrate hot and cold water, are better.

2. Visual confusion Seeing your reflection in a bathroom mirror or shiny surface can be very stressful if you have dementia and don’t recognise the face staring back as your own. Imagine the fright you might get if you thought another person was in the bathroom with you? This can also cause frustration and agitation.

Solve it: Use a roller blind to cover the bathroom mirror, it can be easily pulled up if other people need it. Avoid using a dark coloured floor surface, such as a bath mat which can look like a large hole, and might make the person you’re caring for very reluctant to go into the bathroom. If there’s a shower, use plastic screening which is frosted so it won’t show any reflection. Make sure the bathroom is well lit and ensure the light switch is clear and easily accessible. If not, look into whether you can install automatic lights or night lights that remain on — which are especially useful for trips to the bathroom in the middle of the night.

3. Trouble with toilets This can be a particularly distressing problem for anyone with dementia who fears losing their dignity. But try not to panic. Read through the check list so you know what areas you may need to focus on to ensure that using the toilet remains as stress-free as possible. 17

Your toilet check list Do you need a raised and coloured toilet seat? If they’re struggling to sit down or get up from a chair, they may have a similar problem with the toilet. Installing a raised toilet seat could make life a lot easier. You can choose different heights, which can raise it between 5 and 15cm. Pick a toilet seat that’s a contrasting colour to the cistern, bowl and bathroom floor as someone with dementia will find this much easier to see. (Dementia can cause visual disturbances which affect eye sight).

Would a grab rail help? Pulling yourself up to standing can be tricky as you get older, and it can also be a danger point for falls. Fitting a grab rail next to the toilet could ease this particular worry considerably. Grab rails can be a handle fixed to the wall or floor, or pulled down from the wall and then pushed out of the way after use.

Did you know? If you pick a grab rail that will contrast with the colour of the wall or bathroom, it will make it easier to spot. If there’s a heated towel rail next to the toilet, make sure the heat is very low or completely turned off as it could be tempting to grab it while trying to pull yourself up. The same goes for radiators. 18

Can they easily reach the toilet paper? This might sound very obvious but if they have to twist round or reach out to grab toilet paper, they could easily slip and fall. Set up a toilet roll holder that’s in easy view and preferably attached to a wall. Freestanding holders can be knocked over or pose a tripping hazard. Pick out a toilet paper that’s a different colour to the wall so it’s easier to see.

Are they able to operate the flush? Fancy automatic flush facilities or small buttons giving the option to do a half or full flush may be all the rage, but they can be very confusing for someone with dementia. Traditional flush handles are probably what they’re used to, and may be easiest for them to use. If they’re having trouble gripping handles, you can fix the flush with a wider handle which will be easier to push down.

Have you got enough wiping and bidet facilities? Embarrassing though it may be, the less mobile you are, the more difficult it becomes to wipe after using the loo. But this doesn’t have to be as distressing as it sounds. You can get special bottom wipers, which are basically an extendable handle that you fix the toilet paper to and make it much easier to reach round. At the other end of the price spectrum are integrated toilet-bidets, which have a washing and drying system included within them.

Do they need a commode? If it’s still too difficult for them to always reach the toilet — especially if they have mobility problems — you may want to consider getting a commode. This is a specialised seat with toileting facilities and could make life a whole lot easier.

Chapter 5: Stairs It’s probably the area in the house that you worry about most. After all, falling down the stairs can cause serious injury. If you have dementia, a trip or fall, even if it doesn’t cause much physical harm, can shatter your confidence and leave you feeling more reliant on others. But the good news is that there are lots of ways to prevent any of these disaster scenarios from ever happening.

Did you know? Dementia can affect a person’s depth perception, which can mean they have difficulty finding or stepping onto steps correctly. This can have a real impact on their ability to walk up the stairs to get to a bathroom or bedroom.

Six things to think about to make stairs safer 1. Make stairs easier for them to see If your stairs are all carpeted in one colour (most are) stepping onto them can be quite confusing for your loved one because dementia can affect parts of the brain that deal with depth perception and colour contrast. This means that it’s much harder for them to detect the slight distinction in colours or shadows on the tread (where you place your foot) and the riser (the part of the step that’s at a right angle to the tread), than it is for you. Attach some coloured electrical tape to the edge of the step tread so they can easily see it and have a better sense of perspective. Alternatively, attach contrasting coloured electrical tape or card to the vertical riser of each step. Painting outdoor and front door steps with a white trim will make them more noticeable for people.

2. Think about ramps Small numbers of stairs or the odd step can throw up just as many hazards as a full flight of stairs, often because they’re less noticeable. Ramps can be a useful addition to cover up steps or provide an alternative route to walk down. They’re especially useful for people who need mobility aids to get around.

3. Get rid of trip hazards Make sure stairs are as safe as possible by removing anything that could get in the way and cause trips or falls. This could include items left on the stairs to go to the rooms upstairs, rugs or threadbare carpets that could catch people as they’re walking up or down them.

4. Consider handrails and stair aids Stairs feel much safer if you have something to hold onto. While many stairways already have a banister to hold onto, some don’t. Installing an easy grip handrail, is one of the changes that an occupational therapist might arrange after a home assessment. It may be useful if the person you’re caring for favours one particular hand when walking up stairs and the banister isn’t on this side. You could invest in other stair climbing aids, such as special walking sticks that have a large sturdy box on the end to provide support and make it easier to step up when going up stairs, and moveable handrails.

5. Improve lighting in the hall and landing Lighting throughout their home is extremely important, but particularly around the stairs, where trips and falls are more likely. Make sure there is enough strong lighting on the stairs going from top to bottom. If the light switch for the stairs is only accessible at one end, it could mean that it gets switched off while someone is walking down the stairs — which is very dangerous if you have dementia. Instead, consider adding a switch that lets you turn on lights from either the top or bottom of the staircase. Make sure the switch is easy to spot by putting it on a contrasting background to the wall.

6. Is it time for a stairlift? If mobility has become such an issue that the person you’re caring for can no longer get upstairs unassisted, they may need to get a stairlift. Of course, stairlifts aren’t cheap, and a person with dementia should always have someone with them whilst using a stairlift. It’s worth weighing up the cost and seeing if there are any other alternatives first. For example, could you find space to accommodate a bed downstairs — perhaps by changing a dining room into a bedroom if stairs are no longer manageable.

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Chapter 6: Doors

FRONT DOOR

Being able to get in and out of their own home, or simply move between rooms easily will increase your loved oneâ&#x20AC;&#x2122;s sense of independence. But getting the balance right between keeping someone with dementia safe and secure, whilst still allowing them as much freedom as possible, can be tricky. However, making a few changes to the doors in the home can make a big difference to their quality of life, and your peace of mind.

Four questions to ask yourself about doors 1. Is the door accessible? Imagine wanting to make a cup of tea but not being able to find the door to the kitchen. This is the sort of problem someone with dementia deals with every day, so make their life a bit easier by ensuring the doors they need regular access to are easy to see and easy to walk through. For example, itâ&#x20AC;&#x2122;s crucial the door is wide enough, especially if they need to be able to get through using a walking frame or wheelchair. Ramps might be needed if there is a big step up, and they should be clearly marked to reduce the risk of tripping. A grab rail fitted at the door entrance could be a great help by providing something to hold onto while stepping up. 23

2. Is the door secure? Regular visitors can really brighten someone’s day. So whether it’s family, carers, or grocery deliveries, it’s important that someone with dementia feels safe when they answer the door and can welcome visitors inside with relative ease. Installing an intercom system can be useful as it lets them check who’s at the door before letting anyone in. Video intercoms are best so the caller can be identified properly. You could consider setting up a key safe. This is a small box attached to the wall outside the front door which is opened up by entering a code. Inside the box is a front door key so friends, family or carers can let themselves in. Only the people who should be coming into the house would know the code. It’s a sad fact that dementia will make your loved one increasingly vulnerable, and your urge to protect them will, understandably, grow stronger. But personal freedom is important to everyone — nobody wants to be a prisoner in their own home. Deciding how often they go out and whether they’re safe to go out alone, is something you need to think about and discuss regularly with everyone in your support network, as well as the person with dementia. But whilst discussions are on-going it’s worth setting up an electronic reminder by the front door which plays a reminder to anyone leaving the house to remember to pick up front door keys, check windows are closed, or not let in any strangers. If wandering is becoming an issue, you can fix a magnetic door alarm to doors (both room doors and main entrance doors) which will trigger an alarm once the door is opened.

3. Is the door easy to see? Dementia affects eyesight, in particular, the ability to see different colours easily. So if a door is painted the same colour as a wall, your loved one might struggle to see it. Once you know this, it can be used to protect them. If it’s a door you want them to go through regularly, consider painting it a contrasting colour to the wall. If that’s too much, think about painting the door jam. So if the wall is cream or white, pick out the door or door jam in red or blue. However, if it’s a door you’d prefer them to avoid opening (for example, a door to a cellar or a medicine cupboard) making it a colour that blends into the wall can make it less likely that they’ll see it or open it.

4. Is the door well lit? This might sound obvious but it’s surprising how often hallways in particular are badly lit. Since people with dementia can struggle to see in low light, and can become worried and agitated if an area is particularly dark or shadowy. It’s very important to ensure that light switches are clear and easily accessible in areas near doors so people can see them as they enter a room or building. Consider automatic lighting that’s triggered by movement. This is useful for external entrance lights so they come on as someone approaches the front door. It also means you don’t need to worry if you’ve forgotten to turn the light off as they’ll switch off automatically.

FRONT DOOR

Illuminate important areas of the door such as the keyhole or doorbell, making it much easier to find them. This can be done with lighting or by making them a different colour to the door so they stand out.

Chapter 7: Floors Choosing carpets, rugs, lino or floorboards is usually a matter of personal taste. Your loved one might be very fond of the stair carpet they bought twenty years ago or the tiled bathroom floor they recently spent a lot of money installing. But once their dementia journey has begun, it’s wise to look again at the surfaces they walk on at home because the last thing you — or they — want is a fall. Falls don’t only cause physical injury (sometimes very serious) they can also shatter the confidence of someone living with dementia and lead to a rapid physical and mental decline.

Did you know? Dementia causes visual challenges which, combined with age-related eye sight deterioration, can make it increasingly difficult to discriminate different textures on the floor. Shiny surfaces can appear wet, and dark surfaces can look like holes. Floor patterns such as those found on linoleum or carpet can cause illusions, while visual-spatial problems mean rooms can appear flat or 2D.

Four things to think about to make floors safer 1. Patterned flooring Patterned carpets can cause confusion if you have dementia, as it becomes increasingly difficult to distinguish between design and actual objects that they may want to pick up or step over. For example, a dark carpet with white specks may look like bits of tissue, which a person with dementia might keep trying to pick up. Patterns such as flowers can also be deceptive, as they could believe they’re actually seeing real flowers on the floor. Similarly, if kitchen linoleum or bathroom tiles are in a black and white checkerboard motif, the black areas may seem like holes in the ground which need to be stepped around. Imagine how confusing and frustrating that could feel.

2. Pros and cons of using contrasting colours Visual problems mean you need to help people with dementia pick out certain areas clearly. For example, if their kitchen has a small step, making it a different colour to the surrounding flooring will help them spot it. You can use different coloured skirting boards to pick out the edge of the room and help give it more perspective for someone with dementia. Likewise, picking out furniture in a colour that contrasts with your flooring will make it easier for someone with dementia or Alzheimer’s to see it. But, colour contrasts can also work against you if they make the person you’re caring for think that there’s a step or hole where there isn’t one. Make sure that threshold strips — the strips of metal or plastic that fix flooring between different rooms — are the same colour as the rest of the floor surface. And if possible, try to ensure that the colour changes of floors between each room aren’t too bold.

3. Benefits of matt floors Shiny flooring can appear wet to someone with dementia. This could mean they’ll become hesitant and unsteady, which can lead to falls. For areas of the house that aren’t carpeted, surfaces should ideally be matt to reduce the risk of harm. 27

4. Removing potential hazards Falls pose a real risk for people with dementia, so itâ&#x20AC;&#x2122;s vital that you move any objects that could cause a tripping hazard. Assess all rooms and move or remove potential trip hazards including rugs, pairs of shoes or slippers or low furniture such as coffee tables.

5. Check slippers regularly More than 27,000 people end up in hospital every year because of slip-ups in their slippers. For someone with dementia, worn-out slippers can be lethal, so make sure they have good grips on the soles and plenty of support at the back. The ankle booty type is probably one of the safest, providing theyâ&#x20AC;&#x2122;re been put on correctly.

Chapter 8: Signage It may seem strange to put signs up in the home, especially if your loved one has lived there for years. But for someone with dementia, simple signs can be life changing. You want the person you’re caring for to be able to navigate their own home with confidence and dignity, and one of the best ways to ensure this remains possible is by using signs to help guide them around the house. It can help boost independence and reduce stress. Whether it’s signs for rooms, or labels for cupboards and drawers, keep an open mind. It’s worth considering the following points:

Five things to think about: 1. Using pictures A sign explaining that a particular door leads to the kitchen or toilet is useful, but only if the person reading it is still able to recognise words and letters. Sadly, dementia can lead to a condition called primary progressive aphasia (PPA), which occurs when problems in the brain mean you lose the ability to read, write and understand language. It happens most often in people with frontotemporal dementia. But don’t worry, there are ways of getting round this. Try using signage which includes an image of the room or item associated with it as well as the word. For example, signs for the bathroom could have a picture of a bath or shower, while a label for the sock drawer includes a picture of socks.

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2. Creating a colour contrast Think about where you will be putting the signs. If you’re sticking them on to a dark coloured background such as a wooden door, make sure the sign stands out and is easy to see by making it a contrasting colour, or by sticking it onto a piece of white paper before putting it on the door.

3. Finding the right height Regardless of their height, people with memory loss are more likely to look slightly down, rather than up or straight forward, so it’s best to place signs in their natural eyeline. The best height for a sign is about four to five foot from the floor.

4. Linking colours to rooms Making the signs for particular rooms all the same colour can be a useful way to guide someone around where they need to go if they’re having trouble reading the words. Use common sense when it comes to colour schemes — bathrooms involve water, so use blue as a colour scheme, gardens have grass, so use green as a colour scheme. If the room has a particular colour scheme (a green-tiled bathroom or a peach-coloured bedroom), you could put the sign on the same coloured background so they make the connection.

5. Giving direction If the toilet or bathroom is on the other side of the house from where they spend most of their time, they might need help finding their way to it. Set up signs that have a finger or arrow showing them the direction they need to go in.

Chapter 9: Garden Find out how to turn your garden into a safe haven that your loved one will really enjoy spending time in. Gardens can be wonderfully therapeutic for everyone. They’re a place to unwind, enjoy fresh air, sunlight and maybe do a spot of pruning or planting. There’s no reason why someone with dementia can’t enjoy these same simple pleasures, and taking steps to turn the garden into a safe haven that they’ll enjoy spending time in is easier than you think.

Why are gardens good for you? 1.

Gardens don’t just offer a change of scenery, they also boost health. Exposure to mild sunlight provides the body with vitamin D which can keep bones healthy and protect against diseases such as multiple sclerosis, diabetes and cancer.

Studies have shown that gardens (and gardening) can help beat depression and the blues, reduce stress and anxiety and lower blood pressure.

Gardens that stimulate all the senses (known as sensory gardens) are particularly beneficial to someone with dementia. For example, being able to see, smell, or touch a favourite flower or plants can contribute greatly to emotional wellbeing. 31

Create a safe garden for someone with dementia Maintaining security First things first, if you’re going to be encouraging the person you’re caring for to potter around in the garden you need to make sure they’re safe, especially if they’re prone to walking off. Fix holes in fences, and fit gates at the bottom of the garden with a key so you have the choice to lock them if necessary. If you’re still worried about them getting lost, you could place shrubs in front of the garden gate to hide it from obvious view.

Is there shelter? Don’t let unpredictable weather spoil or limit the amount of time the person you’re caring for can spend in the garden. Whilst nobody wants to sit outside in the pouring rain, a bit of drizzle or a cool breeze doesn’t have to mean going back inside if there’s a sheltered area to sit or stand in. If you can, consider installing a small wooden gazebo to provide shelter from the elements, as well as a place to relax — a large evergreen tree could work too. The more options you can offer to prevent them getting wet and cold, the more likely they are to stay outside for longer.

Providing activities Whilst some people are happy to sit and admire their garden, others (especially those who used to be very keen gardeners) will want to keep busy, and could become very frustrated and agitated if they discover everything’s been done for them! Weeding and planting are great activities, as they provide a sense of purpose and satisfaction. If they struggle to bend over or kneel, raised flower beds are a good idea. If they’re physically fit enough, consider other activities such as raking up leaves, digging and mowing the lawn. Don’t forget that gardens also provide a space for games, painting and crafts.

Sense of direction Many people with dementia enjoy walking, but can become frustrated and confused if they keep losing their way. Creating a simple path that winds around the garden is a great way to help them enjoy their walk without getting stressed. If the garden path is in the shape of a loop, they can simply follow it round and end up where they started. A path can be created using flowerbeds, freestanding plant pots and trellis archways. Make sure there is enough support along the way for them to stay safe and rest if they want to. For example, place a garden bench near the pathway so they can sit down, and make sure steps are safe and have rails if necessary.

Sensory stimulation Gardens which appeal to all five senses can be hugely enjoyable and stimulating. Visual appeal of favourite plants and flowers is pretty obvious, but consider smells, sounds, touch and taste too. Plant flowers and plants with distinctive scents such as roses, lavender or mint. Scent can be a very powerful tool for reminiscence therapy and may trigger some very happy memories. Flowers and plants that have fuzzy or textured leaves can be satisfying to touch or stroke, but watch out for those with spines or thorns. Listening to a wind chime, or plants and grasses moving in the breeze, can be very calming. Consider planting nectar producing plants to encourage bees and birds into your garden and install a bird bath too. Edible plants that are easy to grow in the garden can be very satisfying and a great sensory experience. Go for soft fruits such as strawberries and blackberries or herbs that can be picked and served for dinner. But, remember to only plant shrubs and flowers that are safe to eat (even if theyâ&#x20AC;&#x2122;re not designed to be eaten) just in case the person you care about gets mixed up. 33

Who are Unforgettable? We are the worldâ&#x20AC;&#x2122;s best marketplace of products and services for dementia and memory loss. Our mission is to improve the lives of everyone affected by dementia and memory loss. We do this by: 1. Highlighting products that you didnâ&#x20AC;&#x2122;t even know existed which can make daily life a bit easier. 2. Providing information about dementia and practical tips and advice from experts and carers. 3. Creating a friendly and supportive community of like-minded people and keeping up to date with all the latest news and research about dementia.

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The vast majority of people diagnosed with dementia have one very important wish: they want to stay living at home. Whilst this can become trickier as their condition progresses, it doesnâ&#x20AC;&#x2122;t have to be impossible. Weâ&#x20AC;&#x2122;ve compiled Your Dementia Home to help you find practical solutions to some of the most common challenges around the home. This book will show you how to make your home safe, comfortable and more dementia-friendly.

www.unforgettable.org 020 3322 9070, happytohelp@unforgettable.org Unforgettable.org, Runway East, 58-64 City Rd, London EC1Y 2AL