As we settle into this “wiser” chapter of life, there’s much to celebrate–like stronger sense of self, more freedom and flexibility with our time to do the things we enjoy, and greater financial security to name a few. On the other hand, this is also the time that we may start to notice cognitive changes in our aging parents that make us realize it’s not a good idea for them to be living independently anymore. For many people, the best solution seems to be having their family member move in with them. Comments like, “My house is big enough,” or “I’ll be able to keep a closer eye on them this way,” or “They’ll be much happier around family than in some facility,” are frequently heard, and although these statements may be true, many people don’t consider if their home is ready to actually handle the scenarios and challenges that occur with memory-related illnesses.
One thing I have personally learned about this type of illness is that no two cases are exactly alike, so following the recommendations of your loved one’s health care team is important when caring for someone with dementia. In addition, here are a few suggestions that may help when thinking about how to prepare your home:
1. Make it familiar
Generally speaking, if your home has a completely different feel than what they are used to, it can be more confusing and difficult for them to adapt to their new environment. When caring for someone with dementia, it helps the adjustment go more smoothly if at least some of the spaces and adjacencies are similar. Incorporating some of their favorite furnishings or possessions can also ease anxiety. Provide eye level storage in their closet so they can locate their belongings more easily, since they may have a harder time looking up or down. How’s your lighting? Minimize the use of reflective surfaces and light fixtures that produce glare, as that tends to increase agitation. Aim for even levels of light throughout the house.
2. Make it connected
Provide easy access to areas or activities they enjoy–e.g. backyard garden, family room, etc., so they can move independently as long as possible and still be involved in “normal” family life rather than being socially isolated. Studies have shown that remaining active and engaged can even improve brain function.
3. Make it safe
When caring for someone with dementia, think of it as if you now have a very tall toddler in the house. As their condition changes, create higher level and/or secure storage and move sharp utensils, cleaning supplies, medicines, tools and other potentially dangerous objects out of reach. Pay extra attention to areas like garage, basement, work rooms, and outdoor spaces. You may need to relocate or hide switches to appliances like the garbage disposal, microwave and stove, as well as any connections to the outdoor gas grill.
4. Make it secure
Position exterior dead bolts higher or lower than normal height so they are less likely to wander out the door, and position locks on fence gates higher or lower than normal height so they are less likely to wander out of the yard. (Again, this is because it can be difficult for those with cognitive illnesses to look up or down.) Equally important, remove locks from any interior doors so they can’t accidentally lock themselves in.
5. Make it supportive
Consider what would be helpful for caregivers and family members living in the home. Is there a bathroom with a walk-in shower, wide enough for a caregiver and possible medical equipment to fit? The Invisia line of bathroom accessories is wonderful–it blends style and safety to “invisibly” provide necessary support without making your home look like a hospital.
If your home doesn’t have a separate bedroom close to theirs for a future in-home or overnight caregiver, is there an office or other space that could be converted if the need arises? Is there a bedroom farther away so other family members have fewer sleep disruptions when the caregiver gets up during the night? Disorientation, general confusion, hallucinations and bathroom issues are common as cognitive illnesses progress. Research local options for adult day care programs or the various types of in-home assistance. These can come in handy when caring for someone with dementia, even if just needed occasionally.
Regardless of the configuration of your home, by communicating regularly with other family members, your medical team, and local support groups, you will be able to closely monitor the situation and determine specific ways to adapt your environment to best address the needs that arise while you are caring for a loved one with dementia.