Are you a caregiver for someone experiencing symptoms of dementia?
Even if a person has not been diagnosed with dementia, they may still be experiencing trouble in some of these areas. Keep watching for signs of difficulty with activities of daily living and come back to this resource at any time..
Please Select one area below that the individual you are caring for is having difficulty with. If they are having difficulty in multiple areas, you will be prompted to return to this page later and can select another option..
Bathing & Bathroom. Wheelchair-Specific Mobility. Cooking. Eating & Drinking. Sleeping. Toileting. Wandering, Orientation & Home Safety. Laundry. Dressing.
What specifically is the problem with toileting?
Inability to locate the toilet. Inability to reach the toilet quickly enough. Need assistance using the toilet.
Is the individual's spacial orientation impairment severe or not severe? Severe impairment can include attempts to sit down next to the toilet, grabbing objects and completely missing, walking into bathroom walls, etc. Non-severe impairment can include not being able to find the bathroom itself..
Non-Severe Impairment. Severe Impairment.
Here are two options for home modifications that address mobility issues to make toileting easier. Click for more details..
Colored Toilet Seat. Remove the lid.
Removing the toilet seat lid altogether removes a barrier to accessing the toilet. You can also leave the toilet seat permanently up to solve this issue. Often a person with dementia cannot see the toilet lid and can get confused when they attempt to sit on it..
In a white bathroom, the toilet seat can easily blend into the background. Purchasing a colored toilet seat that contrasts with the toilet and the floor color can help an individual distinguish the toilet from the rest of the bathroom..
Visual cues will allow a person with minimal spacial disorientation to locate the toilet more easily. Click on an option to learn more..
Leave the bathroom door open.. Line on hallway floor leading to bathroom.. Signage on the bathroom door..
The problem could be as simple as the individual not knowing which room is the bathroom since all doors look similar from the outside. If the bathroom door is left open, the toilet can be seen from the hallway..
Having a sign on the bathroom door to distinguish it from the other rooms in the house can help with orientation. The sign should be in large print and include a visual as well..
If an individual walks stooped, or is constantly looking at the floor when they walk, a line on the floor from the bedroom to the bathroom could be helpful in providing direction. This can be done with almost any type of colored tape..
The best adaption when an individual does not have enough time between deciding they need to go to the bathroom and making it to the bathroom is a portable toilet. This brings the toilet to them..
This can be purchased and moved around a house easily. It must be cleaned thoroughly after each use. .
Below are three solutions that can make toileting easier by addressing mobility issues. Click each to learn more..
Grab bars around toilet. Raised toilet seat. Automated Toilet with Bidet Function.
An automated toilet should not be implemented without first trying other methods. It also could be scary to individuals with dementia so the decision is very person specific. An automated toilet requires no wiping by the user, and instead sprays warm water from a nozzle on the toilet bowl to clean a person. They are also self-flushing removing a step required. However, learning to use the new technology and being comfortable with it can be difficult for individuals. .
Often the problem is that an individual cannot get low enough to sit on the toilet easily. A raised toilet seat reduces the distance an individual has to bend down to sit on the toilet. A safe height is up to 3.5 inches. .
Placing grab bars around the sides of the toilet, one vertical and one horizontal, can make it easier to get up and down off the toilet. It can reduce fall risk and assist with mobility. Grab bars should be installed by a professional..
Is the person you are caring for having problems with bathing independently or navigating the bathroom?
General Bathroom Navigation. Bathing Independently.
There are many modifcations available to help an individual bath with increased independence. Below is a list ordered left to right by increasing level of need..
Handheld Showerhead. Grab Bars. Hydraulic Bath Lift. Shower Seat. Roll-In Shower. One-Handed Faucet.
A shower seat with grab bars provides additional stability in the shower and allows the individual to sit down. It should be a different color than the shower floor and walls..
Grab bars provide stabilization in the shower. A person must be strong enough to grab them to benefit from this enhancement. Grab bars should be installed by a professional..
A removable handheld showerhead provides flexibility in the shower, a greater sense of control, and reduces fear of unknown water source. It can be a benefit for both the individual and caregiver to use..
Having an easy to turn faucet that only requires using one hand makes it easier to turn the water on and off. Different faucet grips are made to accomodate different physical capabilites. .
A roll-in shower will accomodate a person with a wheelchair to enter the shower in their chair. .
For individuals that prefer baths, this lift can lower and raise a person into the bath mechanically. It reduces the lifting burden on both the individual and caregiver. There are many types of hydraulic bath lifts for different needs. .
Many problems in the bathroom stem from an issue with grasping objects or need for protection against the added dangers in a bathroom. Which root cause is leading to the individual's difficulties in the bathroom?
Grasping Objects. Need for Protection.
Below are modifications that can help increase a person's ability to grasp and manuever objects in the bathroom. Click for more details..
Faucet Handles. Doorknob Adapter.
If an individual has difficulty grabbing a traditional door knob and turning it, then the doorknob adapter can be a good solution. It requires no gripping and only requires a pressing down motion which can be done with one hand. .
Knobs can be difficult for an individual who is losing motor skills to grab and turn. Installing faucet handles that are push/pull motion rather than grasped can make it easier to turn the water on and off. Another option would be an automatic faucet that is triggered by motion. However, with an older population this may not be intuitive and should be evaluated on an individual basis..
Which area of deficit is the individual experiencing?
Decreased Judgement and Decision-Making Ability. General Confusion. Perception Deficits.
Below are adaptions that provide safeguards for some of the more dangerous areas in a bathroom that can cause burns..
Lower Temperature of Water Heater. Anti-Scalding Valve. Thermostatic Tap.
High water temperatures can cause burns, especially in elderly who are more sensitive to high water temperatures. Lowering the temperature on the water heater limits the maximum temperature the water can reach, but it should not be set below 120 degrees Fahrenheit to prevent growth of Legionella. .
A thermostatic tap/faucet constantly measures the temperature of the water and balances the intensity of hot and cold water to ensure the water coming from the faucet is the perfect temperature. There is also a limit on the maximum hot water temperature it allows to prevent scalding. These can be purchased for a sink, bath tub, or shower..
This valve can installed into the pipes to balance any changes in water pressure from either the hot or cold water to maintain a constant temperature coming out of the faucet preventing scalding. This should be installed by a professional..
Below are simple modifications to reduce confusion in the bathroom..
Label Taps. Remove Door Lock. Lock Cabinets.
Making simple signs that use color and say which handle is hot water and which is cold can help orientation..
A bathroom can often contain chemicals, medicines, sharp objects, and other dangerous materials. Having a locked cabinet with all of the potentially hazardous objects inside it can prevent accidents. .
If an individual is a potential danger to themselves in the bathroom, removing or deactivating the door lock can ensure that you can easily enter the bathroom if they need assistance. Other precautions should be taken first to remove dangers in an effort to maintain privacy of the individual, however, this may be a necessary step to maintain safety in the bathroom..
These modifications can reduce harm from perception issues..
Add Cushion. Remove Clutter. Motion Detected Lighting.
Clutter can be distracting and confuse an individual. Put clutter away, and remove any waste baskets or hampers that can be confused for the toilet if this is a concern. If a person is scared by or does not recognize their reflection, covering or removing mirrors can also be a good choice..
For those items that cannot be removed such as countertops and cabinets adding cushion to edges can prevent injuries. The bathtub can also be cushioned if there is concern about falls..
Quality lighting can make a big difference in improving perception. An automatic lighting system that turns itself on and off can illuminate the room without requiring the step of remembering the light..
Why does the individual struggle to dress independently?
Reduced Mobility or Coordination. Confusion and Impaired Judgement.
There are multiple devices that can assist in dressing..
Long-Handed Shoe Horn. Other Dressing Aids. Stocking Devices.
For someone who cannot bend down and reach their feet, the shoe horn allows them to put on their shoes independently. .
For someone who cannot bend down to touch their feet, this allows them to put their socks on independently. .
Dressing aids come in many different styles and can be used to allow individuals with limited mobility to put on shirts, button buttons, and other dressing tasks. .
Limiting choice and hiding unnecessary options can make it easier for an individual with dementia to dress themselves..
Separate Night/Day & Summer/Winter Clothes. Only 1-2 Outfits in Main Dresser. Picture of outfits on outside of closet/dresser. Open Shelves.
To reduce confusion, keep daytime and nighttime clothes in two separate locations. Summer and winter clothes could actually be hidden away completely during offseason..
Putting clothes on open shelves instead of drawers increases visibility and ease of access..
Placing a photo of clothes on the closet door or dresser helps give a visual cue of where to find clothes for the day..
There are a few object modifications available to make doing laundry safer and easier for people with dementia..
Silent Washing/Drying Machine. Topload Washer & Dryer. Automatic Shut-Off Iron. Install a Flood Detector.
To reduce the need to bend over, a toploading machine can be used. An alternative would be to raise the existing machine using certified equipment and professional installation..
If the noise of the machine causes fear, getting a newer washer/dryer that is quieter can reduce anxiety..
If there is fear that an individual will improperly use the washing machine causing water to leak, a flood detector can be installed that triggers an alarm when water is detected..
If an individual forgets to turn the iron off, purchasing an automatic shut-off iron can ensure the activity remains safe to perform..
What does the individual need help with?
Assistance getting in/out of bed. Protection Against Falls.
Below are options to prevent injury from falling out of bed..
Soft Floor Cover/Mat. Fall-Prevention Alarm. Place Bed Against Wall. Lower Mattress.
A simple solution to reduce risk of injury if there is a fall is to lower the mattress or even place it on the floor. You can purchase a bed that can change height levels so it can be raised again in the morning for dressing..
Placing the bed against a wall protects against an individual falling off that side of the bed. .
With a pad placed under the individual while they sleep, an alarm will go off if the individual gets up. This can alert the caregiver to give assistance. However, the alarm sound can be scary to someone with dementia so use with caution. This can also be done with a welcome mat on the floor beside the bed that plays a more peaceful song to alert a caregiver of wandering..
Placing a soft mat or cushion alongside the bed at night can prevent risk of injury in case of a fall off the bed..
Click the modifications below to learn more about each..
Adjustable Bed. Bed Rails/ Grab Bars.
Bed rails come in many shapes and sizes. They can make sitting up in bed easier if an individual has the strength to grab the bar and pull themselves up..
An adjustable bed can be move electronically to raise or lower the top and bottom sections of the bed. This can be assist an individual in sitting up and getting out of bed..
Is the problem orienting the individual to the home or preventing wandering behavior in unsafe areas?
Orientation. Reduce Wandering.
Below are modifications that can assist in orienting an individual in the home. Click each to learn more..
Colored Stripe on Floor/Wall. Reality Orientation Board. Label Doors/Cabinets/Drawers.
Placing large print labels that include pictures on doors to distinguish the bedroom from the bathroom can be helpful in reducing wandering if it is caused by the individual losing their way. This can also be done for drawers and cabinets around the house that have items the individuals needs to use. .
Often individuals with dementia need visual cues to orient them and jog their memory. Putting up a board that includes the date, clock with time, things happening that day, and other pertinent information can improve orientation. .
Depending on the height and mobility of the individual, you can paint or put colored tape on the wall to trace a path to important places in the home such as the bathroom, bedroom, and kitchen. Make sure it is placed at a height the individual can easily view when they are wandering. .
Persistent wandering behavior can put individuals in unsafe situations. Taking precautions to reduce the urge to wander and protect their safety when they do wander is critical. Click each modification below to learn more about your options..
Camoflauge Exits. Indoor Garden/Pacing Area. Alarm System. Gates by Stairs.
If exit doors are not seen, then an individual is less likely to wander outside. This can be done by placing a curtain over doors, putting furniture in front, or painting the door the same color as the wall. .
To prevent an individual from wandering up or downstairs (if this presents a danger to them) then gates can be placed in front of the stairs. However, if the individual can climb over the gates, this creates a greater safety hazard and should not be used. .
Alarms can be placed on doors and windows to alert a caregiver when the individual is attempting to leave the house. A motion detector can also be used to give alerts when there is movement in certain areas of the house. .
Providing an area indoors where an individual can walk around and feel they are outside can prevent attempts to leave the home. Creating an indoor garden space can be helpful for some individuals. .
What is the goal for helping in the kitchen?
General Assistance. Protection .
Click for suggestions on making the kitchen a safer place to cook..
Install Induction Cooktop. Automatic Shut Off Stove. GFI Outlets.
GFI outlets reduce the risk of shock when plugging and unplugging appliances. Many newer homes will already have these outlets. .
You can purchase an add-on for a gas stove that uses a motion detector and power box. Some versions also connect to wifi and send an alert when it is shut off. This must be installed by a professional. .
An induction cooktop heats up and cools down quicker than a traditional gas stove. The cooktop surface also does not get as hot which reduces risk of burns..
Click to view ways to reduce confusion in the kitchen..
Place Pictures on Cabinets. Transparent Cabinets. Shallow Shelving.
When mobility is reduced, reaching towards the back of shelves can be difficult. Having shelves that are not too deep and at accessible height makes it easier to see and grab objects..
Having transparent (see-through) cabinets and doors allows an individual to view everything in the kitchen. This makes finding objects much easier and reduces the need to remember where things are. This can also be achieved by removing the cabinet doors. .
If transparent cabinets are not feasible, putting pictures of what is in each cabinet on the outside of the cabinet door can provide visual cues to where items are..
Many object modifications exist to help individuals with poor coordination, tremors, or limited grasp eat and drink..
Large Grip Silverware. Spill Proof Cups. Plate Modifications. Weighted Silverware.
With large rubber grips around the handle of the silverware, an individual with limited grasp range can more easily manuever the silverware. .
Weighted silverware can help with hand tremors and spasticity. .
Plate guards or plates with rims can be used to prevent food from falling off the plate. Suction cups on the bottom of plates can also be used to secure the plate to the table. .
Spill proof cups can be used when an individual has poor coordination or spasms in their hands. .
Where do you need better wheelchair access in the home?
Up/Down Stairs. Into/Out of Shower. Around Home. Enter/Exit House.
An interior wheelchair lift can be installed on indoor stairs similar to the one for the outside of the home. .
Ceiling Transfer Lift: This lift follows a path along the ceiling of the home with the individual in a swing that moves electronically along the track. This is more challenging to install and requires a certain level of upper body mobility from the individual. .
Below are viable options for entering and exiting a home via wheelchair..
Stair Climbers. Vertical Platform Lift. Light-Weight Temporary Ramp.
If the wheelchair is not permanent, then a light-weight temporary ramp can be installed for a short-term period. These should be installed by a professional. .
If the entrance is too high for a ramp, a platform lift can be installed that can be raised and lowered..
There are many types of stair climbers. Most can attach to an individual's wheelchair and assist in propelling it up the stairs. Most require one other person to operate. These should be used for homes where there is not space to put in a platform lift or ramp or a person is renting the home/apartment. .
Here are two solutions if the bathroom itself cannot be modified. More modification solutions are discussed in the Bathing & Bathroom Section..
Portable Shower System. Sliding Shower Commode Transfer System.
This should be used when removing the entire tub/shower is not possible. This can be used to transfer an individual from the toilet into the shower. .
If an individual cannot make it into the bathroom for whatever reason, the portable shower system can be used anywhere in the home. .