Safety at home and outside

Dementia slowly changes memory, judgment and how a person sees the world around them. A stove, a staircase, a car or a phone call from a stranger can turn risky in ways that were never a problem before. Safety is one of the biggest worries families have.

Good safety steps do more than prevent injuries. They can help the person feel calmer and less overwhelmed, and stay independent for longer.¹ This page gives an overview of the main risk areas and links to a detailed guide for each one.

Why safety needs change over time

In the early stage, many people still cook, drive and handle money. Over time, the brain has a harder time with planning, judging distance and danger, and remembering steps. A person may also not notice their own changes. See when the person doesn't know they are ill.

The goal is to balance safety with dignity. Too many rules can feel like losing control. Where you can, involve the person in safety choices, especially early on. Our stages of dementia pages explain what tends to come next.

The main risk areas

A quick home safety check

You do not need to change everything at once. Start with the biggest dangers. The Alzheimer's Association suggests steps like these:²

• Kitchen. Use appliances that shut off on their own. Cover or remove stove knobs, or turn off the gas when the stove is not in use.
• Locks and storage. Lock away medicines, cleaning products, gasoline, paint thinner and power tools. Keep cleaning products in their original containers.
• Trip hazards. Remove throw rugs, loose cords and clutter. Add grab bars and non-slip strips in the bathroom.
• Light. Put night lights in hallways, bedrooms and bathrooms.
• Fire and air. Keep smoke and carbon monoxide alarms and fire extinguishers working. Change alarm batteries twice a year.
• Doors. Put latches or deadbolts above or below eye level on outside doors.
• Phone list. Post numbers for police, fire, poison control and the hospital where they are easy to find.

Our full room-by-room checklist, including hot water and lighting, is in making the home safer.

Falls

Falls are common in later life. More than 1 in 4 people age 65 and older fall each year, but fewer than half tell their doctor.⁵ Falls send about 4.5 million older adults to the emergency room each year. They are also the most common cause of brain injury in older people.⁵

Dementia adds to the risk because it can affect balance, attention and judgment. The CDC's main steps help at any age: ask the doctor to check fall risk, have a doctor or pharmacist review all medicines, do strength and balance exercise such as tai chi, get eyes checked every year, and make the home safer.⁶ Talk with the doctor or pharmacist before changing any medicine. See preventing falls.

Wandering and getting lost

About 6 in 10 people with dementia will wander at least once, and many do it more than once. It can happen at any stage.³ Warning signs include coming back late from a walk or drive, pacing, or trying to "go home" while already at home.³

Helpful steps include planned activities at restless times of day, door alarms or bells, and keeping keys and coats out of sight. Never lock a person in.³

For ID bracelets, location devices and search programs, see wandering and getting lost and technology that helps.

Driving

People with dementia often do not notice that their driving has slipped. Family members are usually the first to see the signs.⁴ Watch for:⁴

• New dents or scrapes on the car
• Near misses or several tickets
• Getting lost on familiar roads
• Mixing up the gas and brake pedals
• Driving much too fast or too slow, or poor choices in traffic

A professional driving evaluation, often done by an occupational therapist, can show whether driving is still safe. State rules differ, and many states can require a new test when there are safety concerns.⁴ Bring it up calmly and with care, because giving up the car can feel like a big loss. The Eldercare Locator (800-677-1116) can help find low-cost rides.⁴ Our guide on driving and dementia covers how to have the talk and the Virginia DMV medical review process.

Guns

If there is a gun in the home, think about removing it or keeping it in a locked cabinet. A person with dementia may not recognize a familiar face and may think a loved one is an intruder.² See guns in the home for safe storage, removal options and how to talk about it.

Money, scams and abuse

Dementia can make it hard to spot a trick or to tell anyone about it. Strangers may target people with memory problems on purpose.⁹ Common scams include fake calls from the government, a grandchild "in trouble", tech support, romance, prize and home repair scams.⁷ See scams and financial abuse.

Abuse can be physical, emotional, sexual or financial. It can also be neglect, such as not giving needed food, medicine or care.⁸ Warning signs include unexplained bruises or burns, bedsores, poor hygiene, missing glasses or dentures, sudden money changes, and the person suddenly pulling away or seeming afraid.^8,9 You do not need proof to make a report.⁹ See signs of elder abuse and neglect.

Emergencies and disasters

Storms, power outages and evacuations can be especially confusing for a person with dementia.¹ Ready.gov suggests a supply kit with food, water, a flashlight, a first aid kit, and medicines and medical supplies. Add copies of Medicare, Medicaid and other insurance cards, and batteries and chargers for devices. Make a plan with family or friends and practice it. Make sure at least one person has a spare key and knows where your supplies are.¹² For people with dementia, also pack a recent photo, a list of diagnoses and medicines, and a comfort item. See emergency and disaster planning.

Where to start this week

1. Walk through the home with fresh eyes, looking at the kitchen, bathroom, stairs and outside doors first.
2. Lock up medicines, cleaning products and any guns.
3. Take a clear, recent photo of the person and write down their height, weight and usual places they might go.
4. Ask the doctor about fall risk and a medicine review at the next visit.
5. Talk with the person, if you can, about driving and money plans while they can still share their wishes.
6. List who can help in an emergency. The care circle tool can help.

In this section

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.