Making the home safer

Dementia changes how a person judges risk. It can also affect balance, eyesight, hearing and the sense of time and place. A home that was safe for years can slowly start to hide dangers.¹

You do not need to change everything at once. Start with the biggest risks, like the stove, hot water, medicines and stairs. Then add more changes as the disease moves along. This page gives you a room-by-room checklist you can work through over a few weekends.

Start with a walk-through

Set aside an hour. Walk through every room, plus the garage, basement, yard and porch. These spaces often hold tools, chemicals and cleaning supplies.¹ Ask yourself in each room:

• What could the person burn, cut, swallow or trip on here?
• What could confuse or scare them?
• What could they do on their own if I were asleep or in another room?

Think about the stage, too. In the early stage, a person may only need reminders and a few small changes. In the middle stage, judgment and memory slip more, and the home usually needs more changes. A doctor can also refer you to an occupational therapist. This kind of therapist can visit the home and suggest changes that fit the person.

Keep the home feeling like home. A place that feels too locked down can make a person feel trapped and upset. Leave clear space for activities, and let the person do as much as they safely can.¹

Kitchen

The kitchen holds two big risks: fire and things that look like food but are not.

Stove and oven. Cooking is the top cause of home fires and home fire injuries. Most kitchen fires start when cooking is left alone.⁷ A person with dementia may turn on a burner and forget it.

• Use knob covers, take the knobs off when the stove is not in use, or turn off the gas to the stove.¹
• Choose small appliances, like kettles and irons, that shut off on their own.¹
• Ask a hardware store or electrician about a stove shut-off device. Some turn the stove off if no one is nearby or after a set time.
• If the person still enjoys cooking, cook together. Let them stir, wash vegetables or set the table.

Food look-alikes. Remove fake fruit and toxic plants. Clear vitamins, medicines, sugar substitutes and spices off counters and tables.¹ A person may eat things they no longer recognize.

Other kitchen steps.

• Disconnect the garbage disposal.¹
• Keep sharp knives out of sight.
• Store items the person uses every day at waist height, so they do not climb.⁵
• If a step stool is needed, use one with a handrail, never a chair.⁵

See meals and nutrition for help at mealtimes.

Bathroom and hot water

Bathrooms are wet and hard, so they are a common place for falls and burns.

Hot water. As dementia grows, a person may have trouble telling hot from cold.¹ Hot tap water can burn older skin fast. The U.S. Consumer Product Safety Commission (CPSC) suggests setting home water heaters to 120°F (49°C).²

Source for the table: CPSC.²

So 120°F is much safer, but it is not burn-proof. Most tap water scald injuries and deaths happen to older adults and young children.²

• Turn the water heater down to 120°F. If you are not sure how, ask a plumber or the gas company.
• Test bath water yourself before the person gets in. A bath thermometer that shows the temperature can help.¹
• A plumber can also tell you about anti-scald valves for faucets and showers.

Falls in the bathroom.^1,5

• Put grab bars inside and beside the tub or shower, and next to the toilet.
• Use non-slip mats or stick-on strips in the tub or shower.
• Think about a walk-in shower, a shower chair and a raised toilet seat.
• Keep a night light on in the bathroom and along the path from the bed.

See bathing, dressing and grooming for tips on making bath time calmer.

Bedroom

• Put a lamp within easy reach of the bed.⁵
• Light the path from the bed to the bathroom with night lights.⁵
• Watch closely if the person uses an electric blanket, space heater or heating pad. They may not notice when it gets too hot.¹
• Put a chair near the bed so the person can sit to dress. Keep closet shelves low enough to reach.¹

Living areas, floors and stairs

Falls are the leading cause of injury death for adults 65 and older. More than 14 million older adults, about 1 in 4, report a fall each year.⁴ See preventing falls for the full picture.

Floors.^1,5

• Remove throw rugs, or tape them down with double-sided tape.
• Clear clutter and keep walking paths open.
• Tape cords against the wall or move them out of walkways.

Stairs.⁵

• Put sturdy handrails on both sides.
• Add light switches at the top and bottom, and replace burned-out bulbs right away.
• Fix loose steps and carpet. Never leave things on the stairs.
• If the person tends to go down the stairs at night, a safety gate may help. Talk with an occupational therapist about the safest choice.

Furniture. Anchor bookshelves, cabinets and large TVs to the wall so they cannot tip over. Chairs with armrests are easier to get in and out of.¹

Lighting

Changes in light can confuse a person with dementia. Dim corners, glare and shadows can be hard to read.¹

• Keep lighting bright and even in entries, landings, stairways and bathrooms.¹
• Use night lights in hallways, bedrooms and bathrooms.¹
• Use more bulbs or brighter bulbs in dark rooms.⁸
• Turn lights on before dusk. Late-day confusion is common. See sundowning.
• If the person seems scared of a mirror, a dark window or a shadow, cover it or close the curtains. See hallucinations and delusions.

Doors and locks

About 6 in 10 people living with dementia will wander at least once, and many do it again and again.⁶ Locks can help, but they need care.

• Put deadbolts on outside doors high or low, out of the person's usual line of sight.^1,6
• Add a door chime or alarm that sounds when a door opens. A pressure mat by the bed or door can alert you when the person gets up.⁶
• Make doors less noticeable. Paint them the same color as the wall, or hang a curtain over them.⁶
• Take the locks off inside doors, like the bathroom and bedroom, so the person cannot lock themselves in. Hide a spare house key near the door.¹
• Put away coats, purses and keys that may prompt the person to leave. If the person no longer drives, keep car keys out of reach.⁶

Medicines, cleaning products and poisons

A person with dementia may take the wrong pills or the same pill twice. They may also mistake a cleaning product for a drink.

• Keep all medicines, including vitamins and over-the-counter pills, in a locked drawer or box.¹
• Use a pill organizer or a daily checklist. See managing medicines at home.¹
• Lock up cleaning products, bleach and laundry pods. Keep them in their original containers.¹
• Keep alcohol out of sight if drinking is a problem.

If you think the person swallowed something harmful, call Poison Help at 1-800-222-1222. It is open 24 hours a day and offers help in over 100 languages.³ If the person is having trouble breathing, will not wake up or has a seizure, call 911.

Guns and weapons

A person with dementia may not recognize a family member and could mistake them for an intruder. Think about removing guns and other weapons from the home. If they stay, keep them locked up.¹ See guns in the home for how to have this talk.

Garage, basement, laundry and yard

• Limit access to mowers, snow blowers, power tools and ladders.¹
• Keep gasoline, paint thinner and other chemicals locked away.¹
• A motion sensor on the garage door can let you know if the person goes in.¹
• Think about locks on the washer and dryer. Clean the dryer lint screen and duct often to lower fire risk.¹
• Outside, fix uneven steps and walkways, and light the entry at night.⁵

Smoke and carbon monoxide alarms

Smoke alarms. Put one in every bedroom, outside each sleeping area and on every level, including the basement. Alarms that are linked together are best, because when one sounds, they all sound.⁹

• Test each alarm once a month.⁹
• Replace the whole alarm 10 years after the date it was made.⁹
• If anyone in the home has hearing loss, there are alarms that flash a strobe light or shake the bed.⁹
• Keep a fire extinguisher in the kitchen, and make sure it is checked.¹

Carbon monoxide (CO) alarms. CO is a gas you cannot see or smell. It comes from things like gas furnaces, stoves and generators. Put CO alarms on every level and outside sleeping areas, and check the batteries regularly.¹⁰

CO poisoning causes headache, dizziness, weakness, nausea, sleepiness and confusion.¹⁰ In a person with dementia, new confusion is easy to blame on the disease. If an alarm sounds or several people feel sick at once, get everyone into fresh air and call 911.¹⁰

Some families change alarm batteries twice a year, when the clocks change.¹ Mark it on the calendar so it does not get missed.

A quick checklist

1. Kitchen: stove knob covers or shut-off, automatic-off appliances, no fake fruit, medicines and spices off counters.
2. Bathroom: water heater at 120°F, grab bars, non-slip mats, night light.
3. Bedroom: lamp by the bed, lit path to the bathroom, heaters and heating pads watched.
4. Floors and stairs: no throw rugs or cords, rails on both sides, lights at top and bottom.
5. Doors: hidden deadbolts, door chimes, no inside locks, spare key nearby.
6. Locked up: medicines, cleaning products, guns, tools, gasoline, car keys.
7. Alarms: smoke and CO alarms on every level, tested monthly.
8. By the phone: a list with 911, Poison Help (1-800-222-1222), the doctor, neighbors and family.

Keep the emergency list on the fridge and in your phone.¹ Share this checklist with family members who help. A care circle can split up the jobs. For storms and power outages, see emergency and disaster planning.

Common questions

Will these changes upset the person?

They might at first. Make changes a few at a time, and explain them simply if the person asks. Many changes, like brighter lights or grab bars, are easy to accept. Avoid arguing. See talking with someone who has dementia.

When should we stop letting the person use the stove?

Watch for signs like burnt pots, burners left on, or smoke alarms going off while cooking. Once these happen, it is time to block the stove when you are not there. Cooking together can still be a happy activity.

Can technology help?

Yes. Door alarms and pressure mats can alert you when the person gets up or opens a door.⁶ A motion sensor on the garage door and appliances that shut off on their own can also help.¹ See technology that helps.

What if the person lives alone?

This needs extra care. Safety risks grow as dementia moves along. Talk with the doctor and family about daily check-ins, in-home help or a move. See in-home care and adult day care.

When to get help

• Call 911 for a fire, a CO alarm, a serious burn, a fall with injury or a person who cannot get up, or a person who is missing.
• Call Poison Help (1-800-222-1222) if the person swallowed medicine, a cleaning product or a plant.³
• Call the doctor if the person falls, gets burned, or seems more confused than usual. A sudden change can mean an infection or a medicine problem.
• If you feel worn out or hopeless as a caregiver, you are not alone. Call or text 988 any time. See caregiver stress and burnout.

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.