Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

What is Alzheimerís Disease? . . . . . . . . . . . . . . . . . 2

What are the Symptoms of AD? . . . . . . . . . . . . . . . . 3

General Safety Concerns . . . . . . . . . . . . . . . . . . . . . 4

Is it Safe to Leave the Person with AD Alone?. . . . . 5

Home Safety Room-By-Room. . . . . . . . . . . . . . . . . . 7

Home Safety Behavior-By-Behavior. . . . . . . . . . . . 16

Impairment of the Senses. . . . . . . . . . . . . . . . . . . . 21

Driving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Warning Signs of Unsafe Driving. . . . . . . . . . . . . . 25

Natural Disaster Safety . . . . . . . . . . . . . . . . . . . . . 29

Who Would Take Care of the Person with

AD if Something Happened to You? . . . . . . . . . . . . 31

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Additional Resources. . . . . . . . . . . . . . . . . . . . . . . 34

TABLE OF CONTENTS
Home Safety for People with Alzheimerís Disease

page 1

Introduction

Caring for a person with Alzheimerís Disease (AD) is a challenge

that calls upon the patience, creativity, knowledge, and skills of

each caregiver. We hope that this booklet will help you cope 

with some of these challenges and develop creative solutions to

increase the security and freedom of the person with AD in your

home, as well as your own peace of mind. 

This booklet is for those who provide in-home care for people

with AD or related disorders. Our goal is to improve home safety

by identifying potential problems in the home and offering

possible solutions to help prevent accidents.

We begin with a checklist to help you make each room in your

home a safer environment for the person with AD. Next, we 

hope to increase awareness of the ways specific impairments

associated with the disease can create particular safety hazards in

the home. Specific home safety tips are listed to help you cope

with some of the more hazardous behaviors that may occur as the

disease advances. We also include tips for managing driving and

planning for natural disaster safety. The booklet ends with a list

of resources for family caregivers.
Home Safety for People with Alzheimerís Disease

page 2

What Is Alzheimerís Disease?

Alzheimerís disease is a progressive, irreversible disease that

affects brain cells and produces memory loss and intellectual

impairment in as many as 4 million American adults. This

disease affects people of all racial, economic, and educational

backgrounds.

AD is the most common cause of dementia in adults. Dementia 

is defined as loss of memory and intellect that interferes with

routine personal, social, or occupational activities. Dementia 

is not a disease; rather, it is a group of symptoms that may

accompany certain diseases or conditions. Other symptoms

include changes in personality, mood, or behavior.

Although AD primarily affects people age 65 or older, it also

may affect people in their 50s and, although rarely, even younger.

Other causes of irreversible dementia include multi-infarct

dementia (a series of minor strokes resulting in widespread death

of brain tissue), Pickís disease, Binswangerís disease, Parkinsonís

disease, Huntingtonís disease, Creutzfeldt-Jakob disease,

amyotrophic lateral sclerosis (Lou Gehrigís disease), multiple

sclerosis, and alcohol abuse. The recommendations in this

booklet deal primarily with common problems in AD, but they

also may apply to any of the related dementing disorders.
Home Safety for People with Alzheimerís Disease

page 3

What are the Symptoms of AD?

There is no ìtypicalî person with Alzheimerís. There is

tremendous variability among people with AD in their behaviors

and symptoms. At present, there is no way to predict how quickly

the disease will progress in any one person, nor to predict the

exact changes that will occur. We do know, however, that many

of these changes will present problems for caregivers. Therefore,

knowledge and prevention are critical to safety.

People with AD have memory problems and cognitive

impairment (difficulties with thinking and reasoning), and

eventually they will not be able to care for themselves. They may

experience confusion, loss of judgment, and difficulty finding

words, finishing thoughts, or following directions. They also may

experience personality and behavior changes. For example, they

may become agitated, irritable, or very passive. Some may

wander from home and become lost. They may not be able to tell

the difference between day and night, and they may wake up, get

dressed, and start to leave the house in the middle of the night

thinking that the day has just started. They may suffer from

losses that affect vision, smell, or taste.

These disabilities are very difficult, not only for the person with

AD, but for the caregiver, family, and other loved ones as well.

Caregivers need resources and reassurance to know that while the

challenges are great, there are specific actions to take to reduce

some of the safety concerns that accompany Alzheimerís disease.
Home Safety for People with Alzheimerís Disease

page 4

General Safety Concerns

People with AD become increasingly unable to take care of

themselves. However, individuals will move through the disease

in their own unique manner. As a caregiver, you face the ongoing

challenge of adapting to each change in the personís behavior and

functioning. The following general principles may be helpful.

1. Think prevention. It is very difficult to predict what a person

with AD might do. Just because something has not yet occurred,

does not mean it should not be cause for concern. Even with the

best-laid plans, accidents can happen. Therefore, checking the

safety of your home will help you take control of some of the

potential problems that may create hazardous situations.

2. Adapt the environment. It is more effective to change the

environment than to change most behaviors. While some AD

behaviors can be managed with special medications prescribed

by a doctor, many cannot. You can make changes in an

environment to decrease the hazards and stressors that

accompany these behavioral and functional changes.

3. Minimize danger. By minimizing danger, you can maximize

independence. A safe environment can be a less restrictive

environment where the person with AD can experience increased

security and more mobility.
Home Safety for People with Alzheimerís Disease

page 5

Is it Safe to Leave the Person With 

AD Alone?

This issue needs careful evaluation and is certainly a safety

concern. The following points may help you decide.

Does the person with AD:

! become confused or unpredictable under stress?

! recognize a dangerous situation; for example, fire?

! know how to use the telephone in an emergency?

! know how to get help?

! stay content within the home?

! wander and become disoriented?

! show signs of agitation, depression, or withdrawal when

left alone for any period of time?

! attempt to pursue former interests or hobbies that might

now warrant supervision such as cooking, appliance

repair, or woodworking?

You may want to seek input and advice from a health care

professional to assist you in these considerations. As

Alzheimerís disease progresses, these questions will need

ongoing evaluation.

Home Safety for People with Alzheimerís Disease

page 7

Home Safety Room-By-Room

Prevention begins with a safety check of every room in your

home. Use the following room-by-room checklist to alert you to

potential hazards and to record any changes you need to make.

You can buy products or gadgets necessary for home safety at

stores carrying hardware, electronics, medical supplies, and

childrenís items.

Keep in mind that it may not be necessary to make all of the

suggested changes. This booklet covers a wide range of safety

concerns that may arise, and some modifications may never be

needed. It is important, however, to re-evaluate home safety

periodically as behavior and abilities change.

Your home is a personal and precious environment. As you go

through this checklist, some of the changes you make may impact

your surroundings positively, and some may affect you in ways

that may be inconvenient or undesirable. It is possible, however,

to strike a balance. Caregivers can make adaptations that modify

and simplify without severely disrupting the home. You may

want to consider setting aside a special area for yourself, a space

off-limits to anyone else and arranged exactly as you like.

Everyone needs private, quiet time, and as a caregiver, this

becomes especially crucial.

A safe home can be a less stressful home for the person with AD,

the caregiver, and family members. You donít have to make these

changes alone. You may want to enlist the help of a friend,

professional, or community service such as the Alzheimerís

Association.
Home Safety for People with Alzheimerís Disease

page 8

Throughout the Home

" Display emergency numbers and your home address near all

telephones.

" Use a telephone answering machine when you cannot answer

calls. The person with AD often is unable to take messages or

may be a target for telephone exploitation by solicitors. When

the answering machine is on, turn down the phone bell to avoid

disruptive ringing.

" Install smoke alarms near all bedrooms; check their functioning

and batteries frequently.

" Avoid the use of flammable and volatile compounds near gas

water heaters. Do not store these materials in an area where a

gas pilot light is used.

" Install secure locks on all outside doors and windows.

" Hide a spare house key outside in case the person with AD

locks you out of the house.

" Avoid the use of extension cords if possible by placing lamps

and appliances close to electrical outlets. Tack extension cords

to the baseboards of a room to avoid tripping. 

" Cover unused outlets with childproof plugs.

" Place red tape around floor vents, radiators, and other heating

devices to deter the person with AD from standing on or touching a hot grid.

" Check all rooms for adequate lighting.

" Place light switches at the top and the bottom of stairs. 
Home Safety for People with Alzheimerís Disease

page 9

" Stairways should have at least one handrail that extends

beyond the first and last steps. If possible, stairways should be

carpeted or have safety grip strips.

" Keep all medications (prescription and over-the-counter)

locked. Each bottle of prescription medicine should be 

clearly labeled with the patientís name, name of the drug, drug

strength, dosage frequency, and expiration date. Child-resistant

caps are available if needed.

" Keep all alcohol in a locked cabinet or out of reach of the 

person with AD. Drinking alcohol can increase confusion.

" If smoking is permitted at all, monitor while the person with

AD is smoking. Remove matches, cigarettes, and ashtrays.

With these reminders out of sight, the person may forget the

desire to smoke.

" Avoid clutter, which can create confusion and danger. Throw

out/recycle newspapers and magazines regularly. Keep all walk

areas free of furniture.

" Keep plastic bags out of reach. A person with AD may choke

or suffocate.

" Remove all guns or other weapons from the home, or safety

proof them by installing safety locks or by removing ammunition and firing pins.

" Lock all power tools and machinery in the garage, workroom,

or basement.

" Remove all poisonous plants from the home. Check with local

nurseries or poison control centers for a list of poisonous plants.
Home Safety for People with Alzheimerís Disease

page 10

" Keep fish tanks out of reach. The combination of glass, water,

electrical pumps, and potentially poisonous aquatic life could

be harmful to a curious person with AD.

Outside Approaches to the House

" Keep steps sturdy and textured to prevent falls in wet or icy

weather.

" Mark the edges of steps with bright or reflective tape. 

" Consider a ramp with handrails into the home rather than steps.

" Eliminate uneven surfaces or walkways, hoses, or other objects

that may cause a person to trip.

" Restrict access to a swimming pool by fencing it off with a

locked gate, covering it, and keeping it closely supervised

when in use. 

" In the patio area, remove the fuel source and fire starters from

any grills when not in use, and supervise use when the person

with AD is present.

" Place a small bench or table by the entry door to hold parcels

while unlocking the door.

" Make sure outside lighting is adequate. Light sensors that turn on

lights automatically as you approach the house are available and

may be useful. They also may be used in other parts of the home.

" Prune bushes and foliage well away from walkways and 

doorways.

" Consider a NO SOLICITING sign for the front gate or door.
Home Safety for People with Alzheimerís Disease

page 11

Entryway 

" Remove scatter rugs and throw rugs.

" Use textured strips or nonskid wax on hardwood floors to

prevent slipping.

Kitchen

" Install childproof door latches on storage cabinets and drawers

designated for breakable or dangerous items. Lock away all

household cleaning products, matches, knives, scissors, blades,

small appliances, and valued china.

" If prescription or nonprescription drugs are kept in the kitchen,

store them in a locked cabinet.

" Remove scatter rugs and foam pads from the floor. 

" Remove knobs from the stove, or install an automatic shut-off

switch.

" Do not use or store flammable liquids in the kitchen. Lock

them in the garage or in an outside storage unit.

" Keep a night-light in the kitchen.

" Remove or secure the family ìjunk drawer.î A person with AD

may eat small items such as matches, hardware, erasers,

plastics, etc.

" Remove artificial fruits and vegetables or food-shaped kitchen

magnets, which might appear to be edible.

" Insert a drain trap in the kitchen sink to catch anything that

may otherwise become lost or clog the plumbing.
Home Safety for People with Alzheimerís Disease

page 12

" Consider dismantling the garbage disposal. People with AD

may place objects or their own hands in the disposal.

Bedroom

" Use a night-light.

" Use an intercom device (often used for infants) to alert you to

any noises indicating falls or a need for help. This also is an

effective device for bathrooms.

" Remove scatter rugs.

" Remove portable space heaters. If you use portable fans, be

sure that objects cannot be placed in the blades.

" Be cautious when using electric mattress pads, electric

blankets, electric sheets, and heating pads, all of which may

cause burns. Keep controls out of reach.

" Move the bed against the wall for increased security, or place

the mattress on the floor.

Bathroom

" Do not leave a severely impaired person with AD alone in the

bathroom.

" Remove the lock from the bathroom door to prevent the person

with AD from getting locked inside.

" Place nonskid adhesive strips, decals, or mats in the tub and

shower. If the bathroom is uncarpeted, consider placing these

strips next to the tub, toilet, and sink.
Home Safety for People with Alzheimerís Disease

page 13

" Use washable wall-to-wall bathroom carpeting to prevent

slipping on wet tile floors.

" Use an extended toilet seat with handrails, or install grab bars

beside the toilet.

" Install grab bars in the tub/shower. A grab bar in contrasting

color to the wall is easier to see.

" Use a foam rubber faucet cover (often used for small children)

in the tub to prevent serious injury should the person with AD

fall.

" Use plastic shower stools and a hand-held showerhead to make

bathing easier.

" In the shower, tub, and sink, use a single faucet that mixes hot

and cold water to avoid burns.

" Adjust the water heater to 120 degrees to avoid scalding tap

water.

" Insert drain traps in sinks to catch small items that may be lost

or flushed down the drain.

" Store medications (prescription and nonprescription) in a

locked cabinet. Check medication dates and throw away

outdated medications.

" Remove cleaning products from under the sink, or lock them

away.

" Use a night-light.

" Remove small electrical appliances from the bathroom. Cover

electrical outlets. If men use electric razors, have them use a

mirror outside the bathroom to avoid water contact.
Home Safety for People with Alzheimerís Disease

page 14

Living room

" Clear all walk areas of electrical cords.

" Remove scatter rugs or throw rugs. Repair or replace torn

carpet.

" Place decals at eye level on sliding glass doors, picture

windows, or furniture with large glass panels to identify the

glass pane.

" Do not leave the person with AD alone with an open fire in the

fireplace, or consider alternative heating sources. Remove

matches and cigarette lighters.

" Keep the controls for cable or satellite TV, VCR, and stereo

system out of sight.

Laundry Room

" Keep the door to the laundry room locked if possible.

" Lock all laundry products in a cabinet.

" Remove large knobs from the washer and dryer if the person

with AD tampers with machinery.

" Close and latch the doors and lids to the washer and dryer to

prevent objects from being placed in the machines.

Home Safety for People with Alzheimerís Disease

page 16

Home Safety Behavior-By-Behavior

Although a number of behavior and sensory problems may

accompany Alzheimerís disease, not every person will

experience the disease in exactly the same way. As the disease

progresses, particular behavioral changes can create safety

problems. The person with AD may or may not have these

symptoms. However, should these behaviors occur, the following

safety recommendations may help reduce risks.

Wandering

" Remove clutter and clear the pathways from room to room to

allow the person with AD to move about more freely.

" Make sure floors provide good traction for walking or pacing.

Use nonskid floor wax or leave floors unpolished. Secure all

rug edges, eliminate throw rugs, or install nonskid strips. The

person with AD should wear nonskid shoes or sneakers.

" Place locks on exit doors high or low on the door out of direct

sight. Consider double locks that require a key. Keep a key for

yourself and hide one near the door for emergency exit purposes.

" Use loosely fitting doorknob covers so that the cover turns

instead of the actual knob. Due to the potential hazard they

could cause if an emergency exit is needed, locked doors 

and doorknob covers should be used only when a caregiver 

is present.

" Install safety devices found in hardware stores to limit the

distance that windows can be opened.
Home Safety for People with Alzheimerís Disease

page 17

" If possible, secure the yard with fencing and a locked gate. Use

door alarms such as loose bells above the door or devices that

ring when the doorknob is touched or the door is opened.

" Divert the attention of the person with AD away from using the

door by placing small scenic posters on the door; placing

removable gates, curtains, or brightly colored streamers across

the door; or wallpapering the door to match any adjoining walls.

" Place STOP, DO NOT ENTER, or CLOSED signs in strategic

areas on doors.

" Reduce clues that symbolize departure such as shoes, keys,

suitcases, coats, or hats.

" Obtain a medical identification bracelet for the person with 

AD with the words ìmemory lossî inscribed along with an

emergency telephone number. Place the bracelet on the

personís dominant hand to limit the possibility of removal, 

or solder the bracelet closed.

" Place labels in garments to aid in identification. Check with the

local Alzheimerís Association about the Safe Return program. 

" Keep an article of the personís worn, unwashed clothing in a

plastic bag to aid in finding someone with the use of dogs.

" Notify neighbors of the personís potential to wander or become

lost. Alert them to contact you or the police immediately if the

individual is seen alone and on the move.

" Give local police, neighbors, and relatives a recent picture,

along with the name and pertinent information about the person

with AD, as a precaution should he or she become lost. Keep

extra pictures on hand.
Home Safety for People with Alzheimerís Disease

page 18

" Consider making an up-to-date home video of the person 

with AD. 

" Do not leave a person with AD who has a history of wandering

unattended.

Rummaging/Hiding Things

" Lock up all dangerous or toxic products, or place them out of

the personís reach.

" Remove all old or spoiled food from the refrigerator and

cupboards. A person with AD may rummage for snacks but

may lack the judgment or taste to rule out spoiled foods.

" Simplify the environment by removing clutter or valuable

items that could be misplaced, lost, or hidden by the person

with AD. These include important papers, checkbooks, charge

cards, and jewelry.

" If your yard has a fence with a locked gate, place the mailbox

outside the gate. People with AD often hide, lose, or throw

away mail. If this is a serious problem, consider obtaining a

post office box.

" Create a special place for the person with AD to rummage

freely or sort (for example, a chest of drawers, a bag of

selected objects, or a basket of clothing to fold or unfold).

Often, safety problems occur when the person with AD

becomes bored or does not know what to do.

" Provide the person with AD a safe box, treasure chest, or

cupboard to store special objects.
Home Safety for People with Alzheimerís Disease

page 19

" Close access to unused rooms, thereby limiting the opportunity

for rummaging and hiding things.

" Search the house periodically to discover hiding places. Once

found, these hiding places can be discreetly and frequently

checked.

" Keep all trashcans covered or out of sight. The person with 

AD may not remember the purpose of the container or may

rummage through it.

" Check trash containers them before emptying them in case

something has been hidden there or accidentally thrown away.

Hallucinations, Illusions, and Delusions

Due to the complex changes occurring in the brain, people with

AD may see or hear things that have no basis in reality.

Hallucinations come from within the brain and involve hearing,

seeing, or feeling things that are not really there. For example, a

person with AD may see children playing in the living room

when no children exist. Illusions differ from hallucinations

because the person with AD is misinterpreting something that

actually does exist. Shadows on the wall may look like people,

for example. Delusions are persistent thoughts that the person

with AD believes are true but in reality, are not. Often, stealing is

suspected, for example, but cannot be verified.

It is important to seek medical evaluation if a person with AD has

ongoing disturbing hallucinations, illusions, or delusions. Often,

these symptoms can be treated with medication or behavior

management techniques. With all of the above symptoms, the

following environmental adaptations also may be helpful.
Home Safety for People with Alzheimerís Disease

page 20

" Paint walls a light color to reflect more light. Use solid colors,

which are less confusing to an impaired person than a

patterned wall. Large, bold prints (for example, florals in

wallpaper or drapes) may cause confusing illusions.

" Make sure there is adequate lighting, and keep extra bulbs handy

in a secured place. Dimly lit areas may produce confusing

shadows or difficulty with interpreting everyday objects. 

" Reduce glare by using soft light or frosted bulbs, partially

closing blinds or curtains, and maintaining adequate globes or

shades on light fixtures.

" Remove or cover mirrors if they cause the person with AD to

become confused or frightened.

" Ask if the person can point to a specific area that is producing

confusion. Perhaps one particular aspect of the environment is

being misinterpreted.

" Vary the home environment as little as possible to minimize the

potential for visual confusion. Keep furniture in the same place.

" Have the person with AD avoid watching violent or disturbing

television programs. The person with AD may believe the

story is real.

" Do not confront the person with AD who becomes aggressive.

Withdraw and make sure you have access to an exit as needed.
Home Safety for People with Alzheimerís Disease

page 21

Impairment of the Senses

Alzheimerís disease can cause changes in a personís ability to

interpret what they see, hear, taste, feel, or smell, even though the

sense organs may still be intact. The person with AD should be

evaluated periodically by a physician for any such changes that

may be correctable with glasses, dentures, hearing aids, or other

treatments.

Vision

People with AD may experience a number of changes in visual

abilities. For example, they may lose their ability to comprehend

visual images. Although there is nothing physically wrong with

their eyes, people with AD may no longer be able to interpret

accurately what they see due to changes in their brain. Also, their

sense of perception and depth may be altered. These changes can

cause safety concerns.

" Create color contrast between floors and walls to help the

person see depth. Floor coverings are less visually confusing 

if they are a solid color.

" Use dishes and placemats in contrasting colors for easier

identification.

" Mark the edges of steps with brightly colored strips of tape 

to outline changes in elevation.

" Place brightly colored signs or simple pictures on important

rooms (the bathroom, for example) for easier identification.
Home Safety for People with Alzheimerís Disease

page 22

" Be aware that a small pet that blends in with the floor or lies in

walkways may be a hazard. The person with AD may trip over

a small pet.

Smell

A loss or decrease in smell often accompanies Alzheimerís

disease.

" Install good quality smoke detectors and check them frequently.

The person with AD may not smell smoke or may not

associate it with danger.

" Keep refrigerators clear of spoiled foods.

Touch

People with AD may experience loss of sensation or may no

longer be able to interpret feelings of heat, cold, or discomfort.

" Adjust water heaters to 120 degrees to avoid scalding tap

water. Most hot water heaters are set at 150 degrees, which 

can cause burns. 

" Color code separate water faucet handles, with red for hot and

blue for cold.

" Place a sign on the oven, coffee maker, toaster, crock-pot, iron,

or other potentially hot appliances that says DO NOT TOUCH

or STOP! VERY HOT. The person with AD should not use

appliances without supervision. Unplug appliances when not

in use.
Home Safety for People with Alzheimerís Disease

page 23

" Use a thermometer to tell you whether the water in the bathtub

is too hot or too cold.

" Remove furniture or other objects with sharp corners or pad

them to reduce potential for injury.

Taste

People with AD may lose taste sensitivity. As their judgment

declines, they also may place dangerous or inappropriate things

in their mouth.

" If possible, keep a spare set of dentures. If the person keeps

removing dentures, check for correct fit.

" Keep all condiments such as salt, sugar, or spices away from

easy access if you see the person with AD using excess

amounts. Too much salt, sugar, or spice can be irritating to the

stomach or cause other health problems.

" Remove or lock up medicine cabinet items such as toothpaste,

perfume, lotions, shampoos, rubbing alcohol, or soap, which

may look and smell like edible items to the person with AD. 

" Consider a childproof latch on the refrigerator, if necessary. 

" Keep the poison control number by the telephone. Keep a

bottle of Ipecac (vomit inducing) available but use only with

instructions from poison control or 911.

" Keep pet litter boxes inaccessible to the person with AD. Do

not store pet food in the refrigerator.

" Learn the Heimlich maneuver or other techniques to use in

case of choking. Check with your local Red Cross for more

information and instruction.
Home Safety for People with Alzheimerís Disease

page 24

Hearing

People with AD may have normal hearing, but they may lose

their ability to interpret what they hear accurately. This may

result in confusion or over-stimulation.

" Avoid excessive noise in the home such as having the stereo

and the TV on at the same time.

" Be sensitive to the amount of noise going on outside, and close

windows or doors, if necessary.

" Avoid large gatherings of people in the home if the person

with AD shows signs of agitation or distress in crowds.

" Check hearing aid batteries and functioning frequently. 

Driving

Driving is a complex activity that demands quick reactions, alert

senses, and split-second decision-making. For a person with AD,

driving becomes increasingly more difficult. Memory loss,

impaired judgment, disorientation, impaired visual and spatial

perception, slow reaction time, diminished attention span,

inability to recognize cues such as stop signs and traffic lights

can make driving particularly hazardous. 
Home Safety for People with Alzheimerís Disease

page 25

Warning Signs of Unsafe Driving

Often, it is the caregiver, a family member, neighbor, or

friend who becomes aware of the safety hazards. If a person

with AD experiences one of more of the following

problems, it may be time to limit or stop driving. 

Does the person with AD:

! get lost while driving in a familiar location?

! fail to observe traffic signals?

! drive at an inappropriate speed?

! become angry, frustrated, or confused while driving?

! make slow or poor decisions?

Please do not wait for an accident to happen. Take action

immediately!

People with AD who continue to drive can be a danger to

themselves, their passengers, and the community at large. As the

disease progresses, they lose driving skills and must stop driving.

Unfortunately, people with AD often cannot recognize when they

should no longer drive. This is a tremendous safety concern. It is

extremely important to have the impaired personís driving

abilities carefully evaluated.
Home Safety for People with Alzheimerís Disease

page 26

Explaining to the person with AD that he or she can no longer

drive can be extremely difficult. Loss of driving privileges may

represent a tremendous loss of independence, freedom, and

identity. It is a significant concern for the person with AD and 

the caregiver. The issue of not driving may produce anger, denial,

and grief in the person with AD, as well as guilt and anxiety in

the caregiver. Family and concerned professionals need to be

both sensitive and firm. Above all, they should be persistent 

and consistent.

The doctor of a person with AD can assist the family with the

task of restricting driving. Talk with the doctor about your

concerns. Most people will listen to their doctor. Ask the doctor

to advise the person with AD to reduce his or her driving, go for

a driving evaluation or test, or stop driving altogether. An

increasing number of States have laws requiring physicians to

report AD and related disorders to the Department of Motor

Vehicles. The Department of Motor Vehicles then is responsible

for retesting the at-risk driver. Testing should occur regularly, at

least yearly.

When dementia impairs driving and the person with AD

continues to insist on driving, a number of different approaches

may be necessary.

" Work as a team with family, friends, and professionals and use

a single, simple explanation for the loss of driving ability such

as: ìYou have a memory problem, and it is no longer safe to

drive.î ìYou cannot drive because you are on medication.î or

ìThe doctor has prescribed that you no longer drive.î
Home Safety for People with Alzheimerís Disease

page 27

" Have the doctor write on a prescription pad DO NOT DRIVE.

Ask the doctor to write to the Department of Motor Vehicles 

or Department of Public Safety saying this person should no

longer drive. Show the letter to the person with AD as evidence.

" Offer to drive.

" Walk when possible, and make these outings special events.

" Use public transportation or any special transportation

provided by community organizations. Ask about senior

discounts or transportation coupons. The person with AD

should not take public transportation unsupervised.

" Park the car at a friendís home.

" Hide the car keys.

" Exchange car keys with a set of unusable keys. Some people

with AD are in the habit of carrying keys. 

" Place a large note under the car hood requesting that any

mechanic call you before doing work requested by the person

with AD.

" Have a mechanic install a ìkill switchî or alarm system that

disengages the fuel line to prevent the car from starting.

" Consider selling the car and putting aside the money saved

from insurance, repairs, and gasoline for taxi funds.

" Do not leave a person with AD alone in a parked car.

Home Safety for People with Alzheimerís Disease

page 29

Natural Disaster Safety

Natural disasters come in many forms and degrees of severity.

They seldom give warning, and they call upon good judgment and

ability to follow through with crisis plans. People with AD are at a

serious disadvantage. Their impairments in memory and reasoning

severely limit their ability to act appropriately in crises.

It is always important to have a plan of action in case of fire,

earthquake, flood, tornado, or other disasters. Specific home

safety precautions may apply and environmental changes may 

be needed. The American Red Cross is an excellent resource 

for general safety information and preparedness guides for

comprehensive planning. If there is a person with AD in the

home, the following precautions apply:

" Get to know your neighbors, and identify specific individuals

who would be willing to help in a crisis. Formulate a plan of

action with them should the person with AD be unattended

during a crisis.

" Give neighbors a list of emergency numbers of caregivers,

family members, and primary medical resources.

" Educate neighbors beforehand about the personís specific

disabilities, including inability to follow complex instructions,

memory loss, impaired judgment, and probable disorientation

and confusion. Give examples of some of the simple one-step

instructions that the person may be able to follow.
Home Safety for People with Alzheimerís Disease

page 30

" Have regular emergency drills so that each member of the

household has a specific task. Realize that the person with AD

cannot be expected to hold any responsibility in the crisis plan

and that someone will need to take primary responsibility for

supervising the individual.

" Always have at least an extra weekís supply of any medical or

personal hygiene items critical to the personís welfare, such as:

# food and water

# medications

# incontinence undergarments

# hearing aid batteries

# glasses

" Be sure that the person with AD wears an identification

bracelet stating ìmemory lossî should he or she become lost 

or disoriented during the crisis. Contact your local Alzheimerís

Association chapter and enroll the person in the Safe Return

program.

" Under no circumstances should a person with AD be left alone

following a natural disaster. Do not count on the individual to

stay in one place while you go to get help. Provide plenty of

reassurance.
Home Safety for People with Alzheimerís Disease

page 31

Who Would Take Care of the Person with

AD if Something Happened to You?

It is important to have a plan in case of your own illness,

disability, or death.

" Consult a lawyer regarding a living trust, durable power 

of attorney for health care and finances, and other estate

planning tools.

" Consult with family and close friends to decide who will

take responsibility for the person with AD. You also may

want to seek information about your local public

guardianís office, mental health conservatorís office,

adult protective services, or other case management

services. These organizations may have programs to

assist the person with AD in your absence.

" Maintain a notebook for the responsible person who will

be assuming caregiving. Such a notebook should contain

the following information:

# emergency numbers 

# current problem behaviors and possible solutions

# ways to calm the person with AD 

# assistance needed with toileting, feeding, or grooming

# favorite activities or food

" Preview board and care or long-term care facilities in

your community and select a few as possibilities. If the

person with AD is no longer able to live at home, the

responsible person will be better able to carry out your

wishes for long-term care.
Home Safety for People with Alzheimerís Disease

page 32

Conclusion

Home safety takes many forms. This booklet focuses on the

physical environment and specific safety concerns. But the home

environment also involves the needs, feelings, and lifestyles of

the occupants, of you the caregiver, your family, and the person

with AD. Disability affects all family members, and it is crucial

to maintain your emotional and physical welfare in addition to a

safe environment. 

We encourage you to make sure you have quiet time, time out,

time to take part in something you enjoy. Protect your own

emotional and physical health. Your local Alzheimerís

Association chapter can help you with the support and

information you may need as you address this very significant

checkpoint in your home safety list. You are extremely valuable

and as you take on a commitment to care for a person with AD,

please take on the equally important commitment to care for

yourself.

Home Safety for People with Alzheimerís Disease

page 34

Additional Resources

Several organizations offer caregivers information about AD. To

learn more about support groups, services, research, and additional

publications, you may wish to contact the following groups.

Alzheimerís Association

The Alzheimerís Association is a nonprofit organization that

supports families and caregivers of people with Alzheimerís

disease. Local chapters provide referrals to local resources and

services and sponsor support groups and educational programs.

Online and print versions of publications also are available. In

addition, the Association offers the SAFE RETURN program to

help in the identification and safe, timely return of people with

Alzheimerís disease and related dementias who wander and

become lost. The Association maintains a national photo/

information database and staffs a 24-hour toll-free emergency

crisis line. 

919 North Michigan Avenue

Suite 1100

Chicago, IL 60611-1676

1-800-272-3900

Web address: www.alz.org 

e-mail address: info@alz.org 
Home Safety for People with Alzheimerís Disease

page 35

Alzheimerís Disease Education and Referral

(ADEAR) Center

This service of the National Institute on Aging is funded by the

Federal government. It offers information and publications on

diagnosis, treatment, patient care, caregiver needs, long-term

care, education and training, and research related to AD.

Publications and videos can be ordered through the ADEAR

Center or via the web site.

PO Box 8250

Silver Spring, MD 20907-8250

1-800-438-4380

Web address: www.alzheimers.org 

e-mail address: adear@alzheimers.org

American Red Cross

The Red Cross offers health information, health services, disaster

relief, and emergency services to the public. Local chapters

provide programs for older people, including safety courses and

home nurse care instruction. 

430 17th Street NW

Washington, DC 20006

1-800-435-7669

Web address: www.redcross.org 

e-mail: info@usa.redcross.org 
Home Safety for People with Alzheimerís Disease

page 36

Children of Aging Parents

This nonprofit group provides information and materials for adult

children caring for their older parents. Caregivers of people with

Alzheimerís disease also may find this information helpful.

1609 Woodbourne Road, Suite 302A

Levittown, PA 19057

1-800-227-7294

Web address: www.caps4caregivers.org

Eldercare Locator

The Eldercare Locator is a nationwide, directory assistance

service helping older people and their caregivers locate local

support and resources for older Americans. It is funded by the

Administration on Aging (AoA). The AoA Alzheimerís disease

Resource Room contains information for families, caregivers,

and professionals about AD, caregiving, working with and

providing services to people with AD, and support services.

1-800-677-1116

Web address: www.eldercare.gov

Family Caregiver Alliance

The community-based nonprofit organization offers support

services for those caring for adults with AD, stroke, traumatic

brain injuries, and other cognitive disorders. Programs and

services include an information clearinghouse.

690 Market Street, Suite 600

San Francisco, CA 94104

415-434-3388

Web address: www.caregiver.org
Home Safety for People with Alzheimerís Disease

page 37

Well Spouse Foundation

This nonprofit membership organization gives support to wives,

husbands, and partners of the chronically ill and/or disabled.

Well Spouse publishes the bimonthly newsletter Mainstay.

63 West Main Street, Suite H

Freehold, NJ 07728

1-800-838-0879

Web address: www.wellspouse.org 

Ageless Design

Consultation services, architectural design review, books,

articles, brochures, pamphlets, and audiotapes are provided by

this organization.

Web address: www.agelessdesign.com 

Elder Care Online

Information, education and support for caregivers, safety advice,

and links to additional caregiver resources are featured on this

Web site maintained by Prism Innovations, Inc.

Web address: www.ec-online.net 
Notes:
Notes:
National Institutes of Health

National Institute on Aging

Alzheimer's Disease Education and

Referral (ADEAR) Center

The National Institute on Aging gratefully

acknowledges the caring staff of the

Alzheimerís Disease Research Center at the

University of California, San Diego, and the

Alzheimerís Association of San Diego, who

shared their valuable advice, experience, and

expertise to create this booklet.