How to Keep an Aging Parent with Dementia Safe

As our loved ones age, we often worry more about their safety. It’s a valid area of concern, given a person’s ability to care for themselves often decreases with age.

Concern about safety is even more relevant when a loved one has dementia, as the condition impacts their memory and cognition, making it harder for them to support themselves.

While some people with dementia may be able to live independently for a surprising amount of time, most will need extra support at some point or another – especially as the condition progresses.

So, what can adult children do to keep an aging parent with dementia safe?

Ways to Support Your Aging Parent with Dementia

Learn All You Can

First, it’s crucial to learn about dementia, particularly the type of dementia your loved one has been diagnosed with. This includes learning about how symptoms are expected to progress and the timeframe.

Notably, you need to go beyond the immediate challenges. Do some hard reading and learn what the future may look like, including what happens towards the end of a dementia journey.

Some of the things you learn may be unsettling. Others will be devastating.

It’s tempting to skip this step and only learn what you need to as their condition progresses. Yet, learning is crucial for keeping a parent with dementia safe. By doing so, you can start to prepare for issues before they happen, reducing the risk of wandering, falls, car accidents, and other serious issues.

Learning also means you can start thinking and talking about some of the big decisions now – like deciding when your loved one might move to memory care. These conversations and decisions will be easier now than when you’re dealing with the practical and emotional hits of mid-to-late stage dementia.

Learning about dementia has another important benefit too, it helps you be compassionate. The more you understand about the progression and symptoms of dementia, the easier it is to recognize that the senior isn’t intentionally being difficult. Being compassionate makes it easier to provide gentle care and promote the best outcomes for you and the person with dementia.

Adapt to Changes in their Ability

Dementia is progressive, so the symptoms get gradually worse over time.

To keep your loved one safe, the support you provide will need to change along with their abilities. At the beginning, you might just need to help with a few tasks, like cooking or driving them to get groceries. Later, you may need to help them with more mundane tasks, including eating and toileting.

The senior’s ability to understand instruction and logic will also decrease, requiring additional changes to how you support them. It’s important to keep an eye out for such changes and adapt to them. Doing so makes life better for your aging parent, while hopefully decreasing your stress levels as well.

Simplify The Home

Simplifying the home can reduce confusion and overwhelm for people with dementia, helping them to navigate the home better. Some approaches include: 

• Reducing the number of knick-knacks and other items on surfaces.
• Reducing wall decorations and ensuring those that remain have simple designs.
• Choosing neutral colors over bright ones, and plain designs over patterns. This may include changing upholstery and bed covers to simpler colors and designs.
• Use contrasting colors to help the senior distinguish between items.
• Reducing the senior’s wardrobe to contain fewer items, focusing on ones that are familiar and cause the least confusion.
• Improve the lighting, so navigation is easier. This includes using nightlights and sensor lights, so the senior is never trying to walk in the dark.
• Consider labeling items, like having labels on cupboards to show what is in them. Some people use image-based labels or even photos. This can be powerful, as seniors may be unable to remember what is in cupboards as their dementia progresses (Wendy Mitchell talks about some of this in her book What I Wish People Knew About Dementia).

These approaches are powerful, as dementia impacts a person’s ability to process information, including visual information. Simplifying the environment results in less confusion, which reduces the risk of accidents and helps the senior feel more confident.

When simplifying, choose the items that remain carefully. Look for ones that will help the environment feel safe and familiar to the senior, like familiar photographs or paintings.

Make the Living Environment Safe

Simplifying isn’t enough on its own. You also need to take steps to make the living environment as safe as possible. Here are some crucial approaches to consider.

• Remove trip hazards. This includes removing loose rugs and electrical cords, which can increase the risk of falling. Non-slip pads can be used to secure rugs, but sometimes it’s better to remove them completely.
• Create more space. Larger walkways with fewer items to navigate helps to protect against falls and make the home less confusing.
• Use assistive tools. Grab bars, raised toilet seats, shower chairs, and ramps are just a few tools that can make the home safer and easier to navigate. It’s best to introduce these before they’re needed, so the senior has time to adapt to them.
• Use automatic shutoff products in the kitchen. Seniors with dementia may forget what they’re doing and leave a task incomplete. Automatic shutoffs for devices like kettles and ovens are crucial for protecting them and reducing the risk of a fire.
• Setup a medical alert system. Such systems allow seniors to call for help in the case of an emergency. There are also fall detection devices, like fall detection watches, that require little input from the wearer.
• Secure potentially dangerous items. Medications, cleaning supplies, and other potentially harmful items should be secured away, especially as dementia progresses and seniors no longer understand the appropriate uses of such items. Childproof locks can be effective here or you might store these items in the back of a high cupboard.

You may also want to get an external perspective, particularly from someone who can look through your home. Aging in place specialists, home health nurses, social workers, and dementia care consultants may offer advice about how to make your home more dementia friendly.  

Monitor Wandering

You should also pay attention to wandering behavior. This is a common challenge and can happen at any stage of the dementia journey.

While the issue happens often, it can also be terrifying for family members, as you don’t know where the person with dementia is or how to find them. The person with dementia is also likely to be confused and scared, which increases the risk that something bad happens.

The Alzheimer’s Association provides many tips to help reduce the risk of wandering, including keeping your loved one engaged and ensuring their basic needs are met. GPS trackers and medical alert devices can also be useful for tracking the senior and providing support.

Door locks are helpful too, particularly for keeping seniors out of some rooms. These can also be used to secure cupboards with chemicals and medications.

But, don’t use these to simply lock the senior inside. Doing so is likely illegal and can be highly stressful, and sometimes even terrifying, for the senior.   

Help with Health Management

Basic health practices are still relevant for people with dementia, including a healthy diet, sufficient hydration, and exercise.

However, the senior’s ability to keep themselves healthy will decrease as dementia progresses. Caregivers will need to take an active role in ensuring their loved one eats healthy meals, drinks enough water (dementia water balls can help here), gets to bed at a good time, and gets enough exercise.  

In the early stages of dementia, it may be enough to simply remind the senior to do important tasks, like drinking water or going to the bathroom. You may need to get more involved later on, like getting creative with how food is presented to help them eat or creating a peaceful environment in the bedroom to encourage sleep.  

Ensure They Visit The Doctor Regularly

Doctor visits are crucial for seniors with dementia. The doctor can help you ensure the senior stays as healthy as possible and that any health issues are identified early.

It’s also important to talk about symptoms you notice and how these change.

Notably, some changes to symptoms might not be a direct result of dementia, but due to a treatable condition. UTIs are one example of this, often leading to increased confusion, agitation, and even hallucinations.

Talking to a doctor is especially important as dementia progresses, as those with the condition may no longer be able to tell you that they’re in pain.  

Help with Medication Management

Medications need to be taken at the right time, without missing doses or doubling up. Even without dementia, this can become quickly complicated and confusing, especially when people have multiple chronic conditions.

Some tools make this process much easier, including pill organizers and medication management apps. You can also look for pharmacies that offer automatic prescription refills or prescription delivery.

However, even these tools won’t be enough as dementia progresses. Family members may need to step in to ensure the senior takes their medications when they need to. If no one is available, consider hiring paid support, like a nurse to help with medication management.

You should also regularly review the senior’s medication list with their healthcare provider. This helps prevent adverse interactions and overmedication. This is important, as seniors can easily end up taking medications they don’t even need.

Provide Emotional and Cognitive Support

Treat Them With Respect and Dignity

Respect and dignity are watchwords for dementia care.

No matter who the individual is or the stage of their dementia journey, they deserve to be treated well.

It’s also important to remember that people in the later stages of dementia don’t revert to being children. They’re still adults and experience the world in very different ways than children do.

Person-centered care is a valuable approach to consider. This involves focusing on the person themselves, rather than the symptoms of dementia (even in the late stages of the disease). As part of the process, you’ll often think about your loved one’s preferences, their history, and the things they love.

As some forum members have pointed out, sometimes we need to care for our parents as if they were children, like ensuring they don’t drive and don’t get sucked into scams. But, we don’t need to treat them like children and talk down to them.

Focus on Familiar Routines

Routines are one of the most powerful tools for dementia care. They help reduce anxiety, improve sleep, and even decrease disruptive behaviors.

Routines help, in part, because they provide a sense of structure and control. This can help reduce distress, allowing people with dementia to cope better with a world they don’t fully understand.

Using routines is an interesting idea, as dementia has considerable impacts on memory. Yet, people with dementia still remember some things, and their implicit memory stays intact for much longer than their explicit memory. This means that routines can still have a positive impact, even when the person with dementia seems to not remember any of the routine.

Promote Social Interactions

Social engagement matters to all of us, including people with dementia.

Unfortunately, those with dementia can easily end up isolated, as friends and family members don’t understand what’s happening and don’t know how to engage.

Adult children may need to be proactive in promoting social interactions. Part of the process may involve teaching family members how to engage with the person with dementia. You may need to be present during some visits, especially if the family member doesn’t know what to expect.

There are also external sources of connection, including programs that are specifically designed to help people with dementia to connect socially. You may find programs run through adult day centers, senior centers, and some faith-based organizations, programs that are often run by trained staff who can support and facilitate connection.

Some dementia support groups are also carefully designed so there’s a chance for caregivers to learn from each other while those with dementia can connect as well.  

Keep Them Engaged

People with dementia don’t engage in life in the same way they once did, especially as the symptoms progress. But, engagement remains important regardless of the symptoms.

There should be regular chances for cognitive stimulation, physical activity, social connection, and meaningful connection throughout the days and weeks. Such engagement helps with mental and physical health, while also reducing problematic behaviors.

During the early stages of dementia, activities will often be familiar, including walking, dancing, gardening, puzzles, games, and reading. The person with dementia will be able to do many of the same things they could before, although they may need assistance for some of these. Other times, the activity may need to be simplified so the senior can complete it without frustration.

During the middle stages, activities may need to be further simplified and more assistance may be needed. You can also start looking for activities that are designed for those with dementia, like dementia puzzles. Breaking activities down into simple steps can be helpful too.

During the later stages, familiar activities may no longer be possible. Instead, you can engage with the senior through their senses, such as by playing music or aromatherapy. Physical contact can be powerful here too, as can simple interactions like singing familiar songs and looking at photo albums. Some people also do well with fidget blankets or lifelike companion pets.   

In all stages, it’s important to focus on the experience of the activity – not whether the senior completes it or how well they do.

You should also adapt the activity to the senior’s abilities. Look for activities that are require effort but are not frustrating.

Sometimes this will involve choosing no-lose activities, things like dancing, listening to music, art, and sensory engagement. Such approaches reduce frustration and promote self-esteem. They also keep the focus on enjoyment, so seniors aren’t trying to get things ‘right’.

Establish a Strong Support Network

A support network is crucial for you and your loved one – as you can’t do it all on your own.

This is also a tough topic, as many caregivers find it almost impossible to get others to help. One trick is to get people involved early and do so gently.

This includes talking honestly about your loved one’s dementia diagnosis, what it’s likely to mean in the future, and how things are now. You may also start getting people to help out long before it feels like you need the support.

There are a few benefits to seeking help this early.

• Doing so helps people get more comfortable with your loved one and some symptoms of dementia when things are relatively straightforward. This type of experience makes it easier to provide support later on,
• Seeking help early reduces the chance that you’ll get overloaded. It also helps you and your loved one feel more connected, which is a powerful outcome all on its own.
• If you’re seeking help early, the requests are probably small. This makes it easy for people to say yes and get into the rhythm of helping often. Some may be less able to help as the dementia worsens, while others will stay the course.

Seriously – don’t wait until you need help to ask for it. Ask early and ask often.  

Remember that people vary in their capacity and often have challenges we can’t see. This is one reason why some siblings help with caregiving, while others don’t get involved at all.

Other Areas to Consider

Plan for Financial, Medical, and Other Challenges

Protecting someone with dementia doesn’t stop with the practical tasks. There are less tangible areas to consider as well, including protecting them financially and helping them to avoid scams.

Remember, when someone has dementia, their ability to understand the world around them decreases over time. Reasoning and rational thought become increasingly difficult, which can lead to poor decisions. Such issues also increase the senior’s vulnerability to scams and manipulation.

Part of the problem is that a person with dementia doesn’t necessarily know they have the condition. They’re likely to assume that their thinking is rational and may not second-guess themselves.

Adult children sometimes need to be very proactive in this area. This may include becoming the parent’s Financial Power of Attorney to help protect them from devastating financial decisions.

Plan for End-of-Life

While not directly related to safety, it’s important to start thinking about and planning for end-of-life. This should be done sooner rather than later, so that the person with dementia can contribute as well.

End-of-life dementia conversations are tough, there’s no denying that.

Yet, avoiding them is so much worse. Without such conversations, you may have no idea about your loved one’s end-of-life wishes. How do they feel about being resuscitated if their heart stops? What about mechanical ventilation or tube feeding?

These questions are very relevant, as there are some incredibly challenging situations in the late stages of dementia.

For example, as dementia progresses, the senior’s body increasingly struggles to fight off infection. Illness and injury also take longer to recover from and recovery may not be complete. This can lead to increasing time spent in hospital and less time spent at home.

Dementia-related confusion makes this whole situation worse. It can mean that seniors are terrified in the hospital environment, with no idea what’s happening and why.

At this stage, the person with dementia won’t be able to make decisions for themselves. A family member or Medical Power of Attorney will need to do so instead. Making such decisions is much easier when you know what your loved one would have wanted.

Take Care of Yourself

Finally, family members need to take care of themselves, which includes getting enough rest and caring for your emotional needs. This is particularly important for anyone providing hands-on care, as doing so has a high emotional toll and involves making many small decisions throughout the day.

Self-care is crucial for your own health.

But, this isn’t the only reason. Family members who are stressed, overwhelmed, or burnt out can easily make bad decisions when it comes to care. The caregiver’s stress could even lead to higher confusion and agitation for the person with dementia.

If you feel regularly overwhelmed, then it’s time to find additional support. This could come in the form of a paid caregiver or another family member chipping in. Or, it may be time to move your loved one out of home and into memory care.

Recognize When They’re No Longer Safe at Home

Finally, it’s important to pay attention to changes and recognize when the senior can no longer safely live at home.

There are two main decision points in this process.

The first is recognizing when the senior cannot live safely alone.

In that situation, the senior may still be able to live at home with additional support. This could include an adult child moving in with the senior or the senior moving into the adult child’s home (this is something to weigh up carefully, as there are many hidden challenges to shared living arrangements).

The second decision point is when it is no longer safe for the senior at home, even with support. This may happen when dementia symptoms have progressed to the point that the caregiver is incredibly overwhelmed or they are no longer confident they can keep the senior safe.

Notably, this doesn’t mean the caregiver has failed – not at all. The middle and late stages of dementia present many unique challenges, some of which are difficult to address in the home environment.

At this point, a senior may need to move to a memory care facility. Such environments can make the senior safer and improve quality of life, as they have skilled nursing staff, offer more structure than the home, and provide more opportunities for social connection.     

Final Thoughts

Dementia affects most aspects of a person’s life, including the ability to complete even simple tasks. So, it’s no surprise that there are many aspects to supporting someone with dementia. To do so well, you need to ensure their environment is safe, keep them engaged, promote good health, and plan for the future.

It’s also crucial to think about yourself in the mix.

Seriously. Most aspects of supporting someone with dementia involve being kind, gentle, and making good decisions. You can’t do any of those things well if you’re highly stressed and exhausted.

This is why it’s important to get people alongside you early and find support. If you are struggling with this, look at local agencies that specialize in senior care or dementia. They’ll be able to help tell you more about the types of support in your area and what you can look out for.