Making the Environment Safe for Alzheimer’s Patients

We would not think of placing sight-impaired individuals in an environment without making adjustments for their disability. Similarly, we are expected to make adjustments for Alzheimer’s and other memory-impaired patients; they may see but their perception of what they see could be faulty. They may also forget the features of their environment, giving caregivers cause to boost their sense of safety again and again.

Family Learning Center ® teaches that “it is less about physical structures and more about the feeling inspired by the quality of the place.”

This article aims to guide the caregiver into creating an environment which inspires a sense of safety in Alzheimer's patients.


Clean living room with ample lighting and clutter-free space

Photo by Derek Jensen
Photo by Derek Jensen | Source

The importance of a good physical environment is to "encourage and support independence while promoting safety." - Alzheimer's Association

General Safety Guidelines

  • Make the environment as consistent as possible to inspire feelings of stability and security. Avoid redecorating and rearranging too often. Use the same daily schedule as much as possible.
  • Too much open space, too much clutter, too much noise or too many people can cause agitation in people with dementia. Monitor carefully.
  • Keep furniture and furnishings simple and attractive. Patients may feel anxious surrounded by too many plants, ornaments and pieces of art.
  • Maintain a low level of sounds: no shouting; no loud rock or rap music.
  • Keep living areas bright during the day; at night, use night-lights.
  • Help create a safe, friendly atmosphere by displaying a cheerful disposition. Patients can be affected (positively or negatively) by facial expressions and body language.


Physical Cues

Any space which is open and accessible to the patients is considered their physical environment. With memory loss it is easy for them to lose their sense of direction. Signs and labels can be used as cues to help them navigate their way.

  • Names/Photos on Bedroom Doors

They may gain a sense of independence looking for, and finding their names or photos on their bedroom doors--even if they wander around before they find it.

Example of a Rest Room Sign

Photo by Jan Křivka
Photo by Jan Křivka | Source
  • Picture Signs

Customary signs help them recognize the bath room, the dining room, and other designated areas.

  • Color and Art

Color and art are also more helpful than verbal directions. Finding the green door or the picture of a tree on the door, is easier than finding “the door on the right” or “the second door down the hall.”

Because older people with memory impairment usually suffer from vision impairment, it helps if door frames are painted in a color which contrasts with the wall.

Can This Floor Pattern Be Scary?

Photo by Piotr Siedlecki
Photo by Piotr Siedlecki | Source
  • Solid Floor Colors

Some forms of dementia include psychosis which makes the individuals see holes where there are dark colors in a pattern.

Rugs with busy patterns and dark sections like the one to the right are not recommended.

Erase fear, and boost their sense of safety with solid colors for floors and rugs.

A runner in a contrasting solid color can also be a good guide from the bedroom to the bathroom.


Sensory Input

Sensory input into the physical environment affects the security of the Alzheimer’s patient. The sights and sounds of chaos or an overpowering scent may confuse them. When the input is pleasant, it can reduce their anxiety and depression, and increase their social interaction.

  • Sight

Some dementia with psychosis also make individuals see people and things that are not there. Rather than disagree with them about what they see, just assure them that they are safe. Boost their sense of safety with well-lit rooms, familiar photos and flowers.

Background Music Poll

Did you ever think that background music has an adverse effect on anyone?

See results without voting
  • Hearing

Memory impaired individuals also have difficulty interpreting sounds. Background music is annoying. It can be confusing when they try to listen to someone speak, while at the same time they are hearing additional sounds. Television and music tapes should be turned on specifically for the patients to listen, not to keep playing continually. When there is a listening activity, play their kind of music and encourage sing-a-longs.

  • Touch

Touch is important when the patients have difficulty interpreting what they see and hear. In addition to offering them a cool drink, let them touch the glass. Let them put a hand in the warm water to convince them that the temperature is comfortable for bathing.

  • Taste and Smell

“Weight loss happens to almost everyone with memory loss unless special attention is paid to the senses [taste and smell] involved with eating. . . Popcorn poppers or bread makers are two examples of things that have had great results for increasing the smells that stimulate hunger.” - Family Learning Center ®


The Optimal Environment

(according to the Alzheimer’s Association in "Dementia Care Practice Recommendations for Assisted Living Residences and Nursing Homes")

  • Privacy
  • Sufficient lighting
  • Pleasant music
  • Multiple opportunities to eat and drink
  • Private bedroom and bathroom
  • Personal furnishings, pictures and other items in the living area
  • Easy, safe access to the outdoors
  • Control over unauthorized exits
  • Opportunity to walk around for those who have the tendency to wander off

Human Contribution

The most important human being in the patients’ space is the caregiver. For safety purposes, friendliness is more important than professionalism. They feel safer cooperating with a friend than with a professional helper.

Different people contribute differently to the environment. It depends on who they are—family members, clergy, health care professionals. All should be encouraged to give priority to the interest and safety of the patients. Respect and privacy should be given at all times.

Large crowds of visitors are not welcome. The scene may appear too busy; plus conversation and laughter can easily become too loud. One and two visitors at a time are more acceptable. As the patients’ ability to communicate diminish, it becomes more important to surround them with people who really care and respect their need to feel safe.


Keep medicine cabinets locked.

Photo by MKFI
Photo by MKFI | Source

Additional Safety Tips

Here are a few other safety tips which cater to both the safety and independence of the patients.

  • The height of the beds should allow the patients' feet to touch the floor, enabling them to get out of bed with minimum effort.
  • Use bed rails, not to keep bedridden individuals in bed, but for safety purposes: moving from side to side, or from bed to chair.
  • Use non-slip mats in the bathrooms to prevent slips and falls; keep the floor clean and dry.
  • Hand-held showers help the patients maintain their independence and dignity; they should be lightweight.
  • Medical prescriptions should not be accessible to the patients until administered by the caregiver.


References

Alzheimer's Association: Dementia Care Practice Recommendations for Assisted Living Residences and Nursing Homes, Copyright 2009 by Alzheimer's Association.

Generations Home Care: Family Learning Center ®, Environment is Important; Creating a Calming, Restful Environment; Environmental Hazards & Safety, Copyright 2015 by Institute for Professional Care Education®.

© 2016 Dora Isaac Weithers

More by this Author


Comments 52 comments

Ericdierker profile image

Ericdierker 9 months ago from Spring Valley, CA. U.S.A.

enlightening. The color aspect is very interesting.


Blond Logic profile image

Blond Logic 9 months ago from Brazil

This has been an eye opener for me. I never realized the potential problems which could occur. For example, the multi-colored carpets appearing as though it is a hole.

The brain is so complex and changes such as those seen in Alzheimer's patients must be life changing for everyone.

Also the idea of picture art instead of words makes sense as does colored door frames.

A very interesting article.

With your permission, I would love to put a link to this on one of my recent hubs.


rajan jolly profile image

rajan jolly 9 months ago from From Mumbai, presently in Jalandhar,INDIA.

Useful and practical ideas. Thanks for sharing.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Eric, thanks for following. All this new information is interesting for me too. Alzheimer's is turning into an ardent teacher.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Mary, thanks for your feedback. Please place your link and share. I am so anxious for other people to learn so that we all may be better prepared to care for these patients, especially the number increases daily.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Rajan, I like it when readers consider my articles useful. Thanks for your encouragement.


sukhneet profile image

sukhneet 9 months ago from India

Thanks for the write- up. I completely agree with Blond Logic and have happened to collect a lot of information on Alzheimers after going through your work. Really informative


sallybea profile image

sallybea 9 months ago from Norfolk

MsDora

This subject is fascinating, the human mind is an extraordinary thing but when the mind does not function as it should it is heartbreaking in the extreme. These hubs are so very useful for people caring for family or friends with Alzheimer’s. I watched the film Awakenings two evenings ago for the second time and marvelled at the empathy shown by Robin Williams for the patients with similar or the same condition. If a cure were as simple as taking a pill it would be wonderful but sadly it is not. Thanks for sharing this info.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Sukhneet, you make me happy to know that you find the information helpful. Nowadays, the disease is becoming more popular and I think everyone needs to know something about Alzheimer's. Thanks for your comment.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Sally, thanks for your encouragement. I am now discovering how complex this situation is. I am recommending to my friends that we watch as many movies as possible on this situation. It helps our understanding.


denise.w.anderson profile image

denise.w.anderson 9 months ago from Bismarck, North Dakota

Medication has been an issue for my father, who is living at my brother's home. The last time we visited, they said that he had gotten up in the night and taken his medicine, and it made him disoriented during the day. Now, like you have recommended here, they are keeping it under lock and key. It is interesting the things we learn from our own sad experience!


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Denise, thanks for affirming the importance of locking the medicine cabinet. So happy that nothing worse happened to your father. Thank you for sharing.


DDE profile image

DDE 9 months ago from Dubrovnik, Croatia

Hi MsDora you shared an important topic and always useful from you. Often medication can be forgotten your ideas are effective.


billybuc profile image

billybuc 9 months ago from Olympia, WA

Great points and suggestions, Dora. This is something that never dawned on me...so thank you! I hope many read this. This is important information.


word55 profile image

word55 9 months ago from Chicago

These are great tips Dora. You are consistently sharing great ideas. I'll bet your mom really appreciates you and I do too!


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Thanks, Devika, for your kind comments always. I enjoying sharing while I'm learning.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Thanks, Bill. Much of this information is new to me too. Glad to discover that I'm not alone in my ignorance of this disease.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Thanks Word. My mother is not aware of me, lots of the time but I keep striving for her appreciation. You encourage me.


FlourishAnyway profile image

FlourishAnyway 9 months ago from USA

This is very useful to caregivers for providing a better environment for those with dementia. You have such a well of empathy.


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Thanks, Flourish, and there is still lots more to learn. Paying attention to these facts makes us better caregivers.


lifegate profile image

lifegate 9 months ago from Pleasant Gap, PA

Hi Dora,

Better late than never. You brought up a lot of things I probably would have never thought about, although I probably should. Thanks for the information. It's good to know these things. thanks!


MsDora profile image

MsDora 9 months ago from The Caribbean Author

Bill, happy to share what I have learned. Some things we never think about until we are in that certain situation. Thanks for the feedback.


Michael-Milec profile image

Michael-Milec 9 months ago

MsDora, only patience, love and understanding comes with such a valuable information, and you're manifesting all these virtues throughout this article as well many others, making us knowledgeable to use them as needed, when needed.

Thank you and may the good Lord bless and protect you.


Faith Reaper profile image

Faith Reaper 9 months ago from southern USA

Wow, MsDora, You have given us much to think on and oh so important facts here for all those caring for those with dementia. Some of these were eyeopeners for me!

Thank you for this important hub.

God bless you


Jackie Lynnley profile image

Jackie Lynnley 9 months ago from The Beautiful South

(Just found notice of this way down in my email, sorry. Have a great number more email last several day!)

These are some really great tips Dora, many I would not have thought of and I considered myself pretty observant of safety! Such as rug patterns for example. This well could explain Alzheimer's patient actions sometimes that we wonder what in the world, not thinking of something this simple.

You are doing a great service here! Keep up the good work!


MsDora profile image

MsDora 8 months ago from The Caribbean Author

Michael, always happy to read your beautiful comments. Thanks for your kind words and God's blessings on you too.


MsDora profile image

MsDora 8 months ago from The Caribbean Author

Faith, thanks for your feedback. Happy to share these interesting finds. God bless you, too.


MsDora profile image

MsDora 8 months ago from The Caribbean Author

Jackie, thanks for choosing this to read. True, sometimes the Alzheimer's patient will do things we do not understand because we do not understand what and how they think. Every morning my mother insists that the floor is wet and that her feet are sliding. Nothing I try makes her say differently.


RTalloni profile image

RTalloni 8 months ago from the short journey

A really important post for those caring for patients in-home and for those who must place a patient in a facility. Thank you for putting this guide together so others can draw from it.

I witnessed an effort in a nursing home to provide beautiful music to patients. It was amazing to see the difference in the patients. They were calmer and some commented on enjoying it. Sadly, the staff, especially the night staff, wanted raucous music and rejected the beautiful. In the end, no music was allowed. It was heartbreaking to see.


MsDora profile image

MsDora 8 months ago from The Caribbean Author

RTalloni, your is a very important share. What a pity these selfish staff members forgot why they were there--for the patient's well being. The music they want and deserve to hear is their kind of music. Thanks for your input.


Frank Atanacio profile image

Frank Atanacio 8 months ago from Shelton

MsDora, your tips and your caring is so grounded you are simply an amazing woman and perhaps caregiver God bless you :)


MsDora profile image

MsDora 8 months ago from The Caribbean Author

Frank, you are always so kind. Thank you. I try to deserve these sweet comments.


manatita44 profile image

manatita44 8 months ago from london

A lot here. I know that you do research, but do you find that you have to apply much of what you read, in addition to your own experience? Does it enrichen and empower you? Good to know.

Well-presented Hub. Much Peace.


Nell Rose profile image

Nell Rose 8 months ago from England

Amazing advice and something everyone should read when they have some one in the family with Alzheimers, nell


MsDora profile image

MsDora 8 months ago from The Caribbean Author

Thanks, Manitata. I have learned much from the research, and yes, I find much of it relevant to my situation. The information helps me understand some of my mother's strange behaviors, and makes me more compassionate. So, yes; it enriches and empowers me.


MsDora profile image

MsDora 8 months ago from The Caribbean Author

Nell, I find the information very useful and I hope others who need it find it so, too. Thanks for your feedback.


ChitrangadaSharan profile image

ChitrangadaSharan 8 months ago from New Delhi, India

Great hub that is immensely informative!

All your suggestions and tips are so important while taking care of a Alzheimers patient. The recommendation about the floor colour is noteworthy and even keeping the medicine cabinet locked is so important.

Thank you so much for sharing this valuable hub with others!


aviannovice profile image

aviannovice 8 months ago from Stillwater, OK

Safety is such an important thing. If I had thought about it, I could have come up with a list like this. I believe that if we think about it, we can safely care for another adult. Who knows, this could happen to us eventually. Better to be safe, than sorry.


MsDora profile image

MsDora 8 months ago from The Caribbean Author

Thanks, Chitrangada. I appreciate your affirmations and am glad to share what I learn on this topic.


MsDora profile image

MsDora 8 months ago from The Caribbean Author

Deb, your right. Caregiving becomes easier when we put our minds to it. Thanks for your input.


vocalcoach profile image

vocalcoach 8 months ago from Nashville Tn.

Another very helpful hub for we who have loved ones living with this difficult disease. I,m grateful for your articles as each one provides insight. Thanks again Dora. Sharing.


MsDora profile image

MsDora 8 months ago from The Caribbean Author

Audrey, I appreciate knowing that you find the articles helpful. You encourage me. Thanks!


Peggy W profile image

Peggy W 8 months ago from Houston, Texas

I have an aunt in a memory care unit and a friend whose husband is also in one. I did know some of what you wrote but not all. Thanks for writing this. I will be sharing it, pinning and also tweeting.


MsDora profile image

MsDora 8 months ago from The Caribbean Author

Thanks, Peggy, for reading, commenting and sharing. Happy the article helps the people you mentioned. Best to all!


shanmarie profile image

shanmarie 8 months ago from Texas

Very interesting, particularly the information about the rug patterns. I had not considered that before. Thanks.


MsDora profile image

MsDora 8 months ago from The Caribbean Author

Shanmarie, there all sorts of facts I never considered before I started researching the topic. Glad to share.


bravewarrior profile image

bravewarrior 8 months ago from Central Florida

Dora, I'm going to share this article with a co-worker who has a friend in a memory care center. She visited her a couple of weeks ago and was appalled to see that the bed is entirely too high for her friend to get in and out of easily.

I can see how background music could be annoying. Although I always have background music playing for motivational purposes, I can fully appreciate that it could have the opposite effect on someone who has concentration or recognition issues.

Great article, once again, Dora!


MsDora profile image

MsDora 8 months ago from The Caribbean Author

Thanks for your feedback Shauna, and for sharing the article. The background music may be okay for us who can appreciate it. Dementia patients may not be able to figure out the source of the sound, and that may confuse them.


PegCole17 profile image

PegCole17 5 months ago from Dallas, Texas

All these are truly helpful clues in caring for the elderly and those with Alzheimers. I noticed that my 96 year old auntie becomes quite distressed when her bed has shifted from its usual place and is pushed too close to the wall or is left askew by the caregivers. She frets over the pattern on the dining room table, continually wiping it off with her hand as though something is spilled there as her vision has diminished. Also, when things are moved around in her space it becomes quite disturbing. What she does enjoy is watching the birds that flock to the bird feeder just outside her window.

Thanks for sharing this valuable list of things that will help others in caring for senior patients with challenges.


MsDora profile image

MsDora 5 months ago from The Caribbean Author

Peg, glad it helps and thanks for the feedback. I only learned these facts in my research on caring for my mother. They helped me too.


NewLifeOutlook profile image

NewLifeOutlook 4 months ago

Really interesting! I found the sensory component most intriguing — there is so much more to Alzheimer's than meets the eye. Thanks for sharing!


MsDora profile image

MsDora 4 months ago from The Caribbean Author

Thanks for your feedback, NLO. I share your view; there's so much about Alzheimer's I knew nothing about until I became a caregiver to my mother. Glad to share.

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