Living Safely at Home with Dementia

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1 Living Safely at Home with Dementia June 27 th, 2013 Sherri Howe, OT Reg. (Ont.) VHA & House Calls Team Cara Macanuel, OT Reg. (Ont.) Baycrest Community Behaviour Support Outreach Team (CBSOT)

2 Objectives Increase awareness of safety around the home environment Broaden your knowledge of cognitive deficits specific to home safety Further your awareness of appropriate equipment to be used to enhance client safety

3 Statistics As of 2010 over Canadians live with dementia (Alzheimer Society of Toronto, 2011). By 2015, with baby boomers reaching the age of 65, the number of Canadians with dementia will more than double to 1.1 million (Alzheimer Society of Toronto, 2011). There are more than new cases of dementia each year (approximately 1 new case every 5 minutes) (Alzheimer Society of Toronto, 2011). Environmental factors are the leading cause of falls (Rubenstein & Josephson, 2002). A 20% reduction in falls would result in approximately 7,500 fewer hospitalizations and 1,800 fewer permanently disabled older adults. This would translate to an overall annual savings in Canada of $138 million (Public Health Agency of Canada, 2005). One third of community-dwelling Canadian seniors experience one fall each year and half of those will fall more than once (Public Health Agency of Canada, 2008).

4 Living well with dementia. Look after your health Eat well Exercise daily Maintain a social life Sleep hygiene Self care Support Home safety

5 General Living Area Avoid scatter rugs Clear path, clutter free Phones easily accessible Emergency numbers Smoke detectors Carbon monoxide detectors Fire safety plan Furniture height Personal alarm systems Organization Signs and labels

6 Living Room Equipment Transfer aids

7 Wandering & Exit Seeking Prevention Tips Wandering Prevention Tips: Register with the MedicAlert Safely Home Program at the Alzheimer Society Have a laminated copy of the client s address and emergency contact numbers Consider an alarm for the door (motion detector) Consider removing the client s shoes from the door area Add an extra lock to the door in an unfamiliar area Install child-safety devices Notify neighbours Make note of the areas the client tends to visit most often Put a stop sign on the door Disguise the door Consider the meaning of the behaviour Increase activity throughout the day

8 Medication Tips Medications in blister pack/dosette Medication reminder devices Reminder notes Medication supervision Consider crushing medication* Speak to the pharmacist/md Safe storage

9

10 Kitchen Fire extinguisher Avoid wearing loose fitting clothing Keep sharp items in safe area Remove any clutter around the stove area Clearly mark temperature controls Disconnect stove Remove knobs on stove Automatic shut off appliances Stove alarm or burner covers Cupboards with glass doors Reminder signs Labels Consider Meals on Wheels or supervision

11

12 Bedroom Telephone within reach Nightlight or motion sensor Bed Height Bed rails (risks vs. benefits) Commode Label drawers with words or pictures Sequence clothing Use demonstration (pictures/signs) Consider duplicate outfits Bed alarm Intercom device

13 Bedroom Equipment Hospital beds Bed rails & Saskapoles

14 Bathroom Doors swing out Remove locks Nightlight Cover mirrors Avoid forcing the client Prepare in advance Past routine Allow client to do as much as possible Use demonstration Privacy robes Grab bars Bath chair/transfer bench Non slip mat/stickers in tub Dark mat/strips Coloured bubbles Reminder cues for toileting and hand washing Consider Purel or baby wipes Look for non verbal cues Toileting routines Remove planters/open garbage bins Consider a commode Toilet seat height Coloured toilet seat Hot water heater adjusted

15 Bathroom Equipment Raised toilet seats Bath chairs

16 Bathroom Equipment Cont d Tub transfer bench Tub clamps & Grab bars x

17 Bathroom Equipment Cont d Versa Frames & PT Rails Commodes

18 Stairwells Adequate light Non-slip surface Steps clearly marked One hand free to use handrail Hand rails on both sides Cleared of clutter Cleared of ice/water for outdoors Take one step at a time Duplicate items Supervision

19 Stairway Equipment Stair lifts

20 Outside Equipment Porch Lifts

21 Outside Equipment Cont d Ramps

22 Mobility Cane is for Pain Walkers are for Balance Height Appropriate footwear Review safe use of walking aid Use ramps Correct positioning & transfer techniques Reminder sign Supervision Consider auto stop breaks Manual wheelchairs Tilt wheelchairs

23 Mobility Equipment Canes & Walkers Manual Wheelchairs

24 Alice: Case Study Application Recommendations for Alice and Judy: Tips on medication compliance and monitoring Linking to community supports Improved personal care and hygiene Eliminating physical barriers Fire safety protocols Understanding the responsive behaviours Living safely at home with dementia

25 Questions?

26 THANK YOU!! Contact Info: Sherri Howe: , ext. 2893, Cara Macanuel: , ext. 2798,

27 References Alzheimer Society of Toronto, 2011 pamphlet Rubenstein LZ, Josephson KR. The epidemiology of falls and syncope. Clin Geriatr Med 2002;18: Public Health Agency of Canada. The Safe Living Guide: A Guide For Home Safety For Seniors. 3 rd Edition Revised, Public Health Agency of Canada. Report on Seniors Falls in Canada, 2005.

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