Friday, December 28, 2012

Dementia Safety Issue: Home Alone

There are many safety issues for people with Alzheimer's/dementia such as driving and falls, but by far one of the biggest safety issues is leaving someone with dementia home alone. For some reason most caregivers can understand the need to take away the car keys, put up grab bars and bed rails to prevent falls, but we have a hard time accepting the fact that it is not safe to leave someone with dementia home alone. I think this is due to a few factors, one is that not enough people have the ability to stay home with their loved one or the money to hire caregivers, the other is that our loved one is an adult and we assume they should be able to stay home alone.

Clearly, we need two things, first more resources for people to be able to hire caregivers or find ways to create a community volunteer system of companions for people with dementia. Second we need to accept the fact that even though our loved one is an adult, their mind is reverting back to a child. This does not mean we respect and love them any less, we are just understanding the change in their abilities and we will work to keep them safe.

As soon as you notice your loved one forgetting what they were doing in the house, leaving the stove on, wandering out during the day or night, falling, or being confused in their own house, it is not safe to leave them home alone, even if they are sleeping. This would most likely start in later mid-stage dementia. As dementia progresses, people revert back to a more child-like mind and ability. You will even notice that they may not recognize themselves in the mirror because they only recognize their face from when they were in their 20's. Cognition and memory regress. We do not leave our kids home alone at 3, 5, 8 years old, even if they are asleep. It is not safe. We may not like to admit it, but the same is true for people with dementia who's minds are going back to being similar to that child of 3, 5, or 8.

Leaving someone home alone is not safe because anything can happen. No matter how well we think we know their ability or how safe we think we set up the house, we all know accidents happen. Even someone who is bedridden can get sick while you are gone, decide to try and get out of bed even though they can't and fall, or they could become afraid and panic thrashing and hurting themselves on bed rails. Dementia is unpredictable and while yesterday it may seem like your loved on is fairly safe and won't get too confused, today may be the day they leave the stove on with clothes on top of it, or get hungry and try to cut vegetables with a sharp knife and forget how to use it and cut themselves. Or what if you get in a car accident or get a flat tire and while you thought you were leaving them for an hour, you are now gone for 12 and no one knows your loved one is at home alone? I know all of this sounds scary and you might think "this won't happen to my loved one,"but it does. I was shocked the first time Mom left the stove on because she had not even cooked in months. Or when Mom would get suddenly scared not knowing where the dog is and walk out into the back yard to look for him.

While I wish caregivers were not so expensive to hire, they are, and many people can not afford to hire 24 hour watch for their loved one. However, I have come to realize that if we just ask for the help we need, often we have friends or family members who will help out. I know quite a few people that go over a few hours a week to sit with someone with dementia so that their family member can go to the store. If you find a few people like that then you can have a rotation of people coming in for the week to help out. Or there are even neighbors who will check in on your loved one hourly which is better than just leaving them alone completely all day if you have to work.

Don't be afraid to ask for the help you need, the worst someone can say is that they are unavailable. And if you know someone with dementia and you want to provide help, offer to come over and sit with them. Often families don't ask for such help because we assume it is too much to ask, too much of an imposition, and no one will want to do it. If you offer, you might just be giving that family a wonderful gift they were too afraid to ask for.


Rev. Katie


  1. One of the challenges in caring for a person with Dementia Praecox is the patient's inability to identify the things around them. Thus, it is impossible to leave them alone while awake as they can always hurt themselves, mistaking the shoe for a phone. Back home in Tampa, when patients with dementia swim in a pool, caregivers make sure that they already have a credible fence company to care of the safety of the pool fences as well as a ratio of 1:1 patient and caregiver.

    1. A 1:1 ratio would be great. Difficult in institutional care and even harder in home care depending on the resources of the family. And you are so right that they do mistake things, and also there is the issue of hallucinations where they see things that are not there, like a snake on the floor and they fall trying to quickly avoid it. Quite difficult to make sure they are safe.

  2. Volunteering campaigns that was mentioned over here is a very useful idea for elders who suffer from dementia; I guess it'll be a nice change for our old folks to associate with like-minded peers and obtain a little diversion from the mundane routines of life.

  3. Don't ever leave a person with dementia even its on your own home. There are many unwanted things that can happen to a person with that kind of disease. If you have a pool be sure that it has electric pool cover just to be cautious. The flooring and the stairs should have rubber panels so even if they fall, the rubber would made the impact of the fall less.

    1. Hi Andrew,
      There is a lot of research on environmental issues, like you say, and safety. Such as do not have rugs in the house because they are easy to trip over. Carpet is not ideal because older people shuffle. Patterned carpet, flooring, and walls are confusing. As you say, so many things that are safety issues. I had heard you need to be careful with rubber flooring as it is easy for them to trip on, due to the shuffling, but yes put traction strips on the stairs. Lighting is also an issue. You remind me that I should probably write a post on some of this stuff!

  4. Hi Rev. Katie, I am so glad to have found your blog again (I had saved one of your posts in a document to keep forever, lol, but forgot about it and then tried fruitlessly to find you online a few months after that, lol!)

    I have to say I'm a little anxious about having someone come and help. I see several potential liability problems with it and don't know the answers- maybe you can help.

    One- a kind of liability can fall you you if someone is watching over a person with dementia. You know accusations could arise from either party making for a sticky situation.

    Two - regarding legal liability- what if an injury occurs to the volunteer, caused by the one with dementia? Could they sue you for medical expenses? What if you paid them? What if they are professional but contracted caretakers- without personal insurance? Would/should you ask for a pre-signed waiver or something?

    Thanks for all you are sharing- it's giving me courage and inspiration!

    1. Hi Illoura,
      Thank you for reading the blog. You are right that there are liability issues with volunteers. However, anyone who comes into your house, if they get hurt at your house then you are held liable for it and it comes out of your homeowners insurance. In terms of holding a volunteer liable for injury to your loved one, I do not know if you can do that or what the legal issues are around that. If they are contracted caregivers from a home health agency, the agency should have liability coverage and should go over all of that with you. And yes, you can hold an agency/paid caregiver liable for injury. If you are paying someone who calls themselves a professional caregiver and they are not with an agency, make sure they have personal insurance.

      Good luck with the decisions you make.

  5. Dealing with my mother who has dementia is so difficult. She can no longer distinguish anything anymore, from clean to dirty. So I had the whole house safe. The most important thing I've done was to change the water supply. I placed a filter in the water passages so wherever she drinks from, she drinks it safely.