The Seven Common Senses of Dementia Care – Safety

This blog post focuses on ways caregivers can enhance the safety of someone with dementia and others. It is the third installment of a seven-part series on common sense dementia care. The series features seven principles that can improve quality of life for caregivers and their loved ones.

R-E-S-P-E-C-T is a helpful mnemonic (memory device) for remembering these tried and true tips:

The Seven Common Senses of Dementia Care

1. Respect
2. Enlist help
3. Safety
4. Preparation
5. Engagement
6. Consistency
7. Tolerance

Safety and Serenity

The well-being of a loved one with dementia is a caregiver’s primary concern. Therefore, the safety of a person with dementia and a caregiver’s comfort level go hand in hand. Worry and anxiety are counterproductive. A better strategy is to monitor the safety of a person with dementia, identify red flags and act pre-emptively.

Proactive, Active, Reactive

Aim first to be proactive and prevent safety problems. If someone with dementia has difficulty in a certain sphere of thinking or daily function (e.g., forgetting to turn off the stove, becoming lost while driving, or wandering), the problem is likely to recur and grow worse, not better. Therefore, prevention should be individually-tailored.

Safety measures for people with dementia may include increased supervision, discontinuation of an activity and task-specific interventions. If someone with dementia is forgetting to turn off the stove, perhaps they can cook with a partner and/or control knobs can be removed to prevent accidents. A person with dementia who becomes lost while driving might be directed to drive only with an adult passenger present to give directions or to discontinue driving. Wandering warrants interventions such as home safety modifications, individual GPS/alarm devices, professional in-home caregivers and/or secure long-term memory care.

A caregiver who encounters an ongoing or immediate problem should react with safety top of mind, while remaining as calm and considerate as possible. For example, in the case of a stove left on accidentally, make sure everyone is safe and turn off the appliance without arguing or recriminations. People with dementia may forget leaving the stove on, but they may remember being scolded (and this is likely to only make them—and their caregivers—feel bad, not help them remember in the future). As long as their well-being is secured, (e.g., if they are no longer able to cook unsupervised because the knobs are taken off the stove), it’s okay for them to forget such mistakes. In fact, it’s often better. Although caregivers don’t have the luxury of forgetting, acting proactively to minimize safety issues may allow them to relax (a little), too.

Winning at safety

Be a victor of your good judgment, not a victim of your bad.

Not all safety issues may be foreseen, but many can. Avoid letting your loved one with dementia—and anyone else—fall victim to a preventable problem. When it comes to safety, aim to prevent, act and react, in that order. And repeat. Safety for the patient is sanity for the caregiver.

By Anne M. Lipton, M.D., Ph.D.

Neurologist and Author of The Common Sense Guide to Dementia

For more information on the Seven Common Sense of Dementia Care, see Dr. Lipton’s book, The Common Sense Guide to Dementia for Clinicians and Caregivers.