3.4 Managing symptoms at home

Managing everyday tasks at home

Having dementia can make everyday tasks more difficult for the person you support.  They might find personal tasks such having a shower or getting dresses and/or household chores such as cleaning, gardening, shopping and cooking more difficult or take longer to do.  Older people with dementia may have less strength and mobility, which can make everyday tasks even harder to manage.

Carers and families often worry about the safety of the person with dementia living at home.  If the person you support lives alone, you don’t live nearby, you are unable to visit often, or you have noticed the person doing unsafe things before, you may be more concerned about their safety.

There are things you can do to help the person you support stay safe at home. Home modifications, technology and Occupational therapy can help. Benefits may also be available to help.

Making home ‘dementia friendly’

There are lots of things you can do to make your or the person you support’s home dementia friendly. Research in recent years that shows some easy changes will help the person with dementia to manage better at home.

Many safety issues in the home are caused by the way the person with dementia sees their world.  Find out more about changes in vision and perception.

• Improve the lighting. As we age our eyes let in less light. The older eye receives about half the light of a younger eye, copes less well with glare and reacts more slowly to changes in light levels, such as stepping indoors from a bright day outdoors. Poor lighting and sudden changes in light levels make us more at risk of falls. Putting in brighter bulbs, having clean windows and opening blinds or curtains to let in non-glare light helps people with dementia see more clearly. Consider using ‘stick on’ battery operated lights in dark hallways, cupboards or wardrobes and using night lights to illuminate the way to the toilet at night.  Motion sensor lights are available so that the person doesn’t have to remember to switch lights on and off when you move around at night.  
• Use contrasting colours. The person you support may have difficulty ‘seeing’ things.  This is not caused by sight problems but their brain not understanding what they see.  Contrasting colours can help people with dementia see the world more easily. Does the person you support seem to have difficulty finding things or seeing? Silver cutlery on a pale grey mat is harder to see than on a dark mat, a white toilet seat on a white toilet in a white bathroom makes it harder to see and so on. Use contrast such as a coloured toilet seat or contrast strips on stair edges give more visual information. Colours can help such as yellow against blue or dark blue against light blue Stirling University provide helpful information on colour contrasting for safety in the home.
• Make floors clear and simple.  People with dementia are at a greater risk of falling than people without dementia. Making sense of their environment can be harder. For example, a dark mat can look like a hole or a steps downward. A shiny floor may be mistaken for a wet or icy surface. Swirly carpets patterns can upset the balance. These tricks of the eye can cause people to stumble or fall. Suggest rearranging their furniture so there is more space to walk.  Removing clutter, tidying away loose cables and make sure rugs are secure can also prevent against trips. The NHS website gives safety tips to prevent falls at home and how to arrange a home hazard assessment.  Further information on preventing falls can be found here and you can do a self-assessment on the website.  Talk to an occupational therapist to help you make small changes in your home to improve what the person you support can safely do.
• Keep appliances and fittings familiar. Meenu and Javinder updated their bathroom and kitchen. They chose modern taps and an integrated fridge and dishwasher – ones with doors that looked like the other kitchen cupboards. Now over five years later Meenu finds the taps almost impossible to use and has to open half a dozen cupboards to find the fridge. When replacing items in your home find those that look and feel familiar. For example, ‘old fashioned’ cross hatch taps are easier to recognise and operate that a modern mixer taps. Age UK suggest ideas for designing a dementia friendly kitchen.

An interactive map of rooms in the home and how it can be easily adapted to help support the person with dementia is available.

Age UK also provide helpful tips for making yours or the person’s home dementia friendly.   The Alzheimer’s society also have a guide for staying safe at home which includes issues such as online security and fraud.

Occupational therapy and home modifications

Occupational therapists are trained professionals to help manage everyday activities at home. For example, they might help the person you support to safely manage using their bath or shower, find equipment to keep safe in the kitchen, or advise on falls hazards in the house.

Research show that occupational therapy helps people with dementia keep doing things that are important to them and delays the need to go into care.

Learn more about how occupational therapists may be able to help you.

Ask your doctor for a referral to occupational therapy if you need support with your daily tasks and activities at home.

Benefits and support at home

You can find out more about financial support and benefits in Plan services for support. Here we highlight ways of getting support at home.

There is equipment which is free and available to everyone to help at home via the NHS.  

The person you support can also apply for a needs assessment to help work out which services and financial support they may be entitled to.  Needs assessments are free and available to everyone. 

The person you support will need an assessment to work out if their local authority will provide support such as:

• equipment for use at home such as a walking frame or personal alarm
• home adaptations (such as a raised bath seat)
• practical help from a paid carer

Needs assessments are provided through local government (council) in England and Wales.  You can use the postcode finder to locate your local authority.  

Care information Scotland provide advice for getting an assessment of care needs in Scotland.

Using technologies can help you stay at home

Assistive technology means any product that helps us do a task more easily or to do something we otherwise could not do.  We can use technology to: keep us connected, (like video calls); keep us safer (like smoke alarms or falls detectors); provide entertainment (and exercise) like the Nintendo Switch; and make our everyday tasks easier (dishwasher, vacuum cleaner).

Assistive technologies can help people with dementia to keep independent and safe at home.  Technology can also be used to help with memory and thinking.  Find out more in information for the person you support in Managing difficulties at home.

Devices can be very simple such as rails in the bathroom or quite complex such as emergency call pendants. There is a large range of assistive technologies designed to help older people and people with dementia at home.

Read how technology can help you with everyday life.

Other services to support you at home

If the person you support can afford them, private cleaners, gardeners and tradespeople can help them to maintain their home and garden. They can do jobs that might be difficult or dangerous for the person you support such as making beds, cleaning blinds and mowing lawns. Family, friends and neighbours may be able to make a recommendation.  You can also use websites like Checkatrade and the Age UK business directory . See the section on practical strategies for people with dementia  I find it hard to fix things around my home for ideas to find local tradespeople for home maintenance.  You can read more about help at home through social care services or private services.

Help with personal care

Sometimes people with dementia may need support with their everyday care such as showering, shaving, washing their hair and getting dressed.  You may be able to help by setting out shaving equipment, labelling items, or physically helping the person such as helping to wash their hair.  However this is not always possible and there are services which can help.  Social services, voluntary or private organisations provide support with personal tasks.  Find out how to get this help in Plan services for support.

Moving somewhere new for support

After dementia diagnosis some people think about whether they want to stay at home or move somewhere else.  This could be a smaller property or somewhere you can live independently but with support if needed such as sheltered accommodation or a retirement village.  There are pros and cons for both moving or staying at home.

Dennis and Lynda had retired to the coast two hours away from the city, where most of their family lived.  Tony had a minor stroke a few years earlier and has permanent weakness on one side of his body.  Now in their 80s and following Lynda’s dementia diagnosis they considered how they would manage at home in the future.  They talked about it with their family and decided to move to a retirement village closer to their family, with onsite support. They worried that leaving their familiar home and friends would be particularly hard for Lynda. Now, nearly 3 years later they are very happy. They found that the community offered by the village has been a great support. Particularly now that they don’t drive, the bus to the shops and outings have been a great boost to keeping their independence. Dennis said that moving soon after Lynda’s diagnosis was the right time. It gave her time to adapt to her new home and learn her way around.

 

Ray and Cliff had lived in their inner-city home for 30 years. They were close to friends, knew their neighbours and were regulars at local cafes and restaurants. As Cliff’s memory declined, they chose to stay in their own home, close to their social circle and amenities. They worked with an occupational therapist to modify their home.  This helped Cliff cope with visual problems from macular degeneration which affected how he managed everyday tasks, and resulted in several recent falls at home. Both Cliff and Ray were very happy with the decision to remain in their home. The furniture, pictures and items they had collected on overseas trips over thirty years were familiar and remain a source of joyful memories. Ray commented that “if we had moved, we would have had to downsize. We would have not only lost items – we would have lost a source of happy memories for Cliff as well”.

Careful consideration needs to be made for both yourself and your person about the advantages and disadvantages of moving. Talk with trusted family members, your GP, a social worker or counsellor (if available) and a financial advisor to give you different perspectives on the benefits of moving or staying in your home.