23 simple adaptations to help people with dementia stay at home.

According to the Alzheimer’s Association, 70 percent of people with dementia and related conditions are currently living at home.  New York City is a place where due to its overpopulation and vertical construction style, caring for a loved one with dementia can be a real challenge. There are ways to improve the living space to make the client with dementia more comfortable and safer at home.


Against popular belief, wandering is good for people with dementia and should not be prevented or limited.  It keeps them active and can help prevent other issues such as constipation. Wandering can be done in a safe way inside the home by taking simple steps. Assuming that all the rooms are on the same floor, as is often the case in New York City apartments.

  1. Walkways should be clear of any clutter and furniture. It is also important to keep in mind not to completely change the familiar look of the living space.
  2.  The doors for the rooms that you wish to keep the client from going into should be closed at all times.
  3. Doors should not be so obvious in appearance and their colors should blend in with that of walls.
  4. Make sure to place a chair near the rooms or in the hallway, so that the client can take frequent breaks.
  5. Minimize the use of mirrors around the home as this can make the client confused.
  6. It is ideal to install a passive alarm system that will quietly monitor the client’s routine around the house or apartment and will alert you if something changes.  The Grand Care system can do this for you.
  7. In the event that the client makes it out of the house, make sure to have a plan B. This plan should include having recent pictures of the client that shows what clothes he/she is wearing and a list of places the client frequently goes to.


Hygiene and Self-care

  1. As a rule of thumb, it is very important to try to simplify daily activities. By assisting the client in performing these activities you are encouraging them to become more independent.
  2. The pathway from the bedroom to the bathroom should be clear of any clutter or items that the client can trip over.
  3. Place reminders that illustrate where the bathroom is located.
  4. It is also important that the toilet and faucet are user-friendly. Toilet should be at a comfortable height and faucet should clearly display hot and cold water.
  5. Make sure to install a cold/hot water mixing valve to maintain water temperature consistent.
  6. Try to provide the client with comfortable clothes that will be easy for him/ her to put on and take off.
  7.  Another helpful hint is to take out a few outfits and give them to the client to choose.  Limiting the choice will make it easier for the client and/or caregiver to decide on what to wear. If the client is still able to make this decision on their own it is important to encourage them to do so.


Mealtime and Medications

  1. It is important to maintain a routine that will serve as a consistent reminder that it is mealtime.
  2. As the condition progresses, avoid providing the client with forks. Instead give them a spoon for safety purposes.
  3. Set up for mealtime by placing items in the same location all of the time. For example, if you use a tray place the food, beverages, and utensils in the same spot every time.
  4. Avoid having decorative items that look like food around the house.
  5. Proper seating and positioning is also critical during mealtime to avoid aspiration (food going down the windpipe into the lungs).
  6. Always make sure that the client has swallowed all of their food and/or medication as dementia clients tend to pocket food and medication which may lead to other medical issues.
  7. It is also important that dementia clients take their medications consistently. A pillbox is always helpful in this situation. Simply make sure that you choose a specific location within the client’s reach. 
  8. Set reminders that will help the client remember to take their medication. 
  9. Make sure to establish a system that will ensure that the client actually takes them. The Grand Care system can also help you with that.

These are very simple and very specific ideas that can be implemented in order to keep dementia patients comfortable and safer at home and avoid unnecessary and premature institutionalization. Next time we will continue with another set of great ideas to improve the dementia clients’ quality of life while at home.


Miller Calberto, MS, OTR/L, CAPS
Senior partner
Adapting Spaces, LLC

Leave a Reply