Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Prevention begins with a safety check of every room in your home. Use the
following room-by-room checklist to alert you to potential hazards and to record
any changes you need to make. You can buy products or gadgets necessary for home
safety at stores carrying hardware, electronics, medical supplies, and
Keep in mind that it may not be necessary to make all of the suggested
changes. This booklet covers a wide range of safety concerns that may arise, and
some modifications may never be needed. It is important, however, to re-evaluate
home safety periodically as behavior and abilities change.
Your home is a personal and precious environment. As you go through this
checklist, some of the changes you make may impact your surroundings positively,
and some may affect you in ways that may be inconvenient or undesirable. It is
possible, however, to strike a balance. Caregivers can make adaptations that
modify and simplify without severely disrupting the home. You may want to
consider setting aside a special area for yourself, a space off-limits to anyone
else and arranged exactly as you like. Everyone needs private, quiet time, and
as a caregiver, this becomes especially crucial.
A safe home can be a less stressful home for the person with Alzheimer's, the
caregiver, and family members. You don't have to make these changes alone. You
may want to enlist the help of a friend, professional, or community service such
as the Alzheimer's Association.
Throughout the Home
Display emergency numbers and your home address near all telephones.
Use an answering machine when you cannot answer phone calls, and set it to
turn on after the fewest number of rings possible. A person with Alzheimer's
disease often may be unable to take messages or could become a victim of
telephone exploitation. Turn ringers on low to avoid distraction and confusion.
Put all portable and cell phones and equipment in a safe place so they will not
be easily lost.
Install smoke alarms and carbon monoxide detectors in or near the kitchen
and all sleeping areas. Check their functioning and batteries frequently.
Avoid the use of flammable and volatile compounds near gas appliances. Do
not store these materials in an area where a gas pilot light is used.
Install secure locks on all outside doors and windows.
Hide a spare house key outside in case the person with Alzheimer's disease
locks you out of the house.
Avoid the use of extension cords if possible by placing lamps and
appliances close to electrical outlets. Tack extension cords to the baseboards
of a room to avoid tripping.
Cover unused electrical outlets with childproof plugs.
Place red tape around floor vents, radiators, and other heating devices to
deter the person with Alzheimer's from standing on or touching them when hot.
Check all rooms for adequate lighting.
Place light switches at the top and the bottom of stairs.
Stairways should have at least one handrail that extends beyond the first
and last steps. If possible, stairways should be carpeted or have safety grip
strips. Put a gate across the stairs if the person has balance problems.
Keep all medications (prescription and over-the-counter) locked. Each
bottle of prescription medicine should be clearly labeled with the person's
name, name of the drug, drug strength, dosage frequency, and expiration date.
Child-resistant caps are available if needed.
Keep all alcohol in a locked cabinet or out of reach of the person with
Alzheimer's. Drinking alcohol can increase confusion.
If smoking is permitted, monitor the person with Alzheimer's while he or
she is smoking. Remove matches, lighters, ashtrays, cigarettes, and other means
of smoking from view. This reduces fire hazards, and with these reminders out of
sight, the person may forget the desire to smoke.
Avoid clutter, which can create confusion and danger. Throw out or recycle
newspapers and magazines regularly. Keep all areas where people walk free of
Keep plastic bags out of reach. A person with Alzheimer's disease may choke
Remove all guns and other weapons from the home or lock them up. Installing
safety locks on guns or remove ammunition and firing pins.
Lock all power tools and machinery in the garage, workroom, or basement.
Remove all poisonous plants from the home. Check with local nurseries or
contact the poison control center (1-800-222-1222) for a list of poisonous
Make sure all computer equipment and accessories, including electrical
cords, are kept out of the way. If valuable documents or materials are stored on
a home computer, protect the files with passwords and back up the files.
Password protect access to the Internet, and restrict the amount of online time
without supervision. Consider monitoring computer use by the person with
Alzheimer's, and install software that screens for objectionable or offensive
material on the Internet.
Keep fish tanks out of reach. The combination of glass, water, electrical
pumps, and potentially poisonous aquatic life could be harmful to a curious
person with Alzheimer's disease.
Outside Approaches to the House
Keep steps sturdy and textured to prevent falls in wet or icy weather.
Mark the edges of steps with bright or reflective tape.
Consider installing a ramp with handrails as an alternative to the steps.
Eliminate uneven surfaces or walkways, hoses, and other objects that may
cause a person to trip.
Restrict access to a swimming pool by fencing it with a locked gate,
covering it, and closely supervising it when in use.
In the patio area, remove the fuel source and fire starters from any grills
when not in use, and supervise use when the person with Alzheimer's is present.
Place a small bench or table by the entry door to hold parcels while
unlocking the door.
Make sure outside lighting is adequate. Light sensors that turn on lights
automatically as you approach the house may be useful. They also may be used in
other parts of the home.
Prune bushes and foliage well away from walkways and doorways.
Consider a NO SOLICITING sign for the front gate or door.
Remove scatter rugs and throw rugs.
Use textured strips or nonskid wax on hardwood and tile floors to prevent
Install childproof door latches on storage cabinets and drawers designated
for breakable or dangerous items. Lock away all household cleaning products,
matches, knives, scissors, blades, small appliances, and anything valuable.
If prescription or nonprescription drugs are kept in the kitchen, store
them in a locked cabinet.
Remove scatter rugs and foam pads from the floor.
Install safety knobs and an automatic shut-off switch on the stove.
Do not use or store flammable liquids in the kitchen. Lock them in the
garage or in an outside storage unit.
Keep a night-light in the kitchen.
Remove or secure the family "junk drawer." A person with Alzheimer's may
eat small items such as matches, hardware, erasers, plastics, etc.
Remove artificial fruits and vegetables or food-shaped kitchen magnets,
which might appear to be edible.
Insert a drain trap in the kitchen sink to catch anything that may
otherwise become lost or clog the plumbing.
Consider disconnecting the garbage disposal. People with Alzheimer's may
place objects or their own hands in the disposal.
Anticipate the reasons a person with Alzheimer's disease might get out of
bed, such as hunger, thirst, going to the bathroom, restlessness, and pain. Try
to meet these needs by offering food and fluids and scheduling ample toileting.
Use a night-light.
Use a monitoring device (like those used for infants) to alert you to any
sounds indicating a fall or other need for help. This also is an effective
device for bathrooms.
Remove scatter rugs and throw rugs.
Remove portable space heaters. If you use portable fans, be sure that
objects cannot be placed in the blades.
Be cautious when using electric mattress pads, electric blankets, electric
sheets, and heating pads, all of which can cause burns and fires. Keep controls
out of reach.
If the person with Alzheimer's disease is at risk of falling out of bed,
place mats next to the bed, as long as they do not create a greater risk of
Use transfer or mobility aids.
If you are considering using a hospital-type bed with rails and/or wheels,
read the Food and Drug Administration's up-to-date safety information at
FDA Medical Devices, Hospital Beds
Do not leave a severely impaired person with Alzheimer's alone in the
Remove the lock from the bathroom door to prevent the person with
Alzheimer's from getting locked inside.
Place nonskid adhesive strips, decals, or mats in the tub and shower. If
the bathroom is uncarpeted, consider placing these strips next to the tub,
toilet, and sink.
Use washable wall-to-wall bathroom carpeting to prevent slipping on wet
Use a raised toilet seat with handrails, or install grab bars beside the
Install grab bars in the tub/shower. A grab bar in contrasting color to the
wall is easier to see.
Use a foam rubber faucet cover (often used for small children) in the tub
to prevent serious injury should the person with Alzheimer's fall.
Use a plastic shower stool and a hand-held shower head to make bathing
In the shower, tub, and sink, use a single faucet that mixes hot and cold
water to avoid burns.
Set the water heater at 120 degrees Fahrenheit to avoid scalding tap water.
Insert drain traps in sinks to catch small items that may be lost or
flushed down the drain.
Store medications (prescription and nonprescription) in a locked cabinet.
Check medication dates and throw away outdated medications.
Remove cleaning products from under the sink, or lock them away.
Use a night-light.
Remove small electrical appliances from the bathroom. Cover electrical
If a man with Alzheimer's disease uses an electric razor, have him use a
mirror outside the bathroom to avoid water contact.
Clear electrical cords from all areas where people walk.
Remove scatter rugs or throw rugs. Repair or replace torn carpet.
Place decals at eye level on sliding glass doors, picture windows, or
furniture with large glass panels to identify the glass pane.
Do not leave the person with Alzheimer's disease alone with an open fire in
the fireplace. Consider alternative heating sources.
Keep matches and cigarette lighters out of reach.
Keep the remote controls for the television, DVD player, and stereo system
out of sight.
Keep the door to the laundry room locked if possible.
Lock all laundry products in a cabinet.
Remove large knobs from the washer and dryer if the person with Alzheimer's
tampers with machinery.
Close and latch the doors and lids to the washer and dryer to prevent
objects from being placed in the machines.
Lock access to all garages, sheds, and basements if possible.
Inside a garage or shed, keep all potentially dangerous items, such as
tools, tackle, machines, and sporting equipment either locked away in cabinets
or in appropriate boxes/cases.
Secure and lock all motor vehicles and keep them out of sight if possible.
Consider covering vehicles, including bicycles, that are not frequently used.
This may reduce the possibility that the person with Alzheimer's will think
Keep all toxic materials, such as paint, fertilizers, gasoline, or cleaning
supplies, out of view. Either put them in a high, dry place, or lock them in a
If the person with Alzheimer's is permitted in a garage, shed, or basement,
preferably with supervision, make sure the area is well lit and that stairs have
a handrail and are safe to walk up and down. Keep walkways clear of debris and
clutter, and place overhanging items out of reach.
Reviewed by William C. Shiel Jr., MD, FACP, FACR on 12/5/2013