Crisis Resources

Safety

Home Safety

A room-by-room guide to making the home safer — plus the conversations about driving, wandering, and firearms that nobody wants to have but everyone needs to.

What's Happening

Dementia progressively impairs judgment, spatial awareness, problem-solving, and the ability to recognize danger. The home that has been safe for decades becomes hazardous as the disease progresses. Falls are the leading cause of injury in people with dementia. Wandering occurs in up to 60% of cases. Kitchen fires, medication errors, and scalding injuries are common.

Home safety modifications are not about treating the person like a child. They are about adapting the environment to match the person's current abilities — just as you would install handrails for someone recovering from a hip replacement. The disease changes the brain; we change the house.

Room-by-Room Checklist

Install stove knob covers or an automatic stove shut-off device. Remove or lock away sharp knives, matches, and lighters. Set the water heater to 120°F maximum to prevent scalding. Remove toxic cleaning products or lock them in a cabinet. Consider replacing the stove with a microwave or induction cooktop (which only heats when a pan is present). Remove small appliances when not supervised. Put a lock on the dishwasher (detergent pods look like candy). Install a smoke detector if not already present.

Install grab bars near the toilet and in the shower/tub (properly anchored into studs, not with suction cups). Use non-slip mats in the tub and on the floor. Remove locks from the inside of the door (they can lock themselves in). Remove or lock up medications, razors, scissors, and cleaning products. Consider a walk-in shower or shower bench. Install a raised toilet seat. Use a nightlight. Remove glass items. Set water heater to 120°F.

Install bed rails if there is a fall risk (evaluate carefully — bed rails can also cause entrapment injuries). Use a bed alarm or motion sensor to alert you to nighttime wandering. Remove throw rugs. Ensure a clear path from bed to bathroom with nightlights. Keep a phone or call button accessible. Remove electric blankets or heating pads (burn risk). Secure windows that open wide enough to climb through.

Remove or secure throw rugs (the #1 indoor fall hazard). Ensure adequate lighting in all areas, especially transitions between rooms. Remove or pad sharp-cornered furniture. Secure bookcases, TV stands, and tall furniture to walls. Hide or lock the thermostat. Remove or simplify remote controls. Cover or remove mirrors if they cause agitation (some people with dementia don't recognize their reflection). Block access to stairs with gates if needed.

Install deadbolts that require keys on both sides (but keep a key accessible for emergencies — fire safety). Consider a door alarm that sounds when exterior doors open. Fence the yard if wandering is a risk. Remove or lock access to the garage, workshop, pool, and garden chemicals. Ensure outdoor walkways are well-lit and even. Remove garden hoses and tools that could be tripping hazards. Install a motion-activated light at all entries.

Home Safety Audit

Walk through every room with our interactive audit and get a personalized safety report.

Technology Finder

Find GPS trackers, door alarms, and monitoring systems matched to your specific needs.

Wandering Prevention

Wandering is one of the most dangerous behaviors in dementia. People who wander can become lost, dehydrated, hypothermic, or hit by traffic. Fifty percent of people who wander and are not found within 24 hours will die or suffer serious injury. Prevention is critical.

GPS devices range from wearable watches (AngelSense, Medical Guardian) to small trackers that can be placed in shoes, sewn into jacket linings, or clipped to clothing. Smart watches with cellular connectivity can provide real-time location tracking. The best device is the one they will actually wear — if they remove a watch, try a shoe insert. If they refuse everything, consider sewing a tracker into a frequently worn garment.

Simple contact alarms ($10-30) alert you when a door or window opens. Smart home systems can send alerts to your phone. Motion sensors in hallways can alert you to nighttime wandering before they reach an exit. Place a pressure mat at the front door. Some families install a chime that plays a specific sound when the front door opens, which can redirect the person's attention.

This nationwide program provides 24/7 emergency response, a wandering support line, and a medical ID bracelet or pendant. If the person is found wandering, anyone can call the number on the ID for instructions. Annual membership is approximately $55. This should be considered essential, not optional.

Medication Management

Medication errors are common and dangerous. As cognitive function declines, the person may take the wrong dose, take medications at the wrong time, take someone else's medication, or stop taking medications entirely.

  • •Use a locked medication dispenser that dispenses the correct pills at the correct time
  • •Remove all medications from their direct access — keep them in a locked cabinet
  • •Dispose of expired or discontinued medications (many pharmacies offer disposal)
  • •Keep a current medication list with doses, times, and prescribing doctor
  • •Consider a pharmacy that offers blister packing (pre-sorted medications by time of day)
  • •Set up medication reminders through a smart speaker or phone alarm as a backup

Fall Prevention

Falls are the leading cause of emergency room visits and hospitalization for people with dementia. A fall that results in a hip fracture carries a 50% one-year mortality rate in this population. Prevention is not optional.

  • •Remove all throw rugs or secure them with double-sided tape
  • •Install grab bars in bathrooms and along long hallways
  • •Ensure all areas are well-lit, especially transitions between rooms
  • •Keep floors clear of clutter, cords, and obstacles
  • •Ensure footwear fits well and has non-slip soles (no floppy slippers)
  • •Have vision checked annually (poor vision compounds fall risk)
  • •Review medications for dizziness or drowsiness side effects
  • •Consider physical therapy for balance and strength training
  • •Install motion-sensor lights for nighttime navigation

The Driving Conversation

A dementia diagnosis does not automatically mean the person must stop driving immediately, but it does mean driving cessation is coming. Warning signs: getting lost on familiar routes, new dents or scrapes on the car, failing to observe traffic signs, driving too slow or too fast, difficulty with left turns across traffic. Many states require doctors to report dementia diagnoses to the DMV. Ask the doctor about a formal driving evaluation through an occupational therapist — this removes you from the role of "bad guy."

Options escalate: 1) Have the doctor deliver the news (many people accept it better from a medical authority). 2) Request a formal driving evaluation — the OT can revoke the recommendation. 3) Contact the DMV to request a re-examination. 4) Disable the car (remove a fuse, disconnect the battery, hide the keys). 5) Remove the car from the home entirely. 6) In extreme cases, some families report the car as unsafe to the DMV. Safety for them, other drivers, and pedestrians takes precedence over their feelings about independence.

Firearms in the Home

This conversation can save lives.

A person with dementia who has access to firearms is at risk of accidental discharge, using the weapon during a confused or paranoid episode, or suicide. This is not a political statement. It is a safety imperative.

  • •Remove all firearms from the home. This is the safest option.
  • •If removal is not possible, store firearms unloaded in a locked safe with ammunition stored separately in a different location.
  • •Remove access to the keys or combination for the safe.
  • •Do not assume "they don't know where it is" or "they've forgotten about it." Procedural memory (how to operate a gun) is preserved longer than declarative memory.
  • •Ask the doctor to have this conversation if the family member resists.
  • •Contact your local police department for temporary storage options if removal from the home is needed immediately.

When to Seek Professional Help

  • •If the person has wandered and been found outside the home
  • •If there has been a fall resulting in injury
  • •If the person is leaving the stove on or engaging in unsafe behaviors despite modifications
  • •If you need a professional home safety assessment (ask the doctor for an occupational therapy referral)