Dementia Care Dementia Friendly Environments HELPFUL INFORMATION written by the NRS In-House Occupational Therapist People with dementia often also have the age related difficulties of poor eyesight, hearing and reduced mobility, alongside impairment of memory and understanding. These impairments can be better managed by improving the design of the environment. Research has shown that people with dementia are calmer and less likely to get lost or become distressed in an environment designed with their needs in mind. This is the same whether they are in a care home, hospital ward or in their own home. In the following examples, you will find advice and features for rooms around the home including: Dementia Friendly Bathroom, Kitchen and Bedroom. Dementia Friendly Bathroom 6 2 5 3 H C 1 4 7 1 White toilets are sometimes hard for a person to locate and recognise. It is advised that contrasting colours are used for the Toilet Seat and Grab Rails. Likewise make sure the colour of the toilet paper is also in contrast to the wall. 2 Mirrors can be distressing for people who can no longer recognise their own face and increase fear levels. A simple solution is to place a roller blind over the mirror which can be raised and lowered. 3 If possible stick to traditional shaped taps (or whatever the person is used to) marked hot and cold. Tap Turners can make turning the tap easier. Use bars of soap (if these were used when the person was young) rather than soap dispensers to encourage washing. A contrasting colour hand towel can also be easier to find. 4 To prevent the bathroom flooding use a Magiplug which will release the water in the bath or basin or alarms that alert a carer in the same house if the water has reached a critical level. 5 If a person is having difficulty getting in and out of the bath there are many products which may help. Remember though that too many changes can be confusing so try to achieve a balance between safety and stress. For example if someone has always stepped into a bath perhaps they could be encouraged to do this more safely by using a Bath Step, some contrasting grab rails and a seat to sit on once they are safely inside. 6 Make sure your bathroom is well lit keeping the light on at night can encourage the use of the toilet and prevent falls in the bathroom. Having the route to the toilet lit at night is also very important you could use Night Lights or lighting which comes on automatically when it senses movement to increase safety. 7 Flooring is very important in helping to prevent falls and increase confidence when walking in the bathroom. A shiny floor can look wet which increases fear when walking. Slip resistant flooring is important especially for when a person is wet. Avoid leaving bath mats down on the floor.
Dementia Care Dementia Friendly Environments Dementia Friendly Kitchen 6 3 5 2 4 7 1 5 Relatives often worry about people leaving the cooker on and causing a fire or hurting themselves. A Cooker Guard will detect if the temperature becomes too high or if an electric cooker is left on. 4 Products are available that encourage people to continue to cook and make drinks for themselves as safely as possible. For example a Cooking Basket prevents someone having to lift a pan of hot water or a Kettle Tipper can enable safe and comfortable pouring of hot water from the kettle into a cup. The Airpot Dispenser keeps liquid hot and may be a safer way of getting a drink for some people. and a relative or friend whose number has been pre-programmed. For example the Careline Smoke Detector Alert. 7 It can be very difficult to carry food and drink safely from the kitchen, particularly if a person usually uses a walking aid. A wheeled trolley like the Home Helper Classic may help make this safer. 6 Make sure there is a smoke alarm fitted in the property. If you are worried about the person s ability to respond to a smoke alarm these can be linked to a system which will automatically call the emergency services Dementia Friendly Bedroom 2 2 Make it as easy as possible for the person to work out how to carry out a task by grouping things. For example put cups, teaspoons, teapot and tea bags near to the kettle. Labelling items such as containers and drawers can also be a help. 3 Open shelving, leaving important, everyday items out so they are easily seen, glass fronted, clear cupboards (or remove cupboard doors) all help the contents to be seen and more easily located. Remember to put any bleach or other poisonous substances in a locked cupboard out of sight. PANS 7 1 As with other rooms in the house the flooring is very important in the kitchen slip resistant, non-shiny flooring is best. If a floor surface is too shiny it can look wet which in turn can make a person over cautious about walking on it. The floor should also be left uncluttered to reduce risk of falls. 1 Keep the bedroom clutter free and remove any tripping hazards such as rugs. Automatic lighting can assist at night to prevent falls when getting to the toilet. Make light switches easy to see by placing stickers on them so they are contrasting to the walls. It may be beneficial to have a Daylight Lamp at the side of the bed that provides a high level of light. 6 2 A Door/ Window Open Alarm attached to the bedroom door or window frame and will emit a loud alarm when they are opened. If you are concerned that the noise will distress a person you can have them so they are attached to a pager or that will send an alert to a mobile phone. 3 5 4 4 Make sure the person can get in and out of bed as safely as possible. There are many products available to help with this including Bed Rails and Mattress Elevators to help a person sit up in bed. We recommend Bedside Rails are used in conjunction with rail bumpers for safety. 5 Waterproof bedding which can be wiped clean can also be helpful. Disposable or Washable Bed Pads can also prevent washing and help a person feel more comfortable in bed. Alarms that alert a carer if moisture is detected in the bed will prevent a person lying in a wet bed and possible bed sores. 3 A Bed Sensor Mat will also send an alert to a carer that a person has left the bed or that they have not returned to bed within a set period of time. 1 6 Putting clothes for the following day on view and putting the rest behind closed doors can make outfit selection easier and encourage a person to dress themselves. There are products that can assist with dressing such as Elastic Shoe Laces which, when left tied up in shoes convert them to slip-ons. 7 Products such as Blackout Blinds and Clocks that graphically represent daytime and night can help. Research has shown that keeping people active during the day prevents day time naps and encourages a good night s sleep. Games and activities can help, for example, using Exercise Balls, Activity Cubes and Reminiscence Activities.
Introduction To The House Remote/Automatic Lighting Wall Mounted Emergency Alarm Wandering Alert Floor & Door Sensor Kit Bath Thermometer Flood And Scald Prevention Aids Night Time Health Monitors Pages Bed Leaving Detectors Outdoors: GPS Tracking Devices Wandering & Activity Monitoring Systems Key Safes, Door Intercoms & Bells Motion Detectors & Fall Preventors Pill Reminder Range of Telephones Liquid Level Indicator
Independence At Home The Difficulty: Case Studies John is 26 years old and has a learning disability. He has been living with his parents all of his life but is now moving to his own flat in a supported housing complex. The main things he and his parents had concerns about were: letting people into his flat they were concerned about bogus callers, remembering to take his medication and carry out other routine tasks, and making it easy to contact family and friends. It s time to take your pills MEM-X Memory Aid Pendant Amplified Telephone With Emergency Button Names have been changed and models used to protect identities. View-Com Door Entry System Key Safe Product Solutions: John had a View-Com Door Entry System (M66315) fitted by his Dad. This enables him to see and talk to the caller before he opens the door. His parents have practised with him and feel reassured that he will use this and only open the door to people he knows. They also purchased a Key Safe (M61469) and had it fitted around the corner form his front door out of sight this enables all his carers and family to be able to let themselves into the flat. They purchased a MEM-X Memory Aid Pendant (M31647) and his Mum pre-programmed this to remind him of regular and important events including: 8.00am: a daily message to take his tablets 8.45am: week day reminder to get his coat ready and pick up his keys as the taxi will be coming shortly to take him to college 12.00pm: a reminder for Saturdays that his Mum will be there to take him shopping An Emergency Telephone (M66224) has enabled John to be able to dial his family and friends easily without having to remember telephone numbers. His Mum is relieved that it has a SOS button this will dial his family and allow them to speak to him when he needs help. The Result: John is really pleased that he is now living independently although the fact his mum can still nag him via the MEM-X is a bit annoying and he is hoping over time this can be reduced! His parents are relieved that the move has gone smoothly and feel that the telecare items they have purchased have supported this move.
Safety With Epilepsy Case Studies The Difficulty: Toby is 30 years old and has Cerebral Palsy and Epilepsy. He lives with his personal assistant, Greg, in a fully adapted bungalow. Lately his seizures have been getting worse at night and Greg is concerned that he will not hear Toby if he needs help. As Toby is mobile (with his rollator) he often falls when he has seizures and Greg would like to know straight away if this should happen. MP5 Seizure Monitor Product Solutions: They bought a MP5 Nocturnal Convulsion Seizure Monitor (M08388) to use in bed at night. They have turned down the microphone on this to give Toby some privacy but adjusted the sensitivity on the movement detector so that it alerts Greg (via the pager) when a seizure is detected. Toby also purchased a Care Call Fall Detector, a Pager Unit and Charger (M08820, M08807, M00819). This automatically detects a fall and sends an alert to the pager which Greg can carry around the bungalow with him. Toby also bought a Cadex Databank Watch (M66285). He has stored his entire emergency medical and contact details on this just in case he should be out and have a seizure or fall. The paramedics would be able to deal with him in an appropriate way and contact his carers Toby also likes the fact that the Cadex looks (and can be used like) a standard watch. The Result: Both Greg and Toby are pleased that they can have a good nights sleep knowing that Greg will be alerted if Toby should have a seizure, this has given them both peace of mind. The Fall Detector has already been used Greg was in the kitchen when Toby fell in the bathroom and was able to attend to him straight away due to the alert he received. I like the fact that these products give me peace of mind but also help protect my privacy and independence - Toby Care Call Fall Detector Databank Watch
Case Studies Taking Pills on Time! The Difficulty: Josephine is 68 years old and lives alone in her own house in the countryside. She has arthritis which mainly affects her hands and she is diabetic. She has also recently been diagnosed with dementia after her daughter, Alison, noticed that her mum s memory was getting worse. The main concern was that Josephine kept forgetting to take her tablets on time and as Alison lived away she was not able to always remind her to take them. Automatic Pill Reminder & Dispenser Product Solutions: Alison purchased an Automatic Pill Reminder & Dispenser (M39476). She has programmed this to alert her mum to take the medication when needed and can check that this has been taken when she visits at the weekend. The village pharmacist has also a spare cassette for this and fills it with Josephine s medication each week. Alison was also concerned that her Mum would go out shopping and would forget how to get home or where she was. This was causing a great deal of worry so they sat down and discussed the difficulty and decided that a Location Tracker device would be of benefit particularly at this early stage where Josephine could still learn how to use it and remember to take it with her. They bought a Personal GPS Tracker (M66261) and now Alison knows exactly where she is when she is worried and can talk to her Mum to check she is OK. The Result: Josephine is very pleased that she has been able to reduce the stress on her daughter with a couple of basic products. Her health has improved as she is taking her medication on time and her GP is extremely pleased as the blood sugar levels have stabilised. Alison is relieved that her Mum is still able to get out and about but they are able to get in touch with one another easily if either of them is concerned. She can find out at the touch of a button where her mum is to within 5 metres. Personal GPS Tracker
Case Studies ReducingStressandPreventingFalls The Difficulty: June was very concerned about her mum, Gwen, who was in hospital but due to return home soon. She was admitted 2 weeks ago following a fall at night getting to the toilet. Gwen has memory loss associated with Dementia and lives with June in her bungalow. They had been offered a monitored form of telecare in the past but June would like to be able to respond to her Mum s needs whilst she can. Gwen is able to be left at home for short periods of time whilst June goes to the shops etc, but June is concerned that if something should happen whilst she is out she would not be aware of it until she returned home. Product Solutions: June purchased a Careline Carephone (M66054). This was programmed with her mobile phone number and that of another 9 family members and friends. Along with this she purchased Careline Falls Sensor Watch (M66066). June makes sure that Gwen is wearing this during the day and it will automatically call June s mobile phone if she falls and does not move afterwards. Gwen has also learnt how to press the button on this to call June if she needs help. Now, even if June is in the garden, she carries her mobile phone with her and can be alerted wherever she is. In order to prevent falls at night time when getting to the toilet June bought a Voice Alarm Monitor, Voice Alarm Bed Sensor Mat and Voice Alarm Wireless Pager. The Sensor Mat goes onto Gwen s bed and when linked to the Voice Alarm Monitor will trigger the alarm when she starts to get out of bed. June has recorded a message to play which asks her Mum to stay on the bed until she gets there to help. The Monitor also triggers an alarm to June s Pager which prompts her to go and assist her Mum. The Result: Gwen came home from hospital and soon settled back to being at home. If she gets up to use the toilet now in the night she listens to the Voice Alarm Monitor and waits for June to come and assist her there have been no more falls! It is so nice to know that Mum can call me if she needs help and I will be automatically alerted if she falls I can now go out and do my weekly shop without worrying about what I will find when I return home, what a relief! - June Careline Carephone & Pendant Alarm System Bed Leaving Sensor Mat Voice Alarm Monitor
Choosing The Right Product HELPFUL INFORMATION Helping You Choose The Right Product Choosing the right product can be confusing and time consuming. This self-help guide produced is designed to help you do this more easily. Look down the first column to identify the area of difficulty then across the row at the suggested solutions and products that can help meet a specific need. We have also included some non-telecare equipment, as they can often be used to support Telecare solutions. If you require additional advice we will be pleased to assist you. At the Front Door TASK: Answering the door Getting to the door Opening the door Hearing the doorbell Hand rails / support for mobility - Grab Rails Ensure there are no tripping hazards on the way to the door Key Safe to allow family/carers to let themselves in - Key Safes Large grip handle key turners - Key Turners Loud or flashing door bell - Homecare Alert and Wireless Doorbell, Wireless Video Door Intercom & Cordless Telephone Door intercoms if a person needs time to get to the door - Wireless Door Phone, Wireless Intercom & Cordless Telephone TASK: Picking up the post or newspaper Bending to pick up post or newspaper Basket behind letter box to catch the post Long Handled Reacher - Combi-Reacher TASK: Security when opening the door to visitors and when leaving the house Difficulty remembering to take keys or forgeting security measures Misplacing keys & wallet or purse Memory prompts & memory jogging devices Memo Minder, Memo Minder Plus Don t leave keys in the lock or in a visible place Keep the chain on Object locating Device - Object Locator TASK: Security when opening the door to visitors and when leaving the house Identify person before opening the door Reduce risk of distraction burglary In the Bathroom TASK: Running the bath Ensure doors are always locked Identify person before opening the door - Wireless Video Door Phone, View-Com Door Entry System Wireless Door Intercom & Cordless Telephone Poor eye sight Gadget to release water automatically if not able to judge too deep - Magiplug depth of bath Alert to prevent flooding - Bath Temperature and Bath Overflow Alarm Forgetting to turn Place prompting signs next to the taps or off taps use reminder gadgets - Memo Minder P390, Memo Minder Plus P390, MEM-X Memory Aid Unable to judge Thermometers and alerts - Bath the temperature of Temperature and Bath Overflow Alarm, the water Floating Bath Thermometer Difficulty turning Extra leverage to grip taps taps on / off - Tap Turners TASK: Calling for help in the bathroom Help needed in an emergency At home alone - help needed from outside the home Internal alarms - Wall Mounted Emergency Alarm, Mobility & Toileting Aid Alarm Use emergency call systems or take mobile / cordless phone into bathroom - Amplified Telephone with Remote Emergency Buttons, Carephone Landline Telephone & SOS Pendant, Wireless Door Intercom & Cordless Telephone, Simple Mobile Phone, Minifone Watch Telephone
Choosing The Right Product In the Living Room TASK: Using the phone Poor eyesight Remembering numbers Getting to the phone Hearing the phone TASK: Controlling the heating Unable to access electrical sockets / switch on portable heating Remembering to turn heating on/off Easy to use/see phone - Large Button Phones, Minifone Watch Telephone, Simple Mobile Phone Phones with photos of family members or a large memory - Cordless Photophone, Memory Plus Phone Mobile / Cordless phones - Wireless Door Intercom & Cordless Telephone, Simple Mobile Phone, Cordless Photophone Minifone Watch Telephone Amplified phones or plug in amplifiers. Ring indicators (pillow shakers and flashers). Hearing aid compatible phones - Portable Telephone Amplifier, Plug in Amplifier, Telephone Ring Indicator and Flasher Remote controlled socket systems - Remote Control Sockets Raised sockets - Handisocket Adapt plugs to make them easier to remove - Pull Plugs, Plug Mates Prompts and reminders - Memo Minder, Memo Minder Plus, MEM-X Memory Aid, Cadex Reminder Watch Remote monitoring of temperature by Carer - Mobile Phone Controlled Temperature Sensor TASK: Preventing falls Trips and slips (also see task below: Switch Lights On & Off adequate lighting can help prevent falls at night) Falling from chair TASK: Switch lights on and off Unable to access or reach light switches easily Need light during the night when getting out of bed TASK: Watching the TV Switching the TV on / off or operating standard TV remote control Hearing impaired can t hear the TV or need the volume turned up extra loud Mobility equipment - Home Helper Trolley, Rollators Movement monitors that alert a carer/ relative at home when the person is getting off the chair or walking around the house - Sense-it Falls Prevention System, Badge-It Fall Detection System, Falls Savers Long Life Chair Sensor Mat, Voice Alert Monitor, Voice Alert Monitor Sensor Mat, Pager Alarm Sensor Kit for Bed & Chair, Speaking Pager Chair Sensor Mat, Voice Alarm Chair Sensor Mat, Care Call Chair Leaving Monitor Operate lights via remote control Remote Control Big Switch, Remote Control Window / Door Switch Use automatic or motion sensor lighting - Night Light with Motion Sensor, Automatic Night Lights Remote controllable sockets or TV remote control with - Remote Control Sockets, Jumbo TV Remote Control Hearing aids and products compatible with hearing aids - Neckloop and Induction Loop Systems TASK: Using electrical sockets Unable to access Easy to reach sockets and adapted plugs or reach sockets - Handisocket, Pull Plugs, Plug Mates Remembering to Memory jogging devices & socket control turn sockets on /off device - Memo Minder, Memo Minder Plus, Mobile Phone Controlled Power Socket,
Choosing The Right Product Keeping Safe & Well at Home TASK: Managing medication Problems remembering to take medication Multiple medications which require organising Difficulty identifying the correct medication to take TASK: Prompts and reminders Difficulty remembering the time and date Difficulty remembering appointments, routines and other important information TASK: Monitoring health Medical conditions that require regular checks to be done at home (i.e. high cholesterol, low blood pressure, Diabetes, Epilepsy, Emphysema, Flu) Easy to use clocks and calendars - Large Calendar Wall Clock, Analogue Dementia Care Clock, Easy To See Wall Clock Gadgets to prompt and remind a person - MEM-X Memory Aid Pendant, Cadex Watch Reminder TASK: Fire safety in the home Hearing loss unable to hear standard smoke alarm Unable to alert a carer in the event of a fire Devices that store and alert you at set times to take pills, or which automatically release pills when required - Automatic Pill Dispenser, Medelert Auto Pill Dispenser, Vibration 5 Alarm Reminder Pill Box, Pill Box Reminder Memory aids / prompts - MEM-X Memory Aid Pendant, Cadex Watch Reminder Talking labels - Penfriend Audio Labeller Health monitors - Cholesterol Glucose Monitoring Kit, Fingertip Pulse Oximeter, Talking Ear / Forehead Thermometer, Upper Arm Blood Pressure Monitor, Low Blood Sugar Wrist Alarm Hypoglycaemia Monitor, Nocturnal Epileptic Convulsion Seizure Monitor Pillow shakers / flashing strobe light smoke alarms - Smoke Alarm Smoke alarm linked to carephone - Careline Smoke Detector Contact your local Fire Service for a home safety fire check TASK: Managing wandering Person wanders around inside the home Person wanders outside of the home TASK: Calling for help Movement monitors to alert a carer inside the house - Voice Alarm Door / Window Open Sensor, Care Call Movement Monitor, Border Patrol Safety Beam, Magnetic Door and Window Open Alarm, Bedside Motion Detector Movement monitors which will alert a relative / carer outside of the home - Careline Carephone & Pendant Alarm System, Motion Detector With Autodialler, SeN-Cit Multifunction Care Monitor Movement monitor with voice prompt Memo Minder Plus, Memo Minder GPS systems - Badge-it Fall Detection, Panic & Wandering Alert System, Personal GPS Trackers Person needs to be Pendant / call button to alert carer able to alert a - Badge-it Fall Detection, Panic & Wandering friend / relative Alert System, Speaking Pager / carer within Transmitter, Care Call Pendant & Pager, the home Long Range Home Safety Alert Pager, Home Safety Alert, Mobility & Toileting Aid Alarm, Wall Mounted Emergency Alert, Wrist Worn Emergency Alarm, Key Chain Personal Alarm Person needs to be Alarm systems - Amplified Telephone with able to alert a Remote Emergency Buttons, Careline friend / relative Landline Telephone & SOS Pendant, / carer outside of Careline Carephone & Pendant, the home Family & Friends Auto Dialling Panic Alarm, Simple Mobile Phone & Alarm, Minifone Watch Telephone Unable to press a Gadget to detect falls automatically call button to - Badge-it Fall Detection, Panic & Wandering get help Alert System, Care Call Fall Detector, Careline Falls Sensor Watch Multiple people in Wireless systems to enable residents to a group home attract help from care staff setting who may - Alert-it Radio Pager System, need to alert a Speaking Pager System, carer or have their Care Call Carer Alert System, movement monitored
Frequently Asked Questions HELPFUL INFORMATION Q. If the product takes batteries how do I know they need replacing? A. On most of the products there is a low battery warning light which will light up when batteries need replacing. Q. The person I care for is able to get out of bed by themselves but sometimes forgets to get back in or is prone to falling on the way back. How will a bed sensor mat help me with this? A. Some of the Bed Sensor Mats (for example M08479) will allow you to set a 15 minute delay and will only alert you if the person fails to get back into bed within that time allowance. Q. My mum lives in an upstairs flat and I am concerned that she will forget to turn off the bath taps and flood her own flat as well as her neighbours beneath her, is there anything that can help? A. A Magiplug Flood & Scald Prevention Plug may well be the answer. This will automatically release the water when it reaches a critical level and prevent flooding. Mum, please stay in bed Q. With the Carephone systems and GPS Tracker how can I be sure that no one else will be able to find out where my mum is or talk to her? A. All our systems which allow you to program telephone numbers into the system will only allow those authorised numbers to have access to the systems no one else would be able to access. Q. Do you have a pendant alarm which you can use in the shower and is waterproof? A. Yes the Careline Carephone & Pendant Alarm has a waterproof pendant which you can use in the shower and bath Q. I am concerned that my Father may fall on his way to the bathroom at night he lives on her own, what products could help him? A. You could try using the Remote Control Socket & Motion Detector which can help to prevent falls. It may also be worth investing in a Careline Carephone with a Fall Detector so you are alerted if he does fall. Remember not to forget simple things like removing rugs and providing rails along landing areas. Q. My Aunt lives alone and we have been advised that a Key Safe should be installed to allow her carers to get into the house in the mornings. I don t think they are very safe though and am worried about her having one. A. You can be reassured that the Supra C500 KeySafe has achieved the highest security endorsement by both the police and the Loss Prevention Certification Board. It is recommended that they are installed behind a gate or in an outside cupboard so they are out of sight. It is also advised that you use a pin code larger than 4 numbers to make it extra safe (most people trying to guess a code will be looking for a four digit number). It would be easier for an intruder to break in through the door than get the key safe off the wall!