Creating an enabling home for someone living with dementia

For most people living with dementia, it is important to them that they are able to remain in their own home for as long as possible.

There are some adaptations that can be made for people living with dementia to allow them to live independently, safely and comfortably in their own home, and support available to enable these adjustments to be put in place.

Tips for Creating a Dementia-Enabling Home

There are some general changes around the house that can help someone living with dementia to continue their day to day life as independently as possible.

Around the Home

• Install carbon monoxide detectors and linked smoke and heat alarms, in line with current Scottish legislation. Check at least once a month that the alarms are working. In some areas, it is possible to install alarms that trigger an alert to a call centre or a nominated person, such as a carer, if the person living with dementia would not recognise and act when alarms sound.
• Consider changing patterned curtains and carpets to plainer fabrics. Dementia can affect how some people see things; patterns on curtains, cushions or wallpaper may be confusing. If you are changing the carpets or wallpaper, consider replacing them with a plainer, less patterned design. For any changes that you make, respect the views of the person living with dementia and consult them first.
• Use colour coded keys and locks. You can buy different coloured tabs to put on keys and paint the lock with the colour to match the key.
• Purchase dementia-enabling clocks. These include clocks that display the day of the week, date and time, and show if it is day or night.
• Consider installing dementia-enabling telephones. Telephones are an easy and familiar way to stay in touch. Dementia enabling telephones have larger buttons for those with visual impairment and can include pictures of friends and family next to automatic dial buttons.

Lighting

As people age, they need more light for their eyes to see well. Good lighting is even more important for people living with dementia, because their ability to understand what they see can be affected. Good lighting and access to natural light can help people with dementia stay more alert during the day and sleep better at night. For a home to be more dementia enabling:

• Let in as much natural light as possible. Pull back curtains and make sure windows are clean and not blocked by anything outside such as trees or bushes.
• Minimise shadows, as some people living with dementia resist going near dark areas.
• Avoid spotlights and reduce glare. Light on shiny floors can be mistaken for a puddle.
• Coloured or reflective tape can highlight light switches so they are easy to find.

Assistive Technology

Some people with dementia find assistive technology useful in their home.  Assistive technology can help people with daily tasks that they are starting to find more difficult. Some examples are:

• Item locators that can help you to find easily lost items, such as keys. You can attach an electronic keyring to your set of keys and keep the locator button close to you.
• Reminder aids that can play messages at a certain time, such as a reminder to lock the door at night.
• Talking watches. These speak the time and date in a clear voice at the press of a button.
• Personal alarms, which allow someone to call for help if they have fallen or are unwell.
• Gas, smoke and flood detectors that can automatically alert staff at a response centre or a family member if there is a problem. There are also some gas detectors that can switch off the gas supply when they detect a problem.
• A range of computer programmes are available to download for your smartphone or tablet which can help you in your daily life, such as the IRIDIS app.

Advice for Carers, Friends and Family Members

If you are wondering what you can do to help someone living with dementia to remain safe and in their own home, there is a lot you can do to help. Before making any changes, it is worth considering the following points:

• Not all changes will work for everyone - dementia can affect people in different ways. Any changes you make should consider their individual situation, including any other long-term conditions or disabilities.
• Involve the person living with dementia as much as possible. Try to work together to look at what would help, find solutions and focus on changes which support them to do things, rather than those that may restrict their day to day activities. Include their likes and dislikes too, for example, which colours they prefer.
• Don't make unnecessary changes. A person living with dementia may struggle to learn something new or to adapt to changes in their home, especially when things are moved or replaced with something unfamiliar. If possible, keep things in the same places or if you are buying new furniture and equipment, try to find items that are similar in shape and colour to what the person already has in their home.
• Plan for the future. Where you can, agree any changes sooner rather than later. This will give the person living with dementia time to adjust and to get used to them. It is possible that in the future they may forget that they have agreed to any changes.
• Seek professional advice. The person you care for is entitled to a care assessment from your council’s social work department which may give you advice about changes to make. Your council may also provide financial help with the cost of making some of these changes. If you have a Dementia Link Worker, you can always speak to them.

Advice about Care Assessments

See our guide Caring for Someone With Early-Stage Dementia or call the Age Scotland helpline on 0800 12 44 222 for advice about care assessments.

Keeping Warm in the Winter

People living with dementia may forget to keep warm during the winter, sitting in cold rooms or not wearing enough layers of clothing. Being cold for any length of time can increase the risk of colds, flu and hypothermia, heart attacks and stroke. The individual's home should be kept at an appropriate temperature throughout the year to prevent them from getting too hot or too cold. During the winter, the rooms they use during the day should be kept warm to at least 23°C. Bedroom windows should be closed at night as cold air can increase the risk of chest infections. The person living with dementia should layer clothing to maintain body heat and avoid sitting down for too long, if possible, by getting up and moving about.

There are benefits, grants and schemes available to make your home more energy efficient. Age Scotland offer free energy advice workshops, which cover a range of topics including energy efficiency, accessing benefits and financial support which could help with energy costs, and looking at future options for heating.

What financial support may be available to adapt your home?

Councils have a duty to provide assistance to make a house suitable for a disabled person. The council must give a “mandatory grant” for any changes that they consider to be essential. Grants can be given to adapt a house to enable access to the toilet, bath or shower, wash hand basin and sink. This could include installing handrails, a level access shower or lowering worktops. The minimum level of grant is 80% of the cost. If the person with dementia receives any of the following benefits, they will get a 100% grant, meeting all the costs of the work:

• Income Support
• Income-Based Jobseeker’s Allowance
• Pension Credit (guarantee credit)
• Income-Related Employment and Support Allowance
• Universal Credit

If the person rents their home, they must seek their landlord’s consent before beginning any work. A landlord can withhold consent, but must have a good reason to do so. When giving consent a landlord can set certain conditions, such as asking to comment on plans or requiring that adaptations are removed when they move out.

If common areas of a building need to be adapted, such as shared stairs in a tenement, or adding a ramp outside a shared doorway, a majority of the property owners need to consent. There only needs to be a majority of one owner, so you won’t be prevented from making the adaptation if a minority object. If you have the consent you need to make the adaptation, you can apply to the council for grant help in the same way that a homeowner would.

If living at home puts you at risk, even with support from carers, you may need to consider the longer-term option of a care home.

Dementia resources

Find out more about Age Scotland's work and services to support people affected by dementia.

• Dementia home
• About Dementia - Policy and Practice Forum
• Dementia Training
• Dementia information guides
• Age Scotland helpline
• Order free information guides