Daily care & safety at home

• Their best time of day
• How long meals, bathing and dressing really take
• What they enjoy, and what they find hard
• Their old routines: when they always woke, ate and went to bed

Morning

• Washing and dressing, then breakfast and a chat
• A light activity, like old photos or a simple craft
• A shared chore, then a walk or active game

Afternoon

• Lunch and light tasks
• Music, puzzles, gardening or a visit with a friend
• A short rest

Evening

• Dinner and tidying up together
• Reminiscing over dessert, cards or a film
• Bath or wash, getting ready for bed, reading

• Note what worked and what didn’t, and why
• Watch for parts of the day that are too full or too empty
• Balance activity with rest. Don’t schedule every minute
• Leave room for spontaneous fun
• Change the routine as abilities change

Keeping the same wake and bed times can help with sleep problems and late-day restlessness. The Dementia: changes in behaviour guide has a fuller plan for sundowning and nights.

Before

• Gather everything first: towels, soap, a bath chair, a non-slip mat
• Warm the room, keep it well lit and test the water
• Be matter-of-fact: “It’s time for your bath.” Or offer a choice: “Now or in 15 minutes?”
• Try to bathe at the same time each day

During

• Give them a job, like holding the washcloth
• Tell them each step before you do it
• Start with hands or feet, which feel less threatening
• Drape a towel over shoulders or lap so they feel less exposed
• Never leave them alone in the tub or shower

• Lay clothes out in the order they go on
• Hand over one item at a time
• Keep only one or two outfits in view
• Buy several of the same outfit if they want to wear it every day
• Choose loose clothes, elastic waists, large zippers and slip-on shoes

• Keep up habits they always had, like makeup or a regular haircut
• Use an electric razor for safety
• Show toothbrushing step by step, and let them do what they can
• Try a child’s toothbrush if they bite down
• Find a dentist with dementia experience, and keep regular visits

Accidents often happen because the person can’t find the bathroom or doesn’t recognise the toilet. Ask the doctor to check for causes that can be treated, like a urinary infection.

Try this

• Put a big “Toilet” sign or picture on the bathroom door
• Offer a bathroom trip every two to three hours
• Use loose clothes that are easy to pull down
• A coloured toilet seat can make the toilet easier to see
• Limit drinks in the evening if nights are a problem, but not during the day
• Use waterproof mattress covers and clean the skin gently after accidents

• Serve meals in the same quiet place and at the same time
• Turn off the TV and radio
• Put out only the utensils needed
• Offer one or two foods at a time
• Allow an hour or more, and don’t rush
• Eat together when you can

White plates or bowls on a contrasting placemat help the person tell food from plate, and plate from table. Avoid patterned dishes and tablecloths.

• Offer familiar foods they like
• Cut food into small, soft pieces
• Try finger foods that are easy to pick up, like orange segments or steamed broccoli
• A sandwich-style meal can make eating alone easier

Offer small cups of water or other drinks through the day. Foods with lots of water, like fruit, soup and smoothies, help too. Dehydration can cause dizziness and more confusion.

• Serve soft or cut-up food, and avoid hard-to-chew foods like raw carrots
• Have them sit upright with the head slightly forward
• Check their mouth after meals
• Learn what to do if someone is choking

Refusing food can be a sign of tooth or mouth pain. If appetite drops, try favourite foods and several small meals instead of three big ones, and tell the care team about weight loss or trouble swallowing.

• Add night lights and motion-sensor lights
• Mark step edges with bright tape
• Remove trip hazards and fix loose railings
• Use simple signs or pictures on the bathroom, bedroom and kitchen doors
• Limit mirrors if reflections confuse or frighten them
• Test smoke and gas detectors often. They may not smell smoke or gas
• Post emergency numbers and the home address by every phone

• Fit stove knob covers or an automatic shut-off
• Put “Stop! Hot!” signs near the oven, toaster and iron
• Check the fridge often and throw out spoiled food
• Remove fake fruit or food-shaped magnets that might be eaten
• Consider disconnecting the garbage disposal

• Set the water heater to 120°F (about 49°C)
• Label hot and cold taps clearly
• Install grab bars in a colour that stands out from the wall
• Use non-slip mats, a shower stool and a handheld shower
• Lock away toiletries that might look or smell like food

• Use a baby monitor or room monitor to hear a fall or call for help
• Remove space heaters
• Be careful with electric blankets and heating pads, and keep controls out of reach
• Ask about bed rails or other mobility aids

• Guns and other weapons
• Knives, scissors, power tools and machinery
• Cleaning products, laundry pods, paint thinner and matches
• Alcohol, and anything that could be harmful if swallowed
• Gasoline and other flammable items
• Poisonous plants

• New dents or scrapes, near misses or tickets
• Getting lost on familiar routes, or taking far longer than usual
• Mixing up the brake and gas pedals
• Driving too fast or too slowly, drifting between lanes
• Missing signs, or mistakes at intersections
• Getting angry or confused while driving
• Friends or neighbours raising concerns

A driving evaluation by an occupational therapy driving specialist gives an objective view. Laws differ by state, so check with your state’s DMV.

1. Start talking early, before it is urgent. It may take many conversations.
2. Acknowledge the loss: “I know how much driving means to you.”
3. Appeal to their sense of responsibility and care for others.
4. Ask their doctor to advise them to stop, and to put it in writing.
5. Have alternatives ready: family rides, taxis, senior transport, deliveries.
6. As a last resort, hide the keys, disable the car or sell it.

Warning signs include coming back late from a usual walk, talking about going to work, trying to “go home” while at home, restlessness, and getting lost in a new place.

Practical steps

• Keep the day structured with meaningful activities
• Put deadbolts high or low, out of sight
• Fit door chimes or alarms, and fence the yard
• Keep coats, bags, shoes and keys out of view
• Avoid busy, confusing places like large malls
• Never leave the person alone in a car
• Never lock a person in the house alone

• Have them wear an ID or medical bracelet with your phone number
• Label clothing if they might take a bracelet off
• Consider a GPS tracker
• Keep a recent close-up photo ready for police
• Tell neighbours and local police that they may wander
• List places they might head for: old homes, past jobs, a place of worship
• Know nearby dangers like ponds, busy roads and bus stops

Safe-return programs like MedicAlert + Alzheimer’s Association Safe and Found (1-800-432-5378) can help. There may be a fee.

• Play songs from their teens and twenties
• Ask what they were doing when a song was popular
• Sing along or dance together
• Look for community concerts or choirs for people with memory loss

For example, someone who loved Motown might light up hearing The Supremes, or a lifelong church singer might join in a favourite hymn.

• Look through photo albums together
• Make a simple memory book with large photos and captions
• Ask about childhood, work, places they lived
• Reminisce over coffee and dessert

• Folding towels or sorting socks
• Setting the table or washing plastic dishes
• Measuring, mixing and pouring while baking
• Watering plants or sweeping the porch
• Sorting mail, coupons or recycling

• A daily walk, gentle stretching or tossing a soft ball
• A park, garden, zoo or quiet museum, at a slow time of day
• A favourite restaurant during off-hours, with a table near the restroom
• Keep trips short so they don’t get overtired

• Join worship, prayer, sacred music or holiday rituals they know well
• Tell their faith community about the dementia so people keep reaching out
• Feed, brush or sit with a pet
• Read stories or do simple crafts with grandchildren

Early stage

• Keep up hobbies, clubs, outings and favourite restaurants
• Cook together from a well-known recipe
• Plan the day together each morning

Middle stage

• Simple, step-by-step jobs like folding or sorting
• Music, photo albums and short walks
• Rummage boxes and familiar objects to hold

Late stage

• Soft music, nature sounds or reading aloud
• Hand massage with unscented lotion
• Sitting together, holding hands

A free U.S. government service that connects you with your local Area Agency on Aging for meals, in-home help, transport, adult day care and respite. It can also point you to help with the cost of home safety changes.

Free and confidential, day or night, in more than 200 languages. Staff can help with safety, daily care and finding local services. Callers who are deaf or hard of hearing can use 711 relay.

A safe-return program with an ID the person wears. If they are found, the number on the ID helps identify them and reach their family. A fee may apply.