Safety Around the Home

Consider whether it's appropriate to remove any of the following types of items, or where they're required for use by carers, placing them in a cupboard with a child-proof lock or in a lockable medicine box. Make sure the carer knows where the items (and any key required) are:

• sharp knives etc
• tin openers, especially since they create a very sharp edge on the tin, and someone with dementia may not realise this
• matches and lighters with a flame are obviously hazards, as are candles and cigarettes. Gas hobs can be lit with a piezoelectric lighter if the person is able to use it, but consider a modern self-igniting hob with auto-shutoff. Candles in proper holders might be useful for power cuts when used supervised, but consider having sufficient (rechargeable) LED lights - there are ones that plug in and come on automatically in a power cut. Cigarettes are best only used supervised, if at all.
• household chemicals (including toilet bleach, even handwash refills that might be confused with a drink)
• medicines that are given by a carer (including future supplies)
• undiluted drink
• thickener powder
• cholesterol-lowering margarine etc (which could be eaten in far greater quantities than intended, with a spoon).
• microwave oven - consider whether a microwave oven might be misused, either by setting a long cooking time appropriate for a conventional oven or by leaving inside thin metal objects such as a fork or crockery with gilded decoration etc.

The oval plastic labels on apples and other fruit are a choking hazard and we strongly recommend taking them off as soon as they're in the house (see our note on fruit labels within our section on food safety).

Look round the entire home, and at clothes and shoes, for anything that's worn, damaged or simply not working. We're not suggesting that anything with the slightest issue should be thrown away, but do consider whether the issue could cause a safety problem either now or in the future after further deterioration.

For example:

• is there a sharp edge
• has it been weakened so it's more likely to break
• is a shoe sole slippery because it's worn
• is a hem coming undone liable to open further and cause a trip
• why isn't something working fully (especially something electrical, which may indicate a stray wire that would be unsafe).

Normally your boiler's hot water thermostat may be set to over 50 degrees Centigrade (120 degrees Fahrenheit) in order to prevent Legionnaires' disease bacteria growing, and this will scald.

For modern 'combi' boilers without a separate hot water tank it's likely that a more reasonable temperature can be set, and we'd recommend setting the temperature so that it's right for hand washing without mixing with cold at all (about 40 degrees Centigrade, 105 degrees Fahrenheit). Even a combi boiler will probably have a small tank inside it, and some have a 'hot water preheat' option that keeps this small tank at the set temperature - if so then turn off the preheat option in order to prevent any possibility of bacteria growth. (Don't worry about bacteria growing in the hot water left in the pipes after the tap is turned off - it will soon cool to room temperature and be safe.)

If you have a hot water tank then you could consult a plumber about having a thermostatic valve or thermostatic mixer taps installed.

If necessary, you could attach a label, covered with a plastic sheet to avoid splashes, on the wall behind each tap: 'HOT WATER TAP' in red and 'COLD WATER TAP' in blue.

A modern bathroom lock is able to be opened from the outside in an emergency (such as someone having fallen), by putting a coin into a slot and turning it. For an older lock, we'd recommend making sure that it isn't possible to be locked in, but if changing an unsuitable lock then make sure that the person can easily understand how to use the new one, and that it isn't too stiff for them to turn. The nearest thing to a sliding bolt is the vacant/engaged type, where at least the bolt is visible to reassure them that it's locked, although you turn a handle to open it (which could be labelled if necessary). Consider not having a lock if the person is happy with that, although visitors may want at least some sort of 'in use - do not disturb' sign.

Consider the contents of cupboards, from two points of view. Firstly, things the person uses should be easily accessible, without needing to stretch high or sideways (which could strain muscles or overbalance them), and without other things in the cupboards tumbling out or being pulled out at the same time.

Secondly, things the person doesn't use are likely to be taken out of cupboards en masse at some point, when they're looking for something they can't find or simply wanting to know what's there - so do check for things that are dangerous, including things that will form slip hazards when out all over the floor (like a box of marbles).

In our section on improving the home environment for wellbeing, we include the following safety issues:

• good lighting
• room to manoeuvre a walking frame
• avoid placing two chairs side by side at the sort of distance apart that the gap between them might be misinterpreted in poor light or by someone with poor eyesight as a chair with arms that in reality belong to the chair on each side.

In our section on mobility, we include the following safety topics:

• chairs and aids to standing
• toilet and bathroom aids.

If you use a wheelchair for travelling out, make sure the nuts holding the wheels on are kept tightened up sufficiently and that when the chair's empty the wheels can't be wobbled. The nuts can work loose over time, so check periodically.