How to create a supportive environment for a person with dementia

For many of us, home is where we feel safest and most comfortable. For older adults with dementia conditions, this feeling can be even stronger and important to support.

The home environment plays a big role in the health, wellbeing, and safety of older adults with Alzheimer’s and other dementia conditions. There are many things we can do to make our loved one’s house, apartment, or even bedroom safer and easier to navigate, especially as dementia symptoms progress over time. 

From simplifying furniture layout to adding written labels and other visual cues, we’ll share practical home modifications you can make to help keep your loved one safe and minimize memory-related anxiety, disorientation, and accidental injuries. 

Adjust lighting and sound

Because dementia symptoms have to do with how our brains process information, sight and hearing can be greatly affected over time, which can have an effect on emotions and mood. 

Lighting

Bright, natural, even lighting can help reduce the risk of falls and decrease confusion. At night, be sure that lights can be turned all the way off to promote better sleep. Here are a few suggestions for adjusting the lighting in your loved one’s room:

• Try lights with automatic sensors

• Make sure windows offer plenty of light by removing any obstructions and opening curtains and blinds during the day

• Reduce glare and reflections wherever possible, as this can increase confusion. Mirrored images can be disorienting, so remove mirrors and cover or remove reflective surfaces, such as glass or highly polished furniture

• Use nightlights in hallways and bathrooms to avoid nighttime falls

• As a person ages, regular visits to an eye doctor can help flag any dementia-related vision problems

Sound

Excess noise can be alarming or confusing to a person with dementia, especially as many hearing aids amplify certain sounds. There are a few ways to help create a quiet (but not silent) home environment:

• Reduce background noise by turning off music or tv when no one is watching; turn on subtitles or closed captioning rather than turning up the sound too high

• Try to avoid too many competing sounds all at once by limiting the number of people who visit at one time and making sure music, tv, and games are not on all at once

• Shut the windows when it’s very noisy, for example if neighbors are mowing the lawn or if there are lots of sirens or noisy traffic

• Carpets, cushions, curtains, and soft furnishings can help absorb sound in a room with linoleum or tile flooring.

  • Note: Rugs can be tripping hazards, so opt for wall-to-wall carpeting if possible. See more on safe flooring options below

• If the person wears a hearing aid, check the batteries, settings, and fit often; people with dementia may not remember how to use or wear their hearing aid, decreasing its effectiveness

Make space to move around

Simplifying the layout of your loved one’s furniture is a great first step to reduce tripping hazards and make space for mobility support. Beyond reducing clutter and removing unnecessary small items around the room, there are many other ways you can make it easier for your loved one to move around their home as their vision and mobility become more limited: 

Safe choices for flooring

• Paint walls and furniture a contrasting color from the floor

• Avoid small area rugs; a person with dementia may become confused and think the rug is an object they need to step over

• As with furniture and mirrors, shiny or reflective flooring can also be slippery and disorienting so it’s best to carpet over it or go with a matte, non-shiny flooring choice

• Use brightly colored tape to mark the edges of stairs and steps

• Make sure all cords and cables are removed from the walkway and secured against the wall

Tips for supporting safe movement

• Be careful about small pets, as they can also be tripping hazards and may even cause confusion at times

• When choosing carpeting, curtains, blankets, and other home furnishings, opt for plain colors, as busy patterns may cause visual confusion

• Place a gate across the stairs if your loved one has trouble with their balance; install a sturdy handrail and safety grip strips on stairs for added traction if they aren’t carpeted

• Buy your loved one shoes and slippers with good traction

• Install grab bars in the bathroom, near the toilet and in the shower

Add visual cues

As dementia symptoms progress, your loved one may not remember where they are, what common objects are, or where to find the things they need. While vision also can worsen over time, using contrasting colors and written labels are a great way to help your loved one orient themself and successfully navigate their space.

Contrasting colors

Using contrasting colors can help a person with dementia differentiate between objects and may also assist with their depth perception and knowing where it is safe to step or sit. Contrasting colors can be useful to: 

• Differentiate between walls, floors, and furniture and furnishings (for more on flooring, see section above)

• Make doors and banisters stand out against a white wall, for example

• Reduce risk of falling by installing a toilet seat in a contrasting color to the rest of the bathroom

• Reduce anxiety around bathing by placing a contrasting-colored towel on the shower or tub floor before setting up the shower stool; this can help a person know where it is safe to step when bathing, as it reduces glare and supports more accurate depth perception

• Define the edges of dishware on the tablecloth or table

Bold written labels or signs

Most people with Alzheimers and other kinds of dementia are able to read until the late stage of the disease. Clear, concise labels or signs with simple written instructions can help remind your loved one of where things are and what they’re for. When creating your signs, keep in mind: 

• Language should be direct and clear

• Words and an appropriate picture should be large enough to read easily and contrast with the background 

• Sign should be placed in a low, but easily visible place

Labels and signs can be very personal to each household, but here are a few suggestions of what to label to get you started:

• Doors, such as bathroom, bedroom, and kitchen

• Closed cupboard and drawers should be labeled with what’s inside; you can even include who it belongs to, a brief instruction, and a photo of the contents

• Hot and cold water taps

• Kitchen appliances

• Photo albums with each person’s name and their relationship

• Tip: Labels that describe the function of objects can be helpful (for example, label a sweater drawer with “Wear these when you feel cold”)

Home safety measures

With all the proactive modifications you can do around the house to help your loved one maintain their independence, there are also some essential safety measures to put in place. Here are the National Institute on Aging’s top recommendations for making the home environment safer for a person with Alzheimer’s or other types of dementia:

• Add smoke and carbon monoxide alarms in or near the kitchen and all bedrooms

• Keep emergency phone numbers (ambulance, poison control, doctors, hospital, emergency contact) and the home address near all phones

• Buy a phone with large touchpad buttons and digital clocks with large displays, showing day, date, and time

• Install safety knobs on the stove and a shut-off switch

• Purchase childproof plugs for unused electrical outlets

• Lock up or remove the following from accessible locations:

  • All prescription and over-the-counter medications

  • Alcohol

  • Cleaning products, dangerous chemicals, matches, etc

  • Poisonous houseplants

  • Weapons, scissors, and knives

  • Gasoline cans or other or dangerous tools and items in the garage

How to get started

As you gather information about what kinds of changes you may need to help your loved one make, it’s important to remember that in most cases there’s no need to make drastic modifications overnight. Stay in close contact with your loved one’s doctor and care manager, if they have one, to help prioritize which changes to tackle first. Talk to your loved one to find out what their preferences are and to help them plan ahead for their care.