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Home Care

Principles of Changing and Designing Home Environment
Patients with Alzheimer’s Disease
Fall Prevention

 

Principles of Changing and Designing Home Environment

(A) Safety

  • Keep corridors unblocked and of sufficient width.
  • Do not use rags or cloth as carpet; use anti-slipping mats instead.
  • To prevent slipping and falling, keep the floor dry.
  • Use nightlight at night.
  • Attach eye-catching tape on doorsills to attract attention of the elderly with poor eyesight.
    - Increase awareness when carrying out outdoor activities.
    - Hold the handrail when using escalators or stairs.

(B) Washroom and Bathroom

  • Handrails should be installed in bathrooms.
  • Anti-slipping mats should be placed in bathtubs.
  • Sit on bathing chairs on bathing boards for taking bath and ensure that they are sturdy.
  • Elderly people whose forelimbs are not supple enough can use grooming aids.
  • When taking a warm water bath, turn on the cold water tap first before turning on the hot water tap.
  • Avoid using the bathtub; take a shower instead.
  • Open the windows to ensure good ventilation.
  • Do not lock the door to avoid hindering rescue in case of accident.
  • Use bath gel instead of soap.

(C) Kitchen

  • Clean up puddles as soon as possible and keep the floor dry.
  • Do not place frequently used utensils at high positions to prevent accidents when climbing up to reach for them.
  • Do not stand on folding chairs.

(D) Bedroom

  • Choose a bed of suitable height to prevent losing balance when getting on or off.

(E) Shoes

  • Aviod wearing slippers
  • Choose appropriate size of shoes in order to avoid loosening and accident

(F) Others

In case an accident occurs,

  • Keep calm.
  • Make sure that you are in a safe situation.
  • Call the police (Tell them your name, phone number, address, what has happened and what service you need).
 

Home care for Patients with Various Diseases:
Patients with Alzheimer’s Disease

(A) Tips for Home Safety

  • Patients have low safety awareness and accidents easily occur, thus it is necessary to design home environment with careful consideration.
  • Adopt special designs according to specific needs of patients.
  • If the patient likes a certain celebrity, post a photo of him/her in his room.
  • Amend design of home according to the physical fitness of patient.

(1) Cognitive Hints

  • Hints for indoor spatial arrangement
  • Hints for location of items
  • Hints for refreshing memory
  • Time for activities should be kept constant to enhance time-space concept
  • Assist in accomplishment of daily life activities
  • Provide more opportunities for patients to participate in daily life activities independently.

(2) Sensory Stimulations

  • Do not place patients in a place with too many or too few sensory stimulations.
  • The provision of various environmental sensory stimulations should be adjustable, such as the presence of a movable windshield and lamps with adjustable brightness, for adjustment in different situations.
  • Avoid using dotted shower curtains, as patients may misperceive the black dots as flies.

(3) Home Design

  • Big glass window and over-smooth floors produce reflections that affect patients’ judgement and may induce suspicion. Both adhering anti-reflective stickers on glass windows and reducing polishing and waxing of floors can help in preventing patients from falling.
  • Avoid drastic changes in floor colour and the use of tiles with patterns of holes and pits.
  • Positions of decorations and facilities in home environment should be identical and tidy.
  • Since the abilities to memorize, understand and judge in dementia patients have deteriorated, they find it hard to adapt to changes in the environment and living habits which may cause chaos and danger in their daily routines.
  • Avoid unnecessary changes in home environment, including home moving, renovation, changing the positions of furniture, etc.
  • Manage the ever-changing state of patients with unchanged home environment so that the potentials of patients can be developed through their original living habits in familiar settings.

 

(B) Tips for Safety at Nursing Homes

(1) Private Space

  • Use furniture and plants to separate out private areas from public area.
  • Public phone should be placed in activity rooms or living rooms while family photos and personal possessions of the patients should be placed in their rooms.
  • Interesting portraits or ornaments can be hanged at the ends of corridors to attract the attention of wandering patients and prompt them to engage in some meaningful activities.
  • Design special walking trails for patients to walk freely and safely.
  • Improve patients’ awareness of the environment and orienteering ability.
  • Design notice boards for navigation.
  • Use big clocks, schedules and calendars.
  • Provide familiar contact methods and persons.
  • Place photos and objects that patients are familiar with on their bedside shelves to increase their sense of belonging.

Patients who had Stroke

  • Patients should always assume correct sitting and lying poses with their leg and shoulder on the affected side placed at desirable positions to prevent muscle contracture and stiffening of joints.
  • Relatives should frequently remind or assist patients to flip over to prevent the formation of decubitus.
  • When chatting with patients, relatives should sit on their affected side to let them realize the existence of limbs on that side.
  • Remind patients to look more to the affect side and observe the surroundings to avoid danger.
  • When lifting patients, do not pull the forelimb of the affected side to prevent straining the shoulder joint.
  • Overprotecting the patients will lead to their will lead to patients’ reliance on others, thus patients should be given opportunities to look after themselves as often as possible.
  • Relatives should give patients spiritual support to increase their confidence.
  • Sensory perception of the affected side may be damaged, so relatives should be careful not to let patients get in contact with objects that are sharp or too hot. Before taking a bath, patients should first detect the water temperature with the unaffected hand to prevent being scalded.
  • Patients and their relatives should always pay attention to the hygiene condition of the limbs on the affected side. After bathing, slits between fingers and toes can be wiped with sponge to keep them dry.
  • There are aids that can help patients look after themselves more independently, but appropriate training is needed. For instance, handrails installed beside the toilet bowl can help patients stand up, but improper use can lead to accidents.

Fall Prevention