Just like every older person, elderly with dementia would like to stay in their own home as long as possible. With the help of informal caregivers, home adjustments and (technological) aids, it is now possible to make this happen.
The benefits of living at home with dementia
People with dementia have specific needs. For example, their wishes include safety technology and care services. These and other wishes illustrate that elderly people suffering from dementia want to stay in their own home for as long as possible and are reluctant to move. Therefore, the number of elderly people who want to live independently in their own home has not only increased due to national policy. It is likely that the desire to live at home, even when suffering from dementia, applies even more to the future generation of the elderly, who are more vital, wealthier, better informed and more empowered than the current generation.
Living in their own home offers those that suffer from dementia a familiar environment and a well-known daily life. For them, moving to a new, unknown location means disorientation, confusion and uncertainty. In addition, their partner often wants to look after his or her life companion for as long as possible. It also has advantages for society as a whole if this informal care system is prepared and able to care for their loved one in his/her own home for as long as possible. This of course reduces the need for professional care.
The disadvantages of living at home with dementia
However, there are also disadvantages to living at home with dementia, like unsafe situations, loneliness, malnutrition and boredom. The risks most often mentioned by caregivers are: medicines that are not taken (or taken incorrectly), falling, electrical appliances that are not switched off, pots and pans that are left on the stove, and the fact that the door is opened for strangers. These risks can be directly linked to the behavior of people suffering from dementia. For example, dementia patients often forget to lock their doors or to take their keys with them, they cannot find the things they do not immediately see, they forget what they were doing, and forget to turn off water or gas.
Caregivers make living at home possible
Dementia is a horrible disease. Not only for the person with dementia, but also for family, friends and caregivers. Due to changing wishes of the elderly, a growing shortage of care staff and changes in government policy, people with dementia longer stay in their own homes with less professional care. As a result, caregivers increasingly provide support and care. The most important factors that determine the amount of care are the availability of informal caregivers, the extent to which they feel burdened or sufficiently competent, and the degree of problem behavior and dependency of the person suffering from dementia. The caregiver is one of the most important factors that makes living at home with dementia possible.
More than 50% of caregivers feel fairly to very burdened. This is partly due to the fact that informal caregivers have little chances to live their own life, find it difficult to combine informal care with work and / or family, are under great pressure and have difficulty letting go of the situation. Support for informal caregivers serves two purposes: 1) guaranteeing quality of life for the caregivers, and 2) extending the period of time that people with dementia can stay in their own home. Support for caregivers must focus on being able to better ‘handle’ the person with dementia, preventing excessive stress, and facilitating care tasks through the use of home adjustments and (technological) aids.
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Home adjustments for people with dementia
The use of home adjustments and (technological) aids is twofold, because they can facilitate independent living for the person with dementia and also ease the tasks of caregivers. We will discuss both solutions, starting with home adjustments.
Since dementia develops differently in every person and it is a progressive disease, adaptation of the home is a continuous process. One could start thinking of home modification when the person suffering from dementia is so troubled by the memory loss that items cannot be found anymore and appointments are forgotten, the orientation in the home deteriorates, an unsafe feeling arises, and the home is no longer light enough. The sooner the adjustments are introduced to the resident, the better. If the resident is still at an early stage of dementia, it is much easier for him or her to get used to adjustments and aids. Simple interventions and adjustments can contribute to a safe, familiar and comfortable living environment.
The environment of a person with dementia can strongly influence the quality of life. Home adjustments can have a positive effect on issues such as emotional life, behavior, eating and sleeping patterns, independence, overall health and safety. This of course also has a positive effect on caregivers, because the person suffering from dementia requires less attention and care. This way we can create a situation that prevents stress and unrest, and supports caregivers in caring for their loved ones. Also, overburdening the caregiver can be prevented, so that hospitalization for people with dementia can be postponed.
Home furnishings for people with dementia
Making a home suitable for someone with dementia is first and foremost about looking at the existing interior of a house. Small, simple and often free interventions can already have a big impact. Important principles of a dementia-friendly home and living environment are: recognisability, clarity, simplicity of space and design, and sufficient lightning. So how do you ensure that someone can find their way around their own home, can move about freely and function as independently as possible? And how do we keep the environment as safe as possible and ensure that there is as little problem behavior as possible?
It is advisable to not make too many adjustments (at the same time) to ensure sufficient recognisability and familiarity. Make sure that the layout and design of the home and living areas are as logical as possible, give important things a permanent place and remove unnecessary items. Make use of sufficient lightning, icons, uniform colors and color contrasts, but avoid shiny / reflective surfaces, busy patterns and dark floor areas. Indoor safety can be improved by making adjustments to the stove and taps and installing fire detectors. It may also be advisable to use motion detectors, remove obstacles that people can fall over, and place brackets and non-slip layers. Also, cabinets with dangerous equipment should be locked, stair gates should be installed, and medication distribution systems and personal alarms should be introduced.
To guarantee that people do not just leave their home, doors can be hidden behind curtains. Also, make sure they the person suffering from dementia has as much room as possible to move around, for example by enlarging sanitary rooms, widening doors and removing barriers. Stair lifts can also be a great solution. Furthermore, the presence of plants and pets has a positive, calming influence. Finally, the exact focus of any adjustment should depend on the exact symptoms of the disease. For people with apraxia, adjustments will have to be made so that they can use objects correctly and perform actions in the correct order.
(Technological) aids for people with dementia
Because most people pay so much attention to decorating their home, they experience the presence of aids as disruptive. Aids for people with dementia conjure up a picture of a hospital instead of a home environment. This leads to great restraint regarding the deployment and presence of these resources. It seems like an impossible balance: more homeliness on the one hand, and more tools on the other. However, assistive aids for people with dementia are crucial to independence. This not only concerns general aids, such as walking aids, anti-slip mats and handles, but also products specifically designed for people with dementia. Often these aids also ease the caregiver’s job. Aids can be found in various categories, for example, aids that help with orientation, wandering behavior, mobility, safety and (personal) care.
A special category of aids for people with dementia is home automation. In other words: (advanced) technological applications that make living at home more comfortable and safe, and at the same time ensure greater efficiency of care. Domotics allow people that suffer from dementia to retain more control and increase their quality of life. Domotics are often used to keep a person safe and comfortable when the caregiver is not there. This includes active and passive alarm functions, motion detectors, fall detection, gas detection, fire detection, roaming detection and assistance with the use of medicines. In addition, a number of comfort applications are possible such as remote control of curtains and lighting.
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