Can Someone With Dementia Stay at Home Safely?

For many families, a dementia diagnosis raises an important question: Can my parent or loved one continue living safely at home?

In many situations, the answer can be yes. A person living with Alzheimer’s disease or another form of dementia may be able to remain at home with the right combination of family involvement, home safety precautions and caregiver support.

However, dementia is progressive. A home and care routine that works today may need to change as memory, judgment, mobility and behavior change.

The goal should not simply be to keep someone at home as long as possible. The goal is to help the person remain safe, comfortable and supported while preserving as much independence as possible.

Dementia Does Not Automatically Mean Someone Has to Leave Home

A dementia diagnosis by itself does not determine where someone must live.

In the earlier stages of dementia, a person may still be able to complete many daily activities independently. They may only need help with certain tasks, reminders, transportation, meals or companionship.

As dementia progresses, families often need to provide more supervision and hands-on assistance.

The amount of support needed depends on the individual, including their:

• Memory and judgment
• Ability to complete personal care
• Mobility and fall risk
• Ability to prepare food safely
• Medication routine
• Wandering risk
• Sleep patterns
• Behavior changes
• Living environment
• Availability of family or other caregivers

Rather than focusing only on the diagnosis, families should look carefully at what the person can safely do on their own.

Signs Someone With Dementia May Need More Help at Home

Changes can happen gradually, making them difficult for families to notice.

Some warning signs that additional support may be needed include:

• Missing meals or forgetting to eat
• Wearing the same clothing repeatedly
• Difficulty bathing or maintaining personal hygiene
• Forgetting medications
• Leaving appliances on
• Getting lost in familiar places
• Wandering or trying to leave the home unexpectedly
• Increasing falls or difficulty walking
• Confusion about time or place
• Difficulty managing normal household tasks
• Increased anxiety when alone
• Changes in sleep patterns
• Increased confusion in the evening
• Unsafe driving
• Family caregivers becoming exhausted

One isolated incident does not necessarily determine the level of care someone needs. Families should look for patterns and changes over time.

Can Someone With Dementia Live Alone?

Some people in the earliest stages of dementia may continue living alone for a period of time, particularly when they have a strong support system and their abilities are monitored closely.

The more important question is whether the person can be safely left alone.

Consider whether your loved one can:

• Recognize an emergency
• Call for help if needed
• Safely prepare food
• Remember to eat and drink
• Manage medications appropriately
• Use household appliances safely
• Find their way home
• Lock and unlock doors appropriately
• Avoid falls and other hazards
• Respond appropriately to strangers
• Complete essential personal care

If several of these areas are becoming difficult, additional supervision may be needed.

Wandering Is an Important Safety Concern

People living with dementia can become confused about where they are or where they intended to go.

Someone may leave home intending to take a familiar walk, visit a former workplace or look for a family member and then become unable to find their way back.

Families should pay particular attention if a loved one:

• Gets lost in familiar areas
• Talks about needing to “go home” while already at home
• Attempts to leave at unusual times
• Paces or appears restless
• Tries to follow a previous work routine
• Has difficulty recognizing familiar surroundings

If wandering or getting lost becomes a concern, the care plan and home environment should be reassessed.

Make the Home Environment Safer

Home safety becomes increasingly important as dementia progresses because changes in memory and judgment can turn ordinary household items into potential hazards.

Families can consider:

• Improving lighting throughout the home
• Removing loose rugs and clutter that may contribute to falls
• Keeping frequently used areas easy to navigate
• Securing medications
• Limiting access to hazardous cleaning products or chemicals
• Monitoring stove and appliance use
• Installing grab bars where appropriate
• Keeping emergency information accessible
• Making doors and exits easier for caregivers to monitor
• Regularly checking smoke and carbon monoxide detectors

Home safety should be reviewed periodically because a person’s abilities may change.

Meals and Hydration Can Become Difficult

A person with dementia may forget to eat, lose track of mealtimes or have difficulty preparing food.

They may also lose interest in eating or become overwhelmed by complicated meal preparation.

A caregiver can help by preparing meals, encouraging regular eating and drinking, providing companionship during meals and watching for changes that should be discussed with the person’s healthcare provider.

Personal Care Needs Often Increase Over Time

Activities that once seemed automatic can become confusing as dementia progresses.

A person may begin having difficulty with:

• Bathing
• Dressing
• Grooming
• Toileting
• Oral hygiene
• Choosing appropriate clothing

Caregivers can provide reminders, guidance and hands-on assistance when appropriate while encouraging the person to continue doing the parts of the routine they can safely manage.

Maintaining a familiar routine can also make daily activities less confusing.

Companionship and Routine Matter

Dementia care is not only about preventing accidents.

Regular interaction, familiar activities and a predictable routine can help create a more comfortable home environment.

A caregiver may spend time:

• Talking and providing companionship
• Taking walks
• Looking through photographs
• Listening to familiar music
• Preparing meals together
• Participating in simple hobbies
• Following established daily routines

The activities should be appropriate for the individual’s abilities, interests and preferences.

Family Caregiver Burnout Is Also a Safety Issue

Families sometimes focus completely on whether their loved one is safe and overlook the health and exhaustion of the person providing the care.

Caring for someone with dementia can eventually require significant time and attention.

Family caregivers may benefit from additional help if they are:

• Losing sleep regularly
• Missing work frequently
• Unable to leave the person alone
• Feeling overwhelmed by constant supervision
• Struggling with their own health
• Unable to manage other family responsibilities
• No longer able to safely provide physical assistance

Respite care or regularly scheduled in-home care can give family caregivers time to rest, work, attend appointments or manage other responsibilities.

How In-Home Care Can Help Someone With Dementia

Non-medical home care can provide additional assistance while allowing someone to remain in familiar surroundings.

Depending on the person’s needs, a caregiver may assist with:

• Companionship
• Personal care
• Bathing and dressing
• Meal preparation
• Light housekeeping
• Mobility assistance
• Routine reminders
• Transportation
• Engagement and activities
• Respite for family caregivers
• Supervision and safety awareness

Care needs should be reassessed as dementia progresses.

When Is It No Longer Safe for Someone With Dementia to Be Home Alone?

There is no single point in dementia when the same answer applies to everyone.

However, families should reconsider whether someone can safely remain alone when the person repeatedly:

• Wanders or becomes lost
• Leaves the stove or appliances on
• Cannot respond appropriately during an emergency
• Experiences frequent falls
• Cannot reliably eat or drink without assistance
• Cannot manage essential personal care
• Becomes frightened or severely confused when alone
• Requires assistance throughout much of the day or night

Changes like these should also be discussed with the person’s healthcare professionals.

The question may eventually change from “Can this person live at home?” to “What level of support would this person need to continue living at home safely?”

Dementia Care Needs Change Over Time

One of the most important things families can do is reassess the situation regularly.

A person who currently needs only a few hours of caregiver assistance may eventually need daily care or more extensive supervision.

Consider reviewing the care plan after:

• A fall
• Hospitalization
• A wandering incident
• Significant changes in memory
• Changes in behavior
• New mobility problems
• Changes in eating or personal care
• Increasing nighttime activity
• Family caregiver burnout

Increasing care does not mean the previous plan failed. It simply means the person’s needs have changed.

Helping a Loved One With Dementia Remain at Home in San Diego

Home Helpers Home Care of Mission Valley provides non-medical in-home care for individuals living with Alzheimer’s disease and other forms of dementia throughout the San Diego area.

We work with families to understand the person’s daily routine, abilities, safety concerns and existing family support.

If your family is trying to determine whether a loved one with dementia can continue living at home or whether additional caregiver support may be appropriate, we can discuss the situation and help identify where in-home assistance may fit.

Call Home Helpers Home Care of Mission Valley at 619-292-8001 to discuss dementia care and in-home support options.

Serving Mission Valley and communities throughout the San Diego area.