In plain English
A few simple adjustments substantially reduce risk in the home for someone with dementia, while preserving independence. An occupational therapy home assessment is the most cost-effective starting point.
The principles
Home safety in dementia balances risk reduction with autonomy. The aim is to reduce the chance of serious harm (fire, falls, dehydration, getting lost) without unnecessarily restricting daily life.
The major risks
Fire
- Smoke alarms in every relevant room, with annual battery checks (or 10-year sealed units);
- Cooking: induction hob (cool surface), or shut-off devices on gas/electric cookers;
- Avoid open fires and candles where possible, particularly if behavioural symptoms are emerging;
- Cigarette safety; consider supervised smoking or transition to alternatives;
- Free Home Fire Safety Visit from your local fire service.
Falls
See falls and mobility. Specific home measures:
- Remove loose rugs and clutter;
- Good lighting throughout, particularly stairs and bathroom;
- Grab rails by stairs, toilet and bath;
- Non-slip bath mat;
- Night lights in the hall;
- Bedside lamp within reach.
Hot water
Set hot water thermostat to 43 degrees Celsius or lower to prevent scalds. Single-action mixer taps reduce error.
Getting lost
- Identification card and address tag;
- GPS locator devices (keyring, watch, shoe insert);
- Discreet door alarms;
- Herbert Protocol registration with local police;
- See wandering and getting lost.
Medication safety
See managing medication. Lock medicines away if there is any risk of confused or accidental ingestion.
Electrical and household
- Avoid trailing wires;
- Plug-in carbon monoxide detector;
- Gas safety check annually;
- Cover sharp edges where confusion increases falls into furniture.
Occupational therapy home assessment
An occupational therapist visiting the home provides individual recommendations for safety and independence. Available through:
- NHS community occupational therapy via GP;
- Local authority adult social services;
- Private occupational therapists.
The assessment is usually free through NHS or social services routes. Recommendations may include equipment (free or low-cost via the council) and structural changes (where higher-cost adaptations may have grant funding).
Disabled Facilities Grant
The Disabled Facilities Grant provides up to £30,000 in England (similar in Wales) for adaptations to the home of a person with disability. Common uses:
- Stairlifts or through-floor lifts;
- Walk-in showers;
- Ramp access;
- Door-widening;
- Specialist bathroom installation.
Means-tested in most circumstances. Apply through your local council's housing or social services team.
Telecare
Telecare combines sensors, alarms and a 24-hour monitoring centre that responds to triggers:
- Pendant alarm (worn or by the bed);
- Fall detector (automatic alert if a fall is detected);
- Door sensor (alerts if a door is opened at night);
- Bed and chair occupancy sensors;
- Flood, smoke and gas sensors;
- Medication dispensers with reminder.
Available through local authorities, often subsidised or free for eligible residents. Private providers (Lifeline, Careline) offer paid services typically £15 to £25 a month.
Voice-controlled and smart home technology
Voice assistants (Alexa, Google Home, Apple HomePod) can be set up to:
- Voice-control lighting, heating, music;
- Set reminders;
- Make phone calls hands-free;
- Play music or audiobooks;
- Read out the time, date or weather.
Practical and surprisingly well-received by older adults who find tablet or phone interfaces difficult.
Where to get advice
- Local authority adult social services;
- NHS occupational therapy via GP;
- Alzheimer's Society Dementia Connect: 0333 150 3456;
- Age UK practical help;
- Local Fire Service Home Safety Visit.
Frequently asked questions
Should I get a stairlift?
Where stairs are limiting safe mobility, a stairlift can be transformative. The Disabled Facilities Grant may fund it for eligible households.
Is telecare worth it?
For people living alone or where there is risk of falls or wandering, telecare provides peace of mind for family and rapid response when needed. Local authority schemes are often subsidised.
Will an occupational therapist visit my parent's home?
Yes. NHS community occupational therapy can do a home assessment, usually free, with practical recommendations.
Should I lock the door at night?
Door alarms are usually preferable to locked doors; they alert family without restricting movement. Discuss with your local memory team if locking seems necessary for safety.
Are Alexa-style devices safe to use?
Yes, with appropriate setup. They are particularly useful for older adults who find phone or tablet interfaces difficult. Privacy settings should be configured.
References
- Disabled Facilities Grant. GOV.UK.
- Royal College of Occupational Therapists. https://www.rcot.co.uk
- Alzheimer's Society. Assistive technology and dementia.
- Care Quality Commission. Home care standards.