Autumn Home Safety Checklist for Dementia

Falls in older adults rise when the evenings get dark, and the evenings are already getting dark.

There's a narrow, useful window right now — before the clocks change, before the weather turns, while you still have long light and warm weekends — to do the household work that prevents a fall in November. It takes an afternoon.

Here's the walkthrough.

Start with light, because it's the highest-value fix

Aging eyes need substantially more light than younger ones, and dementia adds problems with depth perception, contrast, and interpreting what's seen. A great deal of what looks like unsteadiness or confusion is actually a room that can't be read.

Increase brightness everywhere. Higher-output bulbs in every fixture your loved one uses. Warm white rather than harsh blue-white.

Eliminate dark patches. Walk the route from bed to bathroom, chair to kitchen, and door to car — at night. Any stretch that's dim is a hazard. Plug-in nightlights along that whole path, especially at the bedroom door, in the hall, and in the bathroom.

Light the stairs from top and bottom. Both switches working, both easy to reach.

Put a lamp within arm's reach of the bed and the chair. A person who has to cross a dark room to turn on a light will eventually cross it without turning one on.

Deal with glare and shadow. Shiny floors can read as wet. Strong shadows can read as steps or holes. Sheer curtains, matte finishes, and even overhead light all help.

Floors and pathways

Remove throw rugs. All of them. This is the most common piece of advice in senior safety and the most commonly ignored. If one absolutely must stay, secure it flat on every edge.

Look for pattern problems. Busy carpet patterns, dark mats, and sharp changes in flooring color can be misread as changes in level. A black doormat can look like a hole to someone with dementia and produce a freeze or a stumble. Aim for plain, uniform, and consistent.

Mark step edges. A strip of contrasting tape on the front edge of each stair makes the depth visible. Cheap and highly effective.

Clear the routes. Cords, magazine baskets, footstools, shoes, pet bowls. The path from bed to bathroom should be clear enough to walk in the dark.

Check the outside too. Loose steps, uneven paving, leaves on the path once they start falling, and outdoor lighting at the front and back doors.

Bathroom

The highest-risk room in the house.

1. Grab bars beside the toilet and inside the tub or shower, properly anchored into studs — towel rails will not hold a person
2. A non-slip mat inside the tub and a non-slip surface outside it
3. A shower chair and a handheld sprayer, which lower fear and resistance as well as risk
4. A raised toilet seat if standing is becoming difficult
5. Contrast: a colored toilet seat against a white fixture is markedly easier to see and locate
6. A nightlight that stays on all night
7. Water heater turned down to prevent scalding, since temperature judgment often fades

Kitchen

1. Move daily items to waist height; nothing important on a high shelf that invites a stool
2. Consider automatic shut-off devices for the stove, or removing the knobs when the kitchen isn't in use
3. Keep a working fire extinguisher and test the smoke alarms
4. Lock away anything harmful — cleaning products in particular, which are increasingly mistaken for other things as dementia progresses

Bedroom and evening

1. A clear, lit path to the bathroom
2. A bed at a height where feet reach the floor easily
3. Slippers with backs and grip, not loose scuffs
4. A phone or alert device within reach

The autumn-specific items

A few things belong on this list only at this time of year:

Heating. Have the furnace serviced before you need it. Check that carbon monoxide detectors work — this matters enormously in a house where someone may not report feeling unwell.

Warm clothing where they can find it. People with dementia often don't feel or report cold accurately. Lay out layers where they're visible, and check the thermostat rather than relying on being told.

Footwear transition. Summer sandals to winter shoes is a real fall risk. Get proper shoes with grip now and let them become familiar.

Wandering risk rises in the dark. Someone who walks outside at 6 p.m. in August is in daylight. The same walk in November is not. If wandering is a possibility, this is the month to sort out door alarms, secure locks placed out of the usual line of sight, an ID bracelet, and a current photograph you could hand to someone in a hurry. Tell the neighbors, too — the most effective safety measure in most neighborhoods is three people who know to call you.

Vitamin D and daylight. Less sun means less exposure. Worth raising at the next medical appointment.

Doing it without a fight

If your loved one still has capacity and opinions, how you approach this determines whether it happens.

Frame changes as convenience rather than incapacity. "I'm putting a light here so I stop stubbing my toe." Involve them in choosing where things go. Do it gradually rather than converting the house in a weekend. And accept that some things will be refused — a grab bar that gets installed is better than a perfect plan that gets rejected.

An occupational therapist can assess the home properly and their recommendations often carry weight that a daughter's don't. Ask the doctor for a referral; it's frequently covered and consistently underused.

One weekend

None of this is complicated. Most of it is a trip to the hardware store, an afternoon, and a willingness to look at familiar rooms as though you'd never seen them.

Do it now, while there's light to work in. The version of you standing in a hospital corridor in November would very much like you to.

→ While you're making the house work better, make the afternoons work too — browse 8,000+ printable activities, free at CarePrints.