Safety Implications for the Homebound Patient With Dementia

Patients with dementia have unique safety needs due to cognitive and behavioral changes associated with dementia. Because the prevalence of dementia is expected to greatly increase with an aging population, and because an estimated 70% of people with dementia live at home, it is essential that healthcare providers receive adequate training on the special needs of this population. This article will discuss home safety interventions with regard to: 1) risk of falling, 2) kitchen use and food safety, 3) medication safety, and 4) wandering and personal safety. A successful health program must include ongoing evaluation of the patient's risk profile with regard to health issues, physical and cognitive deficits, medications, and physical environment. Risks can be accepted, addressed, or actively remediated as appropriate. Good interventions should promote acceptable patient behavior and engage assistive personnel to achieve the desired outcome. To promote safety, the home environment can be modified to encourage positive behaviors and to discourage potentially harmful behaviors. Communication between the patient, trained healthcare providers, and family caregivers is essential.