Full Episode Transcript

Nancy Treaster

I wish I’d known about padding anything with hard corners before my husband started falling. In this episode, we’re talking about overall home safety for your care receiver. We have three main tips. Sue, you about ready to get started?

 

Sue Ryan

I am. 

 

In the areas of wandering and leaving them alone, we recorded separate podcasts and we have the links to those in the show notes. What we’re talking about today is overall safety in the home. And when we’re thinking about their safety needs, these are going to be unique for each one of the journeys we’re on each of our loved ones. And so we want to be looking at them with curious eyes and exploring exactly what’s happening day in and day out as if it were for example a young child who we don’t know what they’re going to get into and so we look with curious eyes about well what what could they possibly get into and we we don’t think about well they would never get into something like that so in the beginning of the journey when our loved one.  We want to be using the same caution for our care receiver and it’s “assume nothing”. There are so many things going on with them in the journey that’s changing for them. For example, their vision is changing. Their depth perception is changing. Their stability, which means their gait is changing. They see shadows where they didn’t used to see them. Their ability to connect with what something was. For example, you see it as a chair.

 

Nancy Treaster 

That’s right.

 

Sue Ryan

They might not. They might start talking to it. So they don’t necessarily connect with things. So as they go on, their ability to connect with things is shifting as well as, as they go throughout the day, their brains have been running on high all day long and toward the middle of the afternoon, they’ve got what I call tired brain syndrome. Their brains have been going for a long time. And especially earlier in the journey, they can become more fearful or more frustrated because they still know that they’ve got a problem and they’re not connecting. And so we want to make sure that we’re helping them, especially when we see them getting frustrated or fearful.

 

Nancy Treaster 

The message really is observe and adjust because home safety is not one and done. We’re constantly observing and constantly adjusting. I said we have three main tips so you want to start with tip one Sue?

 

Sue Ryan

Absolutely. In the Wandering episode, we talk about registering early on with the emergency medical teams. The other thing for us to do that’s as much for us as it is for our care receiver is called File of Life. And the link to that’s in the show notes. You’ll get a document that you fill out that’s got information about your loved one, and then you fill one out for yourself, because sometimes the emergency could be with

 

So one of the things that you do is you fill all the information out. It’s got their name, medical information, hobbies, things like that, other things so that they can have a good conversation with them. And then you’re given a decal to put either on your front door or on your front window so that if the emergency team comes, they know that information about file of life is on the refrigerator and it’s very helpful to them.

 

Nancy Treaster 

That’s a great tip. I really like it. The second tip is about childproofing your home. And when it’s time to childproof is not a guarantee. It’s nothing we can tell you. You’ll just notice that your loved one is starting to be more curious. Just like Sue said, look at things through curious eyes. They’re starting to be more curious and they’re starting to get into things. Now think about this for a second. They used to have a lot of activities that they were able to be involved in. And now they’re restless. And so they’re gonna get into things. It’s just, these are the only activities they have right now. So that’s all that’s left. They need something to do. So part of this is just the natural part of what they’re gonna do when they wander around the house during the day. But in order to keep them safe, we need to childproof. Let’s think about childproofing from the perspective of the kitchen first. 

 

Nancy Treaster

I think that’s the easiest place to start. That’s where the most hazards are anyway. First, think about your cleaning supplies. Think about anything that’s on your kitchen counter or accessible to them. Cleaning supplies are a good example. Knives are a good example. Those need to go under in cabinets or in a separate room somewhere else. If you put them under in cabinets, you should have childproof safety cabinet locks so that you can lock your cabinets to keep them out of wherever you’ve stored things and wherever the things that are potentially dangerous like toxic cleaning supplies are. Anything they do have access to that’s on the counter, please make sure it’s not toxic so that you’re not risking them getting into it and drinking it or doing something with it that they shouldn’t. Also in your kitchen is the stove and stove knobs. My husband loved to twist the stove. We have a gas stove.

 

The good news is they make childproof stove covers, stove knob covers. The refrigerator, the freezer, if they’re opening and closing those regularly, they make locks for the refrigerator and freezer, if that’s starting to be a problem. One of Sue’s friends’ husband left the refrigerator open all night long. Not exactly what you want.

 

Sue Ryan

All night

 

You can also put chimes on. She learned that afterward, yes.

 

Nancy Treaster

You can put chimes or a lock actually, very good point. The garbage, my husband loved to get into the garbage before we put a lock on the garbage so that he could, a childproof lock on the garbage so he couldn’t get in it because that was needless to say a mess. And the garbage disposal, if it’s something they have accessibility and an interest in, then you can put a cover over the switch for the garbage disposal as well. So that’s the kitchen. Now let’s kind of walk around to the rest of the house for a minute.

 

Sue Ryan

Where the lock, yep.

 

Nancy Treaster 

First, probably at this point, once they’re starting to get into things, if you haven’t already, this is a good time to limit the amount of space they can get into in the house. You can use those childproof doorknob covers to put on the outside of any doors, any rooms that you’re not gonna make safe so that they can’t get in those rooms during the day when you’re letting them wander around. So limit the amount of space they can get into and then we’re going to child proof or at least safety proof that space. In addition to the rooms they can get into, think about the windows. So funny story, my husband, well, once they’re restless at this point, there’s a lot of fidgeting going on. So he would fidget with the window sash locks and unlock the window. No, we never did that before. No, interest in the sash locks before. Now all of a sudden they’re very entertaining.

 

Sue Ryan

Which he had never fidgeted with before. They’d never been a thing for him. Never.

 

Nancy Treaster 

He’d unlock the window sash, the top of the window would fall down, it’s the middle of the winter. I’m hauling the ladder up from the basement into the house to try to get the window locked back up so that the cold air is not blowing in our house. So window sash locks, they’re literally key sashes with keys and you just put the key somewhere else so they can’t unlock the windows. Lamps are another form of entertainment apparently. Sue I think you had this as well as I did. So.

 

Sue Ryan 

Yes, we did.

 

Nancy Treaster 

I probably now have about 20 % the amount of lamps in my house in the area that my husband can wander in than I did before because lamps are another thing to fidget with and he picks the lamps up and tries to carry them away and they’re still attached to the wall. So minimize the number of lamps if your loved one finds lamps interesting. So remember this is customized to curiosity and what your loved one is curious about.

 

I have a gas fireplace, the fireplace key. My husband wanted to fidget with that. That also now is underneath the cabinet. And steps. Steps, if they have access to steps and they have to have access to steps, Sue was talking about depth perception and vision challenges. And depth perception definitely shows itself in a big way when it comes to steps. Part of that is you can walk my husband up the steps, but don’t ask him to come back down because he is completely scared to death to come down the steps. As a matter of fact, to take him to the doctor, he’d have to get down only two steps into our garage. And they were painted gray, which is the same color as the garage floor. And I’m telling you, it took me as long to get him down those two steps to get than it took to drive to the doctor’s office. Heck, probably for the whole doctor’s appointment. So I came back after the first time I thought, this has got to be a depth perception problem. So I went to the hardware store, bought some white paint and painted just a white strip on the end of each step. The next time he had to go into the garage, amazing the difference in his confidence to walk down the steps. Now, if your steps are indoors, I found a site that actually recommended reflective tape at the end of each step, but it’s the same concept.

 

How do you make it easier for them to know where that step ends? And the next step begins.

 

Another thing, once you’re letting them wander inside the house, you’ve safety -proofed as much as you possibly can, is you might want to consider getting cameras for inside the house. If you’re not going to follow them around everywhere they go, or the space they’re in is not so limited that you can just look behind you and see them, if you let them wander around the house where they’ve got a little more free rein, you can use indoor cameras. You can have an app on your phone or an iPad where you can see what they’re doing. This is also helpful to keep an eye on how things are changing. What are they becoming curious about now that they weren’t so curious about last week? It’s another way to make sure that you observe and adjust for home safety.

 

That’s really about home safety, but there’s a tangential topic I want to talk about here, which is valuables and understanding that while they’re fidgeting, they may run into some of your valuables or breakable items. So you’re going to want to just put those away for now. Your valuables and breakable items do not need to be out into the world of entertainment, becoming entertainment now. Sue loves this story because it is entertaining.

 

Sue Ryan

Yeah.

 

Nancy Treaster

We used to keep cash in one of our drawers. And one day I saw the cash that morning, I went in the door to get a pen and there was the cash like it always is. And later in the day, I went into that drawer and the cash was gone. Well, there’s only two of us here. So there was no one to blame, except for I’m sure that Kim had taken the cash and put it somewhere, my husband. So I went back, I have an indoor camera. So I went back to the video history in the indoor camera and

 

Saw where just in that room watched until saw him get into the drawer, saw him take the cash, watched through the other cameras in the other rooms, saw that he went back into the bedroom and then back into the closet. There is no camera in the closet. So then my detective skills had to come into play. Went back into the closet, got in there, started searching in the closet. Somewhere in here is the money, most likely. In his shoes stuffed in the toe was the money. Not just the money, his watch, one of his rings. There were all sorts of interesting, valuable items, I guess, that he wanted to hide from other people that were stuffed in the toes of his shoes. goodness I did not take those shoes to Goodwill, or someone would have had a nice surprise, I think. So keep an eye out for your breakables, for your valuables. These are, once they’re in this… fidgeting stage, they don’t need to be so accessible.

 

Sue Ryan

Nancy, you called me at the time when you were trying to figure out what to do now that you had taken away so much.

 

Nancy Treaster 

Yes, I called Sue as I typically would do when something was escaping me as to how I was going to fix this. And you know, she had a good point. They’re in a fidgeting stage. That’s part of what’s happening. And the only things they have to entertain themselves with are the breakables and valuables and the lamps and the other things you have in their area that they’re wandering in. So replace those with children’s toys.

 

So I did actually buy some big plastic children’s toys. I bought the rings actually. He loves to unscrew the bottom of the rings and carry the rings around. Other children’s toys, find something else for them to fidget with. There are even things online in sites that are focused on people with dementia that are called fidget toys. So go out there and just replace them. Give them something to fidget with. The fidgeting is not going away. They’re restless and they no longer have access to other activities. So help them

 

Sue Ryan 

I got a fidget blanket. There’s a dementia fidget blanket and I got one of those for Jack and we had several of those throughout and it’s amazing. It’s comforting for them. We’ve got something to do. Yeah, different textures and things like that. One of the other things, hmm? Okay, one of the other things toward the topic with Kim shoes that I learned in a support meeting was that in early in the journey,

 

Nancy Treaster

Well good.

 

Right, good help. Are we ready for tips? Go ahead.

 

Sue Ryan 

They’re putting things down and they’re not necessarily surely remembering where they put them they often feel like someone is stealing from them and one of two things happens they either feel like somebody’s stealing things for them or they can’t find it and they get very agitated and frightened because they can’t find something and I’ve got to have it I’ve got to have it I’ve got to have it so with either one of those first of all having the camera is very helpful because almost every single time it’s just that they’ve put it in a separate place and they don’t where it is. However, in the support meeting, one of the women said that her husband was having this challenge. And she said she couldn’t find anything. I mean, it would disappear and she had no idea. She’d gone to any of the obvious places. One day she was changing the bed and she just touched something. She lifted up the mattress and between the mattress and the box springs were all these things her husband had put there because he felt that was a safe place.

 

Nancy Treaster

My goodness. And it was apparently.

 

Sue Ryan

And so while I will say it was a very safe place. Yeah. So first of all, don’t donate anything without looking through it. And if they are having agitation or frustration with that, often it is because they’ve found some place to put things away. And then one of the other things with that is if they are having something like still their wallet or something else that they could misplace, make sure there’s nothing actually valuable in it

 

Nancy Treaster 

Very good point, very good point. Okay, are we ready for tip three?

 

Sue Ryan 

We are ready for tip three and yeah. yes.

 

Nancy Treaster 

Tip three is about minimizing fall risks. One of the first things is to talk a bit about falling. Falling is inevitable, unfortunately. We’re gonna do everything we can to minimize falling, but also recognize the fact that it is inevitable. Part of falling is depth perception. I really believe that’s a big part of the falling. And part of it is they’re more unstable and they start to shuffle their feet. So Sue actually, once again, another tip from Sue early on in my journey as a caregiver was to watch out for the rugs because when they start to shuffle their feet, the rugs become a fall hazard. So that was really good advice. Thank you, Sue. And for more than one reason, because also once incontinence starts, you’re going to be happy to have your rugs put away somewhere else.

 

Sue Ryan 

You’re welcome.

 

Nancy Treaster 

So roll those rugs up if you have area rugs and put them under a bed. You can get them back out later. rugs, once you observe the shuffling of the feet or the incontinence starts, the rugs need to find another

 

Sue Ryan

Yeah, absolutely. And another one is fall tracking devices. And there are a couple of applications of that. One is the ones that are physically on you. So whether it’s on the wrist, whether it’s in the shoe, whether it’s in the phone or on the neck, one of the things that it is is making sure that you know where they are at any point in time with the fall risk. The other one is to your point about having the cameras is that we can monitor them and monitor how they’re wandering and where they’re wandering and things they may be getting in that could lead to them falling. Or if they do fall over something, it helps us rearrange their area so that they can keep what we want is their independence as long as possible. We want them to be able to wander as much as possible because that means they’re walking and they’re getting exercise and that may be the only exercise they’re getting. So we want to make sure the environment is as safe as possible.

 

Nancy Treaster 

Good point.

 

Sue Ryan 

And then next we’re getting to the one that you wish you had known earlier.

 

Nancy Treaster 

Yeah, that is absolutely true. Well, you go ahead with the tip and I’ll explain later why I wished I had it because people…

 

Sue Ryan

That’s the padding on the corners. And then you can also have padding across the counters. There are all different kinds of ways you can do it. You can use pool noodles. You can do other things, but anywhere. And especially when you’re observing them, look at the areas where they might potentially fall. And one of the things that’s a trigger for that, like Nancy pointed out, is if they think they’re seeing shadows. So one of the things that you can do even without the padding up before the padding on the corners, is looking at lighting. You know, light it up like it’s an airplane landing so that they’re not going to have shadows in their area, in the area where they’re going to reach down for it. And then yet if there is something where they might reach down or they might start to fall, have the padding that will minimize any risk they’ve got or any harm they do.

 

Nancy Treaster 

Yes, and the only reason I wanted to wait is I want to merge the padding and the cameras together for a second. In my husband’s bedroom, one time the next morning, he had a cut on his head. And we’re wondering, where did this cut come from? That’s strange. So once again, using video history, I was able to go back and see that he had reached down to pick something up while he was wandering around the bedroom at night and he’d come back up and hit the corner of one of the dressers in his room. So we put the padding on the corner of the dresser. So using the combination of things, had I known before about the padding, I probably could have thought that all the way through without him ever having to get the cut on his head to begin with, if I’m honest.

 

Sue Ryan

That’s why we’re doing the podcast so we can help other people learn from the things that we wish we had known we had known earlier. And then the next one is, okay, we got the showers and there’s a lot to do with safety with shower entry. Some of it, of course, is obvious. How safe is it for them to get into the shower, whether that’s on their own or whether it’s assisted? We had a walk -in shower and yet I went into the shower with my husband for the longest time.

 

Nancy Treaster

Yes, ma ‘am. Yes, ma ‘am.

 

Sue Ryan (22:49)

I would, took everything out that he could reach for and that he, that might distract him. I also put him in the best environment to be safe. There were grips on the floor so he wouldn’t trip or fall. I made sure the lighting was really good so there wasn’t any, any kind of a shadow anywhere. And yet even with that, as the journey goes on, just getting into the shower can become fearful for them. That it’s, know, forget about taking the shower.

 

They don’t want to get in. They see this as something that’s frightening for them, and we can’t get them into the shower. And Nancy, you’ve got a tip on that, yeah.

 

Nancy Treaster 

All right.

 

You know, I noticed that Sue as well. I did. So my husband could see, you know, we’ve been married 34 years. So you sort of just can read the expression on their face at that point. I could see that it wasn’t so much the shower that was the problem. It was getting into the shower that was the problem. He was scared to get in there. And I believe it was depth perception oriented. I, there was, this went on for several months where I still,

 

We had a big battle over taking a shower because I didn’t realize that eventually he wasn’t going to take a shower anymore. And there’s plenty of fabulous products on the market that you can use to keep your loved one clean and they smell great. It’s all good. So why did I fight over the shower had someone told me upfront they’re eventually not going to get in the shower? I would have saved both of us three or four months worth of agony.

 

Sue Ryan 

That’s true.

 

Nancy Treaster 

fighting over the shower, which he won anyway, so, you know, he won that battle. So I fought and lost, but for no good reason. No good reason.

 

Sue Ryan

But the helpful part of that is that there are a variety of different reasons why they might be resisting that. And so this is where you observe and adjust. And we had different reasons why we adjusted, you’ve got yours. So with all of that, is, and then ultimately it did with Jack as well as, nope, we’re not doing the showers. Your showers are gone. And then another part of the safety is putting the grips on their socks, having grip socks, and the same thing with shoes to make sure that their feet,

 

Nancy Treaster

Good point.

 

Nope, it’s out.

 

Sue Ryan

are never uncovered to where they could slip, especially if you’ve taken rugs off that might give some traction. Depending on the kind of flooring you have, they could have a chance of slipping. And as their gate becomes less stable or they stub their toe, if they’ve got the grippers on, at least it’s a little bit of something else. And then I mentioned it before, lighting as we go through.

 

Observe with those curious eyes the lighting where you’ve got the shadows. I you might have beautiful I’m looking over here at some lighting we’ve got over a picture. Well that created shadows for my husband and and that looks different so look at any of the places where the the lighting might be an issue and then You know Nancy you kind of introduced it But I think it’s it’s something important for us to talk more about is that as our journey goes on They are going to

 

And my husband outweighed me by more than 100 pounds. When he falls, there’s only so much I can do to lift him up. So I’ve worked on keeping him safe and I’ve worked on minimizing the fall risk. When they fall and they may, you’ve got a few options. I can call 911 or I can do what you did.

 

Nancy Treaster 

Right, when my husband… Yes, yes. Yeah, so depending on how bad it is. My husband does fall periodically. That’s just part of where we are in our journey. And if someone else is here, we can still get him up with the two of us. But often I’m alone. And if I’m alone and he falls, I…

 

Sue Ryan 

And or, I mean, depending on the fall, you can still call 911, but.

 

Nancy Treaster 

we just finally got past the point where I couldn’t help him up. Early on I could help him up, but now he doesn’t know what to do. And he’s 6 ‘2 and all legs. There’s no way I’m getting him up. So I did get something called, it’s a transfer lift. And I’ll tell you, it’s almost like a dolly for a person. So it looks like a dolly and you scoot it up to their backside and you pull them onto it and you hook them with a belt and then you press the button and it lifts them up to chair height and then you undo the belt and he steps off of it and all is good. And that thing is wonderful and it has kept me from having to call 911 which is even better. Technically the name of the product that I use is called an Indeelift but a transfer lift is something you may want to invest in.

 

Sue Ryan 

And you’ve got a link to that in the show notes.

 

Nancy Treaster 

Yes, ma ‘am.

 

So let’s summarize. Today we talked about overall home safety for your care receiver. We had three main tips. The first tip is about filing with a file for life, creating a file for life. The second tip, childproofing your home. The third tip, minimize the risk of falling. And I know in this episode, we had a lot of detail under these tips. So it probably feels like a

 

But it is doable, it is manageable, you will get your arms around this and you will be able to handle it.

 

Sue Ryan

Yes, you will. And we’re here for you. We’re all on this journey together.