Make the home environment safer (avoiding behavioural alterations)

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Do you know?
A safe environment can improve the quality of life of people living with dementia!


If you are a person living with dementia, a safe environment can improve your well-being. The inappropriate setup of the house could generate behavioural and emotive alterations, such as hallucinations or delusions.
Make sure your home is protected and implement measures and changes to make it safer.
Since you might experience hallucinations and delusions, it would be best to avoid mirrors, paintings, dark corners, figurines or ornaments with animal shape. These objects that can generate alterations. To avoid them, you can modify the environment. When hallucinations and delusions occur, be cautious! First, assess the situation and respond with appropriate actions.

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And you, how do you do in order to make the home environment safer?

Discuss it with the community members


Do you know?
A safe environment can improve the quality of life of people living with dementia!




Make the home environment safer

A safe environment can improve the well-being of a person living with dementia. The environment is essential in determining symptomatology of a person living with dementia. The setup of the house could generate behavioural and emotive alterations, such as hallucinations or delusions. Treatment of behavioural alterations begins with addressing potential contributing factors and attempting specific behavioural and environmental changes (1).
Make sure your home is protected and implement some measures and changes to make it safer.

What are behavioural alterations?
Dementia is not only characterised by cognitive symptoms, it also includes behavioural alterations, such as hallucinations and delusions.
The estimated prevalence of delusions in dementia ranges from 9% to 59%, whereas for hallucinations it ranges from 6% to 41%. The incidence of these symptoms was two-threefold higher in moderate-to severe cognitive impairment compared to mild impairment (1).

Hallucinations are false perceptions of objects or events involving the senses (2). For example, a person living with dementia might talk to people who are not there, see objects or people who are not there, taste things or smell that are not present (1).
Delusions are misconceptions and beliefs that don’t match reality, aren’t shared with others and persist despite evidence to the contrary.
For instance, a person can believe that they are in danger, believe that caregivers are imposters, believe that caregivers will abandon them. It is very important to distinguish between delusions that cause distress to the person and those that may be considered as “comfort phenomena”. A study reported that 40% of delusions didn’t result in discomfort to the patient. In fact, some delusions, such as imagining that one’s deceased spouse is still alive, may enhance mood and generate a feeling of greater well-being.

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How to make the home safer?
  • Mirrors, dark corners, silhouettes or knick-knacks in the form of animals, and paintings (3) are some examples of objects that can generate alterations.
  • To avoid these alterations, caregivers can modify the environment:
  • Check for sounds that might be misinterpreted, such as noise from a television or an air conditioner;
  • Look for lighting that casts shadows, reflections or distortions on the surfaces of floors, walls and furniture. Turn on lights to reduce shadow!
  • Cover the mirrors with a cloth or remove them if the person living with dementia thinks they are looking at a stranger.
  • These simple actions can prevent the risk of seeing things that don’t exist.

How to deal with them?
  • When hallucinations and delusions occur, be cautious! First, assess the situation and respond with following actions:
  • Offer reassurance (respond in a calm and supportive manner; acknowledge the feelings behind the hallucination and try to find out what the hallucination means to the individual)
  • Use distractions (suggest a walk or move to another room; try to turn the person’s attention to music, conversation or activities you enjoy together)
  • Respond honestly (if the person asks you about a hallucination or delusion, be honest) (2)
1650015982973.png
And you, how do you do in order to make the home environment safer?

Discuss it with the community members


References

Deardorff, W. J., & Grossberg, G. T. (2019). Behavioral and psychological symptoms in Alzheimer's dementia and vascular dementia. Handbook of clinical neurology, 165, 5–32.

https://www.alz.org/help-support/caregiving/stages-behaviors/hallucinations

 
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