When considering somebody living with dementia, people generally think about doors in one of two completely polarised ways: either wanting to make sure that it is locked and their loved ones cannot open it or wanting to ensure that their love one can still understand how to use the door and gain access to the other side.
As with every other stage of somebody’s life, being able to get in and out of your own home is an important part of an individual’s sense of identity and independence. Moving between rooms within your own home is also important, but there is a balance.
You need to know that they are safe if they leave their home unescorted, otherwise, they will quickly be at risk of harm or getting lost and probably become very scared. So the simple mantra is probably don’t deny access to doors unnecessarily but also don’t do so irresponsibly.
You want to give them as much freedom as possible but it is important to keep them safe at the same time. This can be a tricky balance to strike, and what is right today might well change tomorrow; so be ready to reassess regularly. Once you decide a door should be available to someone living with dementia you should consider the following:
1. Make it easy to find
People living with dementia deal with a number of problems every day where they want to complete a simple task but can’t find the right door. They might be in the hall desperately trying to find the kitchen door but can’t and all they want to do is make a cup of tea.
You can make it much easier by ensuring the door is easy to find, check the door is a contrasting colour to the walls. It might seem like a silly suggestion, but make sure it looks like a door, it might be obvious to you but is it to somebody living with dementia. You could even put a name tag on the door which describes where the door leads to, for example ‘Kitchen’.
Is the door furniture easy to spot and easy to use, is it obvious where the handle is and how to use it. If their memories are from years ago would they recognise it as a door handle?
You could illuminate important areas of the door such as the keyhole, handle or doorbell, making it much easier to find them. This can be done with lighting or by making them a different colour to the door so they stand out.
Be aware that black door mats often look like a hole in the ground to people living with dementia. They will often avoid stepping on them, try and step round or jump over. This can create obvious risks of falling as well as acting like a barrier to entry.
You should also be aware that a change in colour of the floor coverings between two different rooms can also cause confusion. A change in carpet colouring or from carpet to wood can sometimes create a barrier in their mind and stop a person living with dementia entering a room.
2. Make it easy to get through
Is the door wide enough to get through (not for you but for them)? Can they get their walking frame through if they use one or their wheelchair? Is there a step they will have to manage and if so would it be better installing a ramp? This is not just relevant to the front door but any other doorway in the house.
At the front door would a grab rail alongside the ramp assist with stability as they approach the house? Would grab rails elsewhere assist with staying safe?
Be aware that black door mats often look like a hole in the ground to people living with dementia. They will often avoid stepping on them, try and step round or jump over. This can create obvious risks of falling as well as acting like a barrier to entry.
You should also be aware that a change in colour of the floor coverings between two different rooms can also cause confusion. A change in carpet colouring or from carpet to wood can sometimes create a barrier in their mind and stop a person living with dementia entering a room.
3. Make it secure
It is important that certain people that should get into the house do so. That includes carers, doctors, the district nurse or just as importantly family and friends to socialise and brighten up their day. It is a vital to somebody staying at home and remaining independent that they can receive visitors.
Depending on where people are on their dementia journey will govern which of these is the most appropriate solution. Or it could be a combination of more than one. Consider the following:
Would an intercom system be appropriate, there are many available with a range of features and levels of complexity. They will allow the person to check who the caller is and ensure they are ok to come in. The ones with video cameras are really good because they allow your loved one to see and hear the visitor giving greater confidence they are who they say they are. However, like everything else, it is a balance! It is likely that an intercom will be confusing and challenging to use especially as their dementia progresses.
Installing a Key Safe, with a combination code next to the front door will allow you to let authorised visitors to gain access. Just give the code to the carers, close family and friends etc. and they will come and go as needed. If you need to change the code for whatever reason this can easily be done.
If you want to support your loved one to stay independent at home but worry about unwanted visitors gaining access consider a SMART Doorbell. These allow you to monitor anybody that approaches the house or presses the doorbell via your Smart Phone. You can talk to them, see them, check their credentials, tell them to leave if necessary or even open the door for them. This provides a genuine additional level of security and confidence that your loved one is safe at home.
4. Make sure the door is well lit
As people age, their eyesight often degrades, this is especially true of people living with dementia. It is therefore essential that any hallways and doorways are well lit and easy to see. It is not just low light that can be an issue, shadows can also present a problem. Shadows can appear to someone living with dementia to be a hole in the ground and just like with black door mats they can be confusing and scary.
Ensure that light switches are clear and easy to find, have multiple light switches next to every door and entry point. Make sure that there is some colour contrast between the light switches and the walls so that people can easily see them.
Think about installing automatic lights they are easy to put in and inexpensive and are triggered by the movement of your loved one. They are often used in bathrooms, stairs and landings or in external areas, such as the garden or front door.
To find out more about dementia care and whether your loved one will be better living at their own home or at a specialist dementia care home, please contact your nearest Greensleeves Care home.
