Homes That Help: Advice From Caregivers For Creating A Supportive Home

Access - Controlling and Increasing It

The bathroom and the kitchen are not the only places where your family member can get hurt. Most households have other danger zones as well. Controlling access to these areas becomes an issue sooner or later in most caregiving households.

When you care for someone with Alzheimer's disease, accessibility can be a double-edged concern. You may want to make some areas in your home "off-limits", such as outside doors, stairways, closets and other places where important or potentially harmful materials are stored. On the other hand, you may want to improve access to some areas - making tubs and showers more accessible or making stairways and outside steps easier to use.

As a rule of thumb, try to improve access in areas that encourage the person to do things independently as long as it is safe. Limit access when the family member's abilities and understanding have diminished to the point that he or she needs supervision to be in an area.

Gates and Partial Doors If you need to limit access to stairs, kitchens or other areas where it is not practical to have a door with a lock, here are some suggestions:

  • Portable Gates at the top or bottom of stairs are commonly used. Gates are often unsuccessful because they give a "stop" message to the person. However, unless your loved one is very small, frail, or compliant, he or she may try to climb over the gate and fall or knock the gate down. If a gate is your only option, select one that is high, sturdy and that attaches to the opening in a reflex fashion.

  • Place a wrought iron gate at the top of the stairs higher than the family member's waist so that he or she could not climb over it. A specially designed two-step latching technique makes the gate too complicated for the confused person to unlatch. Hire a carpenter to install this type of gate and make sure it's anchored properly to the wall.

  • Dutch doors or half doors solve some access problems. They are sturdy and allow viewing over the top of them. A strong half door at the top of the stairs in a split-level home allows a person in a wheelchair to watch what's happening in the living room.



A project of the National Resource Center on Supportive Housing and Home Modification,
in affiliation with the Fall Prevention Center of Excellence, funded by the Archstone Foundation.
Located at the University of Southern California Andrus Gerontology Center, Los Angeles, California 90089-0191 (213) 740-1364.