Dementia and Winter Safety

Many of the following winter safety tips are good advice for anyone during the cold winter months. However, as we grow older our bodies respond differently to the cold weather making us more vulnerable; and living with dementia can further complicate matters. Caregiving is already a demanding job and the winter months can often make it much more difficult. Whether you live with the person you are caring for, or you support them living on their own, awareness, preparation, and asking for assistance can help you and your loved one make it through the winter months safely, maybe even cheerfully.

INDOOR TIPS

  • Keep indoor temperatures around 68 to 70 degrees. A person with dementia may not recognize if the house is too hot or cold, so it is important to keep the house a steady warm temperature. Additionally, health problems such as diabetes, thyroid problems, arthritis, and certain medications may make it more difficult to stay warm.
  • Indoor air becomes very dry with increased use of the heating system, so be sure that your loved one is staying hydrated. Perhaps leaving a cup by the sink as a reminder to drink or having plenty of their favorite beverage on hand will encourage more fluid intake.
  • Avoid the use of electric blankets. People with dementia may burn their skin on these, not realizing that the blanket is getting too hot. As we age, our skin becomes thin and we lose subcutaneous fat stores, so burns from an electric blanket become an increased risk. Encourage the use of long underwear, both under clothing and pajamas, wearing socks and slippers, and keep blankets available for use over the lap and shoulders.
  • Be wary of space heaters that can pose a fire risk if knocked over. If a space heater is necessary, be sure to use one that will automatically turn off if tipped over.
  • Physical activity and a healthy diet can be particularly helpful during the winter months to provide energy, boost the immune system, and elevate mood.
  • Watch the weather forecast, if there is a storm on the way make sure that prescriptions are refilled, that shelves are stocked with food, toiletries, and paper goods, and that blankets and warm clothing are available. Keep the phone numbers of utility companies and emergency services accessible and have your loved one’s health information and medication list in a convenient location. Remove candles from the home and instead keep flashlights well-located. If you do not live near your loved one, make arrangements with their neighbors to check-in on them.
  • Because it can be harder to get around during the colder months, many older people have less contact with others. This can lead to feelings of loneliness and isolation. Make sure to check in on your loved ones as much as possible. A phone call a day can make a world of difference.
  • People with dementia may feel increased anxiety, confusion, and sleepiness due to the decreased sunlight in the winter months. These exacerbated sundowning symptoms may be relieved by turning lights on earlier, opening curtains during sunny daylight hours, or adding special light bulbs that mimic natural sunlight.
  • Place smoke detectors and battery-operated carbon monoxide detectors in strategic places – especially if there are areas where fireplaces, wood stoves, or kerosene heaters are used. Be sure that detectors are in good working order and batteries are replaced regularly.
  • Make sure that fireplaces, wood or gas stoves, and kerosene or other fueled appliances are properly vented, cleaned, and used. These items can leak dangerous amounts of carbon monoxide - a deadly gas that cannot be seen and is odorless. Know the symptoms of carbon monoxide poisoning: dull headache, dizziness, nausea, vomiting, confusion, weakness, blurred vision, shortness of breath, and loss of consciousness.
  • Have the heating system serviced by a qualified professional at least once per year, install storm windows, keep curtains closed, and place a rolled towel in front of outside doors to block drafts.
  • Make sure arrangements have been made for the heating bill to be paid on time.

OUTDOOR TIPS

  • Someone living with dementia may not dress appropriately for the cold weather, especially when traveling outside. Encourage them to cover as much exposed skin as possible using light layers. Due to loss of warmth through the top of the head, make sure they wear a warm hat. Mittens are a good option for someone with dementia as they are easier to get on and off than traditional gloves. Keep their lungs protected from the cold air by providing a scarf they can use to cover their mouth and nose.
  • Assume that all surfaces are slick and slow down when walking outdoors.
  • Apply for a state-issued Handicapped Parking sticker or license plate so that you can park close to stores, reducing the risk of slips and falls.
  • Provide your loved one with appropriately fitting non-skid boots to reduce falls.
  • Consider adding a sharp tip to the end of a cane for extra grip on slick surfaces.
  • People living with dementia may have vision problems that make it harder for them to recognize a slippery walkway. Keep driveways and sidewalks clear of snow and ice. Install motion detector lights for increased vision when traveling between car and home after dark.
  • Use a mitten clip (designed for skiers) to keep track of mittens, and Velcro on boots provides increased independence with dressing.
  • When possible, use indoor parking garages.
  • Avoid driving on icy roads, being especially cautious driving on overpasses and bridges. Consider alternate routes, even if it means driving a longer distance. Often bigger roads are cleared of snow better than smaller roads.
  • Stock your car with basic emergency supplies such as a first-aid kit, blankets, extra warm clothes, booster cables, windshield scraper, shovel, rock salt or bag of sand or cat litter, water and snacks, and a flashlight.
  • Winterize your car before the bad weather hits. Check antifreeze levels, tires, windshield wipers, and wiper fluid.
  • Bring your cell phone when you drive in bad weather. Always let someone know where you are going and when you should be expected back.
  • If your loved one with dementia exhibits wandering behavior, this can become extremely dangerous during the winter. Not only may they become lost, but they may not be dressed appropriately, making the need to find them quickly even more important. Make sure you have a plan of action in place. Use a permanent marker or sew identification into their clothes with your contact information. Keep a recent photo and medical information on hand to share with police and other authorities who will be helping you search for them. There are programs available that can track your loved one using GPS. The risk for people with dementia to go missing are particularly high in the cold winter months and can happen without warning. They may become confused and disoriented even close to home. The best way to prevent wandering is to secure their home using locks, fencing, exterior door alarms, and not leaving them unattended if they have a history of wandering.
  • Hypothermia is a concern for everyone during the winter, but a person with dementia can be at an even greater risk. Some individuals living with dementia may find it difficult to detect temperature and weather changes. To help keep them safe, know the signs of hypothermia: exhaustion, sleepiness, weakness, slurred speech, memory loss, clumsy motor skills, and sometimes shivering, though this is not a reliable warning sign because older people tend to shiver less or not at all when their body temperature drops.

In summary, it is vital that all potentially risky scenarios are thought through and protections are built in to help keep your loved one safe. Consider having your loved one wear an ID bracelet or a GPS tracking device. If they live independently, set up video cameras in their home (with their approval) to keep tabs on how they are doing. Have everything you may possibly need on hand, and make sure that all devices are in good working order. By thinking through the various “what ifs,” you will be prepared to keep your loved one safe, and then perhaps you can both enjoy the winter months. And, remember to ask for assistance. It is up to all of us to make sure that our loved ones and neighbors are safe during the cold winter months.

For further information visit:

The National Institute on Aging, regarding hypothermia: https://www.nia.nih.gov/health/cold-weather-safety-older-adults

Seniorlink, regarding GPS tracking devices: https://www.seniorlink.com/blog/the-50-best-gps-trackers-for-seniors

Centers for Disease Control and Prevention, regarding preparing your home: https://www.cdc.gov/features/winterweather/index.html

Cedars-Sinai, regarding carbon monoxide poisoning: https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/carbon-monoxide-poisoning.html