At some point in the disease progression, the person will be unable to engage in simple household chores. Washing dishes and removing food scraps from the sink – ordinary tasks that we take for granted, will become unmanageable.
Consequently, you may encounter plumbing problems from trapped food or grease. Or sink strainers may be missing or broken. And due to impaired judgment, objects may be hidden in the drain for “safekeeping.”
Here are some things you can do:
- Buy or replace a strainer. Some drop over the existing drain and some require tools to install. Check with your local home or hardware store.
- For the sink, use an opaque sink mat with holes to cover the drain, if it’s being used as a hiding place. For some individuals, if the drain is hidden from their view, they will forget it’s there.
- If the person is living alone or with a frail family member, you will need to hire a housekeeper. Click on the housekeeper link for tips on introducing home services if the person is resistant.
- You may need to hire a plumber, or – if you’re handy – learn how to unclog a sink.
Some people with dementia forget to turn off the faucets when leaving the kitchen or bathroom. If the drain is plugged or has debris, the sink will overflow. Overflowing sinks not only cause emotional distress, but flooded kitchens and bathrooms can be difficult to mop up. Flooding can also cause building damage and increase eviction risk for renters.
The good news is that there are many things you can do to reduce flooding. On the following pages, we offer several tips and solutions for dealing with flooding. As always, see which one(s) work best for your situation.
As the disease progresses, your care receiver may not be able to tell what’s safe to eat and drink, due to loss of judgment and memory. They may mistake one item for another – like orange-colored liquid soap for soda. So it’s vital to know when you need to remove or deny access.
Some caregivers have success placing select items out of view in the same room, while others move materials to another room. And some put a lock on the cabinet. Just in case someone eats or drinks a harmful substance, post the national poison control hotline in an easy-to-find location.
The American Association of Poison Control Centers advises to pay special attention to liquids, as they’re absorbed rapidly, and a large quantity can be swallowed in a short period of time.
People with dementia are at an increased risk for hot water burns. They may confuse the hot and cold water handles, and they may forget how to blend the hot and cold water to a safe temperature. Homes and apartments have water heaters commonly set at 140° F to 150° F – a temperature at which a severe burn can occur within 1 to 5 seconds.
However, lower water heater temperatures tend to increase bacterial growth. For example, 120° F has been the standard recommended water heater temperature for reducing hot water scalding risk. But individuals with compromised health and those undergoing chemotherapy are at increased risk for Legionnaires Disease with water stored at these lower temperatures.
It’s important that you assess your and your care receiver’s scald risk and overall health and safety. We’ve sorted through a wide body of literature to help you choose a scald safety strategy to meet your needs.
Use Visual Cues
For some people, especially those in the early and middle stages of dementia, a visual cue helps them to remember which faucet handle is for hot water versus cold. Some people may respond better to text or color. Try placing a “HOT Water” sign, in large red bold letters, directly above the hot water handle. Or, depending on the type of faucet handle, apply red electrical waterproof tape, available at home supply and hardware stores. If your care receiver disapproves, tell them it’s for the grandchildren’s safety.
Use Anti-Scald Valves
Using anti-scald valves allows water in the hot water tank to be kept at higher temperatures, reducing the risk of Legionella bacteria and delivering the tap water at lower, safer temperatures.
There are several types of anti-scald valves, each with its own pros and cons. The do-it-yourself screw-on valve can be installed at the faucet or showerhead to reduce scalding water to a trickle. This protects against burns, but the sudden shut-off of the water flow may be confusing to a person with Alzheimer’s or other types of dementia. Moreover, the water needs to be properly remixed before the water resumes flowing.
A better solution is the second type of valve, which installs directly on the water pipe. This type of valve can be installed directly on the pipes at sinks and bathing areas, mixing cool and hot water in the pipe before the water flows out of the faucet. Or, if you have access to the water heater in a single-family home, you can install a scald valve for the entire house.
Selecting the right valves for scald protection depends on your budget, your individual needs, and the size of the home. See our consumer guide for more information, including product resources, and talk to your plumber to discuss what is best for your situation.
Lower Hot Water Heater with Caution
120° F has been the standard recommended water heater temperature for reducing hot water scalding risk. A severe full thickness burn can still occur at 120° F, but it takes 5 minutes – allowing the person and caregiver more time to react and remove the person from the hot water.
And as we’ve discussed, individuals with compromised health and those under chemotherapy are at increased risk for Legionnaires Disease with water stored at 120° F. So a better solution is an anti-scald valve. But it’s important that you assess your care receiver’s scald risk and overall safety and make the decision that’s right for them – and for you, too, if you’re living with the person you care for.