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The Definitive Guide to Stair Safety
for a Person with Dementia

Chapters

Dementia is associated with symptoms of deteriorating brain function as we age. It is an umbrella term given to a number of neurodegenerative diseases. We commonly think of Alzheimer’s and related conditions as affecting memory and cognitive performance. But because the brain controls our physical movement as well as our mental processes, dementia can also cause mobility problems.

In many cases elderly people with existing mobility issues, which may have been caused by stroke or arthritis for example, go on to develop dementia as they get older. In other cases, able bodied people with dementia can subsequently experience mobility issues that are either related to their dementia or another health condition.

Understandably family, friends and carers of dementia patients worry about their safety around the home and particularly on the stairs, where the risk of a fall and serious injury is high.

A loved one may have been using their stairlift for years and is now showing signs of dementia. Will they be able to continue using the stairlift safely?

Or they may have been diagnosed with dementia for some time and only now be experiencing mobility issues. In both cases the question is whether it is safe for someone with dementia to use a stairlift. Here we will examine the issues in more depth to help you find the right solution for your loved one.

4 Simple Ways to Make Stairs Safer for Someone with Dementia

Dementia can affect a person’s ability to use the stairs because it can affect their depth perception and how they see colour contrast. This can make it hard for them to judge where the step treads are, making it more likely that an accident will happen.

Increase colour contrast

The carpet on the staircase is likely to be all one colour or the same repeating pattern. This can make it difficult for a dementia patient to distinguish between the stair tread and the riser. You can make each step easier to see by attaching strips of brightly contrasting coloured electrical tape along the edge of each tread. Care must be taken though to ensure the tape is securely fixed so as not to be a trip hazard.

Remove Trip Hazards

Another thing you should do around the whole house and not just on the staircase is to get rid of trip hazards. These include worn out or uneven carpets, rugs and items left at the top or the bottom of the stairs waiting to be taken up or down stairs.

Maximise Lighting

You should ensure there is bright lighting on the stairs and in the hall and on the landing. There should be light switches within easy reach at both ends of the stairs. The switches can be made more visible by mounting them on a contrasting colour background or putting a brightly coloured sticker on them.

Add a Handrail

Although most stairs have a banister, you could consider fitting a handrail on the opposite side of the stairs. This can help someone who is unsteady on their feet by giving them something to hold on to with their preferred hand in both directions.

How Can Dementia Affect Mobility?

Dementia can affect mobility in a number of ways. Someone with Dementia with Lewy Bodies may exhibit Parkinsonism symptoms, which means they will have difficulty controlling their movements. This can result in them moving slowly, with short shuffling steps. Another sign of Parkinsonism in dementia is stiffness and tremor, which can cause a person to move rigidly or with a limp.

Dementia can also impact on a person’s coordination and balance, which makes them more susceptible to falling over. Having a fall can lead to secondary issues, such as broken bones that can take longer to heal in an elderly person.

Apraxia is another issue common in dementia patients. This is where there is a breakdown in signals from the brain that tell the body to move. This manifests itself in a person having problems when they try to move. For example when they try to stand up from a sitting position or begin to walk after standing still. Sometimes this issue can be helped by touching their arm gently. This can act as a sensory stimulus to trigger the brain to help them move.

Whether a dementia patients experiences one or all of these symptoms, the effects can be debilitating and have a profound impact on their quality of life. The mobility challenges increase the risk of additional problems such as serious injuries from falls.

Is a Stairlift the Best Solution?

If reduced mobility is becoming an issue for your loved one in addition to their dementia, it is time to look at your options. Walking aids such a stick, cane or wheelchair, can help a person get around, but the stairs still present a dangerous obstacle.

Some people overcome this by moving their loved one’s bed downstairs if there is space – into a dining room for instance. This can work if there is a bathroom on the ground floor. Some people have building work done to reconfigure the layout of their downstairs to accommodate a bedroom and bathroom.

With both these options there is a fair amount of upheaval both for the dementia patient and other members of the household. Consideration must be given to how to prevent the person with dementia trying to continue to use the stairs, as they may forget they can no longer use their upstairs. Installing a stairgate at the bottom of the stairs may be one solution, so long as they don’t attempt to climb over it.

An alternative option is to move to a bungalow or ground floor flat. This can be expensive. In addition, the upheaval of moving to an unfamiliar environment can cause confusion and distress in someone suffering from dementia. However, this can be the best long term solution in many cases.

Installing a stairlift is another option to consider, but the safety of the user is paramount. It is a good idea to arrange for an assessment by an occupational therapist to see if a stairlift is a feasible option for your particular circumstances. Someone with dementia should always be supervised when using a stairlift as it could be dangerous for them to try to use it on their own.

Some dementia patients are able to use a stairlift safely if there is someone else present to supervise. A carer or family member should make sure they are securely strapped in and be there to prevent them from trying to get off the lift whilst it’s moving.

They can also be there to assist if the lift stops halfway up the stairs. There needs to be adequate space at the top and bottom of the stairs for a carer to help the user in and out of the seat without falling.

In other situations a stairlift would not be suitable, even under supervision. Some dementia patients experience terror and panic at the thought of descending on a stairlift, as it can look to them like going into an abyss.

One of the characteristics of Dementia with Lewy Bodies is hallucinations, and patients with this type of dementia may well be terrified of going on a stairlift. If you think your loved one will become distressed by using one then you should consider another option.

In some cases it’s a good idea to try renting a stairlift in the short term to see how the user gets on with it. If they are comfortable with it, you could then purchase one, as buying usually works out cheaper than rental over the longer term.

For someone with dementia who is struggling with their stairs, a stairlift may be the best solution. However, it is important to weigh up all the options before deciding which course of action is best for your loved one’s needs over the long term.

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