Outside

This Help Sheet suggests ways to make the outside areas of the home as useful and safe as possible for a person with dementia, their family and carers. Not all suggestions will suit all people or situations, but some people may find a solution to a particular problem they are experiencing outside the house.

The aim of access to an outside area for a person with dementia is to provide a space that is pleasant, relaxing, secure, safe and offers suitable activities.

Ideally it will also be:-

• Calming
• Pleasurable to the senses
• A trigger for memory
• Safe for walking
• Restful, with shady places to sit

What to try
• Install ramps and rails where there are significant changes in the level of the floor or ground. Outside steps should have a non-slip surface and a sturdy handrail. Mark the edges of steps with paint to help the person with dementia negotiate the levels.

• Promote access by making entrances and exits easy to find, clear away overgrown shrubs, emphasise doorway or door frame with contrasting coloured paint or use cues like pot plants or night lights to lead person to the door.

• If the person has difficulty recognising the house or finding the front door, paint the front gate a distinctive colour and ensure a clear and obvious path, perhaps using garden borders showing the way. Do not make any changes while the person is able to recognise the way independently, as any changes may confuse them.

• Put a comfortable sturdy chair or bench in a shaded part of the garden or verandah for a rest and to enable the person to stay longer and enjoy the outside area.

• If you need to discourage access to a shed or garage try camouflaging the doorway.

• Sunburn can be an issue if the person with dementia is unable to detect temperature. Shade cloth or 'anti-UV roofing' can provide some protection over a verandah.

• Check that the clothes line is not a hazard because it is positioned too low, and store any LP gas cylinders in a safe place.

• Check and clear the mailbox regularly if the person with dementia lives alone.

• If it is no longer possible to get the person with dementia out of doors, encourage them to sit near a window with a view. A window box with flowers could be installed near where they sit and lots of pot plants could be introduced inside.

Fences
Adding an 'open' fence where there has not been one previously may cause problems for some people with dementia. It may make them feel trapped and frustrated and may even precipitate them trying to get out. Carers have reported that solid fencing or brush fencing is effective because it removes the visual cue to go outside. Lots of shrubs and bushes planted inside the fence will camouflage the fence and minimise the feeling of being locked in. It may be necessary to raise the height of the fence to prevent climbing over.
Gates may need to be locked with pull latches, a system which requires two hands, or a simple padlock.

Paths
• If possible, walking paths should be wide, flat, even and slip-resistant. Ideally, paths should lead a person to pleasant places such as a flower garden or a bench in a shady spot, then lead a person back to the house.

• Remove hoses and any obstacles from walking paths that may cause a fall.

• If the person walks outside at night make sure steps and paths are well lit.

• Sensor lights are useful, but can be confusing for some people.

Rubbish and garden compost
If rummaging through rubbish or eating spoiled food from the rubbish or compost is a problem, lock the bin, hide or screen from view or put rubbish in a locked area. A neighbour may agree to keep your rubbish bin in their garden.

Garden
• Take any poisonous plants out of the garden which may be eaten. Remove spiky plants if injury is likely.

• Make a raised garden bed if the person with dementia is keen on gardening but finds bending difficult.

• Timers can be installed on hoses if the person likes to water the garden but forgets to turn off the tap.

Pool
Safe pool fencing is vital.

Garden shed and garage
Access to the garden shed and garage and related activities can be important for some people. However, dangerous and toxic substances and goods should be locked away. This may include power and other tools depending on the level of the person's skills and their ability to recognise and use objects appropriately.

Tools and items if they can still be used safely by the person with dementia, should be displayed in such a way as to invite participation in activities and to make it easy for the person to find things. Depending on what they can still do safely, a number of activity boxes could be assembled.

For example:-
• Gardening box of gloves, tools, seeds, pots and potting mix
• Carpentry box of softwood off-cuts, manual carpentry tools and supplies
• Repair kit with some gadgets, spare parts and tools

Did you know?

Combined investment in dementia research is 7 times lower than spending on cancer research.