Caregiver Safety Guide: Leaving a Loved One with Dementia at Home

Caring for a loved one with dementia requires compassion, patience, and difficult decisions. One of the most challenging decisions is whether it’s safe to leave a loved one with dementia at home alone. As a caregiver, you occasionally need to run errands, attend events, or go to a doctor’s appointment. Even if you’re gone for a short time, you may worry about your loved ones' safety.

Balancing Independence and safety is a delicate act. Although your loved one may insist they are fine on their own, they may not recognize the level of care you provide to keep them safe. While you may feel conflicted, safety should always be the deciding factor.

Ultimately, the decision you make is personal. Do what’s best for yourself and the well-being of your loved one. Don’t hesitate to seek help from family members, physicians, social workers, home health nurses, or other caregivers for advice.

In addition, your oved one’s physician can perform a cognitive evaluation, such as the MoCA test, to assess their processing and judgment abilities. These insights can help provide a clear picture of whether your loved one can be left safely at home.

Critical Question to Consider Before Leaving Them Alone

Before deciding if it’s safe to leave an individual with dementia alone, there are key questions to ask yourself:

• Emergency Awareness: Can they recognize or respond to emergencies? Would they call 911, someone for help, or exit the home safely if the smoke alarm went off?
• Stranger Safety: Can they distinguish family and friends from strangers? Would they open the door for anyone, or can they safely identify who’s outside
• Phone Safety: Seniors are often targeted and victims of scammers, online, by telephone, and door-to-door. Do they believe everyone who calls on the phone?
• Daily Functioning: Are they able to prepare and eat meals? Use appliances and kitchen tools safely? Go to the bathroom, groom, or walk independently?
• Emotional State: Do they seem calm, frightened, anxious, or angry when you return? Do they feel isolated and abandoned while you’re away?
• Wandering: Are they prone to wandering or have a tendency to get lost easily or forget where they are
• Health Issues: Do they experience frequent health issues requiring constant monitoring, such as frequent falls or breathing difficulties
• Behavioral Issues: Are they destructive to your home or physically harmful to themselves?

If any of these questions raise concerns, or you've experienced them in the past, it may not be safe to leave them alone. If you feel confident, your loved one may be capable of being alone for short periods of time.

Because dementia is a progressive disease, abilities can and will change over time, making it critical to regularly assess and monitor the situation.

Safety Strategies & Tips

There are ways to prepare for and maximize safety when an individual with dementia is home alone.

• Install a granny cam or monitor with voice to observe them when no one is home
• Consider asking a trusted family member, friend, or hiring a home health care professional to sit with your loved one while you're away
• Install safety devices, such as smoke detectors, stove shut-off devices, door alarms, and motion sensors
• Set up a phone system with large buttons and preprogrammed numbers, such as 911, neighbors, or your phone number, to help them call for help
• Remove potentially dangerous items such as sharp objects, medications, and toxic substances
• Post notes or pictures for reminders, simple instructions, or cues, such as do not open the door to strangers
• Arrange for regular check-ins if you’re going to be out for the day. Call or video chat to monitor how things are going while you’re away

Wrap up

The decision to leave a loved one home alone with dementia, even for short periods, can be emotionally challenging. It's normal for caregivers to feel guilt, sadness, or worry. But whatever you decide, your primary goal is to make sure your loved one is safe.

Safety must always take priority over independence when dementia is involved. There is no perfect decision or solution. Some people go a long time without needing supervision or support, while others may need support sooner. It depends on the environment and the stage of dementia. Balancing independence and safety is a delicate dance that caregivers have to navigate.

You’re not alone in your caregiving journey. Give yourself grace, trust your decisions, and ask for help when needed.

To learn more, listen to the “Home Alone with Dementia: Safety Guide for Caregivers” episode of The Disappearing Mind, an award-winning podcast hosted by National Dementia Coach Dawn Platt that helps listeners navigate along their personal journey with dementia through exclusive and direct perspectives of people diagnosed with the disease, their caregivers and experts in the field.