Creating a Safe Home Environment

Ensuring a safe and supportive home environment is paramount when caring for patients, particularly in hospice and end-of-life care settings. This comprehensive guide outlines key strategies and practices to create a secure and nurturing atmosphere for both caregivers and patients. From effective communication techniques to safeguarding against accidents and preparing for emergencies, these guidelines encompass various facets of home caregiving. Whether you’re a family caregiver or a professional healthcare provider, these recommendations will help you establish a safe haven that prioritizes the well-being and comfort of those under your care.

Infection Control

Hand Hygiene

Teach caregivers and patients how to wash hands effectively with soap and water. Encourage handwashing before and after all care activities and as needed.

Steps to hand hygiene:

  1. Wet Your Hands: Begin by wetting your hands with clean, running water. The water can be warm or cold.
  2. Apply Soap: Apply enough soap to cover all surfaces of your hands. This includes your palms, fingers, between your fingers, under your nails, and the backs of your hands.
  3. Lather Up: Rub your hands together vigorously for at least 20 seconds. Be sure to create a soapy lather on all areas of your hands. Don’t forget to scrub your wrists, between your fingers, and under your nails.
  4. Scrub Thoroughly: Pay special attention to areas that are often overlooked, such as the tips of your fingers and the creases of your palms.
  5. Rinse Well: Hold your hands under clean, running water to remove the soap. Ensure that all soap residue is washed away.
  6. Dry Properly: Use a clean towel or air dryer to thoroughly dry your hands. Drying is important because wet hands can spread germs more easily than dry ones.
  7. Turn Off the Faucet: If possible, use a paper towel to turn off the faucet to avoid recontaminating your hands.

 

Disinfect

Regularly disinfect high-touch surfaces, such as doorknobs, light switches, and remote controls, to prevent the spread of infections.

Respiratory Considerations

Cover your nose and mouth when coughing or sneezing. Use a tissue if available and discard in a trash can or bag. If no tissue is available, cough into your upper sleeve, avoid coughing into your hands. 

Fall Prevention

Clear Pathways

Keep hallways and walking areas free of clutter and obstacles.

Slip & Trip Hazards

Removing slip and trip hazards is crucial for ensuring a safe home environment. This involves securing rugs and mats, tucking away loose cords, and promptly cleaning up spills to prevent accidents.

Hand Rails & Grab Bars

Install sturdy handrails along staircases and grab bars in bathrooms and other areas where patients may need support.

Appropriate Lighting

Ensure that all areas are well-lit to prevent tripping hazards. This is of increased importance in the bedroom and bathroom. The pathway between the bedroom and bathroom should also be well lit with no slip or trip obstacles and free of clutter. 

Footwear

Promote the use of non-skid footwear to enhance stability, which may involve recommending rubber-soled shoes, slip-resistant slippers, or gripped socks.

Essential Items

Arrange furniture and essential items within the patient’s arm’s reach to minimize the need for stretching or bending. This includes common items like glasses, hearing aids, phones, bells to summon assistance, tissue, lip balm, and a trash can/bag. 

Regular Screenings

Schedule regular screenings for vision and hearing to address any sensory impairments promptly.

Assistive Devices

Ensure that assistive devices, such as canes or walkers, are within the patient’s reach. Ensure walkers and canes are appropriately adjusted for the individual’s height. Encourage use of assistive devices.

Standing

Advise the patient to rise slowly from a lying or sitting position to prevent dizziness and fainting.

Bathroom Safety

Non-Skid Mats

Place non-slip mats in the bathtub and shower.

Grab Bars

Install sturdy grab bars near the toilet and in the shower.

Raised Toilet Seat

Consider using a raised toilet seat to make sitting down and standing up easier.

Shower Chair

Provide a shower chair or transfer bench for seated bathing. This can facilitate ease of entry into and out of the shower and prevent injury while showering. Hospice provides durable medical equipment under the hospice benefit.

Ventilation

Ensure proper ventilation to prevent humidity-related issues.

Lighting

Install a night light to increase safety for nighttime bathroom visits.

Electrical Devices

Keep electrical devices (hair dryer, razors, radios, heaters, etc.) away from water sources to prevent accidents.

Water Temperature

Set the water heater to a safe temperature to prevent scalding.

Kitchen Safety

Utensil Storage

Store frequently used kitchen items within easy reach to avoid stretching or bending. Keep sharp knives and items that may increase risk of injury stored securely.

Fire Extinguisher

Keep a fire extinguisher in the kitchen and ensure caregivers know how to use it.

Appliances

Unplug appliances when not in use to prevent electrical accidents.

Secure Cabinets

Use childproof latches on cabinets containing hazardous items.

Stove Safety

Install stove safety knobs to prevent accidental ignition.

Clothing

Encourage patients and caregivers to avoid wearing loose clothing around open flames.

Hazardous Materials

Store cleaning products and other hazardous materials away from food and in a secure location.

Soiled Linens

Dispose of soiled linens properly in accordance with local hazardous waste disposal guidelines.

Communication Techniques

Important Contact Information

Maintain a list of crucial contact numbers, including healthcare providers, hospice team members, poison control, and emergency services. Keep it easily accessible.

Allowing Emotions

Encourage open and honest communication between caregivers, patients, and family members. Create a safe space for expressing concerns, fears, and emotions.

Summoning Assistance

Provide the patient with a bell or call button that they can use to signal when they need help. Ensure it’s within their reach.

Remote Monitoring

Install a baby monitor or intercom system in the patient’s room to listen for calls and check on them from another part of the house.

Fire & Disaster Preperation

Tornado

Designate a safe area, stock it with emergency supplies, and have a weather radio for tornado emergencies.

Extreme Cold & Snowstorm

Ensure access to heating sources, emergency blankets, warm clothing, and ready-to-eat meals during cold weather.

Extreme Heat

Limit exposure to sun, styaing cool indoors as much as possible. Set environment to a comfortable temperature. If unable to utilize air conditioning, use fans and cool compresses when possible. Avoid strenuous activity and drink plenty of fluids to ensure hydration.

Thunderstorm

Prepare for power outages with flashlights, batteries, and a battery-operated weather radio.

Fire Safety

Educate caregivers about fire safety, including escape routes and the proper use of fire extinguishers. Ensure smoke and carbon monoxide detectors are present and functioning routinely.

Emergency Supplies

Prepare an emergency kit with essential supplies, including ready-to-eat meals, water, flashlights, and first-aid items. Ensure contact numbers for important individuals are available in a safe place. 

Oxygen Safety

No Smoking

Prohibit smoking in and around the home when oxygen is in use.

Securing Oxygen

Ensure oxygen tanks are properly secured to prevent tipping. Store in a protected area protected from extreme temperatures.

Caregiver Education

Educate caregivers about the dangers of oxygen in fires and promote fire safety practices. Keep fire extinguishers accessible and ensure caregivers understand use.

Signage

Place signs indicating the use of oxygen in prominent places to inform others.

Petroleum-Based Products

Do not use petroleum-based (i.e. Vaseline) products near oxygen, as they can pose a fire hazard.

Medication Safety

Medication Management

Organize, label, and track medications to ensure accurate administration. Ensure understanding of route, administration times, strength, dose, and side effects.

Security

Store medications in a locked cabinet or container out of reach of children.

Disposal

Properly dispose of expired or unused medications following local regulations.

Tracking

Maintain a record of medication administration to prevent errors.

Counting

Regularly count and document the number of pills or doses to track medication use.

Setting Up the Room

Bed

Provide a comfortable and supportive bed with clean linens. Keep the temperature comfortable in the bedroom with commonly used items within arms reach. Ensure the bed is locked and in low position if utilizing a hospital bed.

Safety Rails

Install bed rails if necessary to prevent falls.

Environment

Create a soothing atmosphere with calming colors, familiar items, and soft lighting. Arrange personal items, such as family photos, mementos, and cherished possessions, within the patient’s view to create a familiar and comforting atmosphere.

Entertainment

Provide books, music, television, movies magazines, or other forms of entertainment that the patient enjoys.

Communication Tools

Place communication aids, such as a notepad and pen or a communication board, within easy reach if the patient has difficulty speaking.

Assistive Devices

Ensure that any necessary assistive devices, such as hearing aids or glasses, are readily available.

Nightlight

Install a nightlight in the room to provide gentle illumination during the night without disturbing the patient’s sleep.

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