Avoiding accidental poisoning for people living with dementia 

Dementia can affect memory, attention, sensory perception and thinking. As the condition progresses, a person may forget the purpose of certain items or how to use them safely. They may become easily confused or distracted and struggle to read, interpret or act on safety information found on product labels.  

In addition, they might have a limited ability to self-monitor or recognise when they have made an error. Many people with dementia also experience visual impairment—either due to poor eyesight or difficulty processing sensory information—which can further increase their risk. 

These factors can sometimes lead to the accidental ingestion of hazardous substances, such as cleaning or laundry products. Alarmingly, accidental poisonings have risen by 96 per cent since 2013, according to RoSPA's report Safer Lives, Stronger Nation, highlighting the urgent need to reduce preventable harm in the home. 

Dementia can also affect recognition. A person living with dementia may not recognise new cleaning products, or novel objects like vapes, causing them to mistake something harmful, like a cleaning product or vape fluid, for something safe, such as a drink. 

In addition, medication poses a risk. For example, someone with dementia may forget they’ve already taken their medicine and take another dose, resulting in accidental overdose. 

As abilities decline, tasks that were once routine, like doing laundry or taking medication, can become riskier. To minimise the chance of an accident, carers may need to provide more supervision and support. Ongoing assessment of hazards in the home is essential to helping the person with dementia stay safe.  

Some of the most common sources of poisoning in the home include: 

• Medications, including overdose and wrong usage
• Household cleaning products
• Laundry products
• Spoiled food
• Garden chemicals 
• Toiletries.  

Medication is a particular risk. Between 2014 and 2023, the most common causes of hospital admissions for accidental poisoning among over-65s in England were exposure to medications and drugs. 

The rooms where products that can cause poisoning are typically stored include:

• Kitchen 
• Utility room
• Bathroom
• Garden and shed
• Garage.

Dementia is a progressive condition, which means a person’s abilities and awareness will change over time. Tasks or environments that were once safe can gradually become more hazardous, sometimes without obvious warning signs. That’s why it’s important for carers, family members and professionals to regularly reassess the home environment and daily routines.  

As the condition advances, someone may become more confused, forgetful or less able to recognise hazards, increasing the risk of accidents such as poisoning. Continually assessing risk helps ensure the home remains as safe as possible and is adapted as the person’s needs change. 

Regular checks might include: 

• Observing the person while they carry out daily tasks
• Reevaluating how and where hazardous chemicals and potentially harmful items are stored
• Assessing whether the person can still manage their medication safely
• Identifying new behaviours or difficulties (e.g. swallowing non-food items, getting up at night to eat or struggling to read and understand labels)
• Identifying when precautions, extra supervision or home adaptations are needed.

There’s no one-size-fits-all interval for assessing the home of someone living with dementia. It’s important to review the environment regularly and respond to changes in mental abilities and behaviour—both day-to-day and over months and years—because dementia is a progressive condition that worsens over time. You should risk assess: 

• At regular intervals
• After any noticeable change in the person’s memory, behaviour or ability to carry out daily tasks
• After a fall, accident or close call, including any incidents involving medicines, cleaning products or other hazardous items 
• When introducing new products or changes to the home, such as moving house, having visitors or redecorating. 

Your familiarity with what is normal for the individual living with dementia is crucial for assessment of their day-to-day activities. Look out for small changes, like becoming confused around certain tasks or struggling with instructions and recall. This can be an early warning sign that changes or more support are needed to maintain a safe home environment.  

It’s also important to be aware that factors beyond dementia itself can worsen symptoms or trigger sudden changes. These include: 

• Stress and tiredness: High levels of stress, fatigue or sleepiness can heighten confusion and impair memory
• Physical illness: Infections (such as urinary tract or chest infections), pain, dehydration, poor nutrition, constipation and electrolyte imbalances can all cause a sudden increase in confusion and worsening of mental symptoms, a condition known as delirium. People with dementia are particularly susceptible
• Environmental changes: Changes in daily routine, unfamiliar surroundings, or even rearranged furniture can be disorienting, making it harder for a person with dementia to function or cope
• Medication side effects: Some medicines can cause sedation, drowsiness or confusion, which may mimic or worsen dementia symptoms. Interactions between medications can also increase confusion. 

Regular medical assessments are vital, as they can reveal signs of dementia progression that may not be immediately apparent in a person's behaviour.

A person living with dementia should have a care plan developed in partnership with them, their family or carers, and the relevant healthcare professionals. This plan helps ensure their needs, preferences and any risks—including those related to safety in the home—are clearly understood and addressed. 

The care plan should be reviewed at least once a year, but it may need updating more often if there are changes in the person’s behaviour, particularly if they start taking risks that could affect their health or safety. 

Families and carers have the right to request a review at any time, especially if they notice new or increased risk-taking behaviours. Reviews can usually be requested from the healthcare professional or service overseeing the person’s care, such as their GP, memory clinic, community nurse or occupational therapist.

Things that you could consider include: 

Safe storage tips 

Keep products in their original containers. Storing cleaning products or medication in old chocolate or biscuit tins can be confusing and could increase the risk of a person consuming them. Plain containers without the original product branding could also be confusing.  

Consider whether products are in appropriate packaging. Original packaging is usually designed to be child-resistant or tamper-evident, which can add an extra layer of safety. However, some people with dementia may struggle with packaging due to dexterity issues, while others may be able to open child-resistant containers too easily. In both cases, carers can balance safety with accessibility by supervising use or speaking to a pharmacist about alternative packs that are easier to manage safely. 

Store medications and household cleaning products in different areas from where food is stored. This can help to reduce the risk of the person with dementia ingesting a hazardous product because of mistaking it for food or drink. Separate cleaning products from medications too.  

Consider labelling cupboards where food and non-food items are kept with an easy-to-read sign or photograph.  Make sure labels are clear, easy to understand and at eye level. Printable images can be purchased online or from shops selling assistive living aids. 

Disposal and simplification 

Dispose of unnecessary medications. If the person you are caring for has supplies of medication that they no longer take or are out of date, they should be taken to a pharmacy to be disposed of safely.   

Keep the number of bottles and containers to a minimum. Store or remove duplicates and make sure harmful substances, like cleaning products, are not placed near food or drink. 

Consider replacing products with less toxic alternatives. For example, the most toxic cleaning products can be replaced with natural alternatives that are less harmful to the environment and the individual. Consider removing the most toxic products, such as oven cleaner, household bleach, toilet cleaner and caustic soda – particularly those which are only used occasionally.  

Where more support is needed 

As the person’s mental abilities decline, you may decide you need to keep them safe by restricting access to certain products. At this stage, measures could include: 

Keep household cleaning items out of sight.  Small, brightly coloured products—like dishwasher or laundry tablets—can be mistaken for sweets, and small bottles or cartons may be confused with milk or juice. After use, store them in a cupboard, ideally away from food and drinks. 

Keep e-cigarettes and vapes and their refills out of sight. These chemicals are highly toxic if consumed. If the person you are caring for uses these themselves, supervise them during refilling and ensure they are stored safely after use. 

Many people with dementia take multiple medications several times a day, whether for dementia or other health conditions. Keeping track of doses and timing can be challenging. A person with dementia may need reminders or assistance to take their medication, or they may forget that they’ve already taken it. 

Tools such as pill organisers (including lockable versions with built-in timers), alarms, or simple checklists can help make this easier. Where there are concerns about memory, vision or understanding, it may be safer for a family member or carer to take responsibility for administering medication. 

Medications should be stored securely, ideally in a locked box or cupboard, especially if the person has reduced awareness or confusion about what tablets are for. 

Pharmacists can support by supplying medicines in blister packs or monitored dosage systems, which help ensure the right dose is taken at the right time. They can also advise on alternative packaging that’s both safe and manageable. 

If carers or family members have concerns about the number or suitability of medications, they should speak to the person’s GP or pharmacist about arranging a polypharmacy review. Many older people are prescribed medicines that may become less beneficial—or even harmful—as they age. A review can help to: 

• Reduce the number of medicines taken
• Switch to less toxic or safer alternatives
• Simplify routines by changing dose timings or frequency. 

In some cases, it may also be helpful to use a Medicine Administration Record (MAR) chart. These charts provide a clear record of when medicines should be given and by whom, helping carers administer them safely and accurately. 

As dementia progresses, most carers will need to take full responsibility for managing and administering medication, supported by advice from healthcare professionals.

Products must carry warning labels if they can be harmful to people or the environment. These labels are part of the Globally Harmonized System of Classification and Labelling of Chemicals (GHS) used across the world to help people recognise hazardous products. Being able to spot and understand these symbols can help you quickly identify products that could pose a risk to someone living with dementia. 

Here are some key symbols to look out for:

Since 2004, to help prevent accidents including poisoning, the cleaning products industry also now uses A.I.S.E.'s ‘safe use’ icons, which offer guidance on using household products safely. Look out for the ‘Do not ingest icon’.

Pay attention to other products carrying the warning to keep out of reach of children, such as button batteries. The risk of accidental ingestion by children can be just as relevant to vulnerable adults and people living with dementia, so appropriate precautions should be taken with storage and use.

Symptoms of poisoning can depend on what's caused it, and may include: 

• Feeling sick or being sick
• Diarrhoea
• Feeling sleepy
• Blurred vision
• High temperature
• Confusion
• Difficulty breathing
• Seizures (fits)
• Loss of consciousness. 

These symptoms may be harder to identify in someone with dementia, as they may be less able to recognise or communicate that something is wrong. Carers and health professionals might also attribute symptoms to dementia, medication side effects or other existing health conditions. It is therefore important to remain vigilant for changes in behaviour and signs of distress. 

In addition to medical symptoms, carers should watch for early signs that someone may be becoming confused around household items. For example, food stored alongside cleaning products, toiletries kept in the kitchen or medicines left in unusual places can all indicate difficulty distinguishing between safe and unsafe items. Noticing these behaviours early can help prevent accidental poisoning. 

Seek medical advice immediately. Further information on the best course of action is available on the NHS website. 

If you have the product packaging, keep it nearby and show it to paramedics or healthcare professionals. This can help them assess the situation and choose the right treatment. 

It's also helpful to share: 

• The time of the incident
• The person’s age, weight, and any medical conditions, including that they have dementia
• Any regular medications they take.