Dementia Fall Prevention: Keeping Your Loved One Safe
Understanding dementia fall prevention is crucial for ensuring the safety of your family member living with dementia. According to the CDC:
- One out of five falls causes severe injury, such as broken bones or head injuries.
- Each year, 3 million older people are treated in emergency departments for fall injuries.
- Over 800,000 patients are hospitalized yearly because of a fall injury, often due to head injuries or hip fractures.
- Each year, at least 300,000 older people are hospitalized for hip fractures, with more than 95% of hip fractures caused by falling.
People with dementia are at a heightened risk of falling, which increases as the disease progresses. As dementia advances, individuals may experience difficulties with coordination, walking, balance, and depth perception, making them prone to falls, even in familiar environments like their homes.
Understanding the Risk
Living with dementia can make even familiar environments feel daunting for our loved ones. As the disease progresses, they may face difficulties with coordination, walking, balance, and depth perception, putting them at a higher risk of falls, even within the comforts of their own home.
Coordination
Dementia can impair motor skills and coordination, making it difficult for individuals to move smoothly and effectively. Tasks that once seemed effortless, such as walking across a room or reaching for an object, become more challenging. As their coordination deteriorates, the risk of stumbling or losing balance and the likelihood of falls increases.
Walking
Walking becomes more challenging for those with advanced dementia. You may see changes in gait, such as shuffling or uneven steps. They may need help walking. Some people experience freezing episodes, where they suddenly stop moving. This increases their risk of falling, especially in crowded or cluttered environments.
Balance
Maintaining balance becomes more difficult as dementia robs people of their ability to sense and adjust their body position. Poor balance control makes standing up from a chair or turning around more awkward, especially when switching between different surfaces or negotiating obstacles within the home environment.
Depth Perception
Dementia can distort individuals’ perception of depth and spatial awareness, making it difficult to judge distances between objects or surfaces accurately. As a result, they may misinterpret the distance between furniture, steps, or doorways. The result is often missteps, collisions, or falls. This also causes problems with stairs or uneven surfaces.
Environmental Familiarity
Even in their own home, individuals with dementia may struggle to navigate safely due to cognitive decline and memory loss. They may forget the layout of their surroundings, fail to recognize potential hazards, or become disoriented, increasing their vulnerability to falls, particularly in dimly lit areas or rooms with cluttered pathways.
Home Safety Check
Let’s start by taking a stroll through your home together, looking at it through the eyes of someone with dementia. We want to make sure that every corner is as safe as can be. Check for stability in furniture, clear pathways, ample lighting, and remove any rugs or tripping hazards. Oh, and don’t forget about our furry friends – make sure pets aren’t underfoot, adding to the risk of falls.
We also created a home safety checklist for you to use to ensure the safety of your loved one. Our checklist can be found HERE.
Furniture Stability
Evaluate the stability of all the furniture in the home. Pay close attention to items frequently used for support or balance, such as chairs, tables, and handrails. Ensure that furniture is sturdy and securely anchored to the floor or wall to prevent tipping or shifting. Consider removing any wobbly or unsteady pieces.
Chairs with Armrests
Selecting chairs with armrests can significantly reduce the risk of sliding off or losing balance while sitting or standing. Armrests provide support and stability when sitting down or rising from a seated position, helping them maintain balance and preventing falls. Chairs with sturdy armrests also offer a secure and comfortable seating option for individuals to rest and relax, minimizing the risk of accidental slips or falls due to instability.
Clear Walkways
Maintain clear pathways throughout the home for safe movement and navigation for those with dementia. Remove obstacles, clutter, and unnecessary furniture from hallways, doorways, and high-traffic areas to create unobstructed pathways. Clearing walkways minimizes the risk of tripping or stumbling and allows for easier maneuverability, especially for individuals using mobility aids like walkers or wheelchairs.
Adequate Lighting
Ensure all home areas are well-lit to enhance visibility and reduce the risk of falls, particularly during nighttime or in dimly lit areas. Install bright, energy-efficient lighting fixtures in hallways, staircases, bathrooms, and other critical areas to illuminate potential hazards and improve spatial awareness. Consider using motion-activated lights or nightlights to provide additional illumination during nighttime hours, making it easier for individuals to navigate safely.
Removal of Rugs
Remove or secure loose rugs, mats, and carpets to prevent tripping hazards. Loose floor coverings pose a significant risk of slips, trips, and falls, especially for those with mobility impairments or gait abnormalities. Consider replacing slippery rugs with non-slip alternatives or using double-sided tape or rug grippers to secure them firmly to the floor. Alternatively, eliminate rugs altogether in areas prone to falls, such as hallways, bathrooms, and kitchen spaces.
Elimination of Tripping Hazards
Identify and eliminate potential tripping hazards throughout the home, including electrical cords, loose wires, thresholds, and uneven flooring transitions. Securely fasten cords along baseboards or use cord covers to keep them out of pathways. Repair or replace damaged flooring and ensure that thresholds between rooms are flush and free of obstacles. Adding grab bars and handrails in critical areas, such as bathrooms and staircases, can provide stability and support during transfers and mobility tasks.
Pet Safety
Ensure that pets are not underfoot or in areas where individuals with dementia frequently walk or move. Pets can pose a tripping hazard, especially if they dart unpredictably or lie in pathways. Establish designated pet-free zones within the home or use pet gates to restrict access to certain areas while allowing those with dementia to move freely and safely. Additionally, consider training pets to stay clear of high-traffic areas or providing them with designated resting areas away from foot traffic.
Personal Precautions:
When it comes to clothing and footwear, comfort is key! Opt for non-skid footwear like tennis shoes or rubber-soled slippers to provide better grip and support. And remember to adjust their clothing to prevent any tripping hazards – we want them to move freely and comfortably.
Non-Skid Footwear
Provide appropriate non-skid footwear, such as tennis shoes or rubber-soled slippers, for stability and traction while walking. Non-skid footwear helps prevent slips and falls on smooth surfaces by providing better grip and support. Avoid allowing them to walk around barefoot or in socks, as these offer minimal traction and increase the risk of sliding or losing balance, especially on polished floors or stairs.
Clothing Adjustment
Adjust their clothing to reduce tripping hazards and promote safe mobility. Ensure that pant legs or nightgowns are not too long, they may pose a risk of entanglement or tripping. Choose clothing with smooth, non-binding fabrics that allow for comfortable movement and do not impede mobility or restrict circulation. Additionally, consider securing loose or dangling accessories, such as belts or scarves, to prevent them from catching on objects and causing falls.
Alarm Systems
Consider using an alarm system to empower you with timely information when someone with dementia tries to move independently, especially if they are at risk of falls or wandering. Alarms provide an extra layer of safety by notifying you of potential safety concerns in real-time. It allows for timely intervention and assistance, giving you the power to prevent accidents before they happen.
Various types of alarms are available, including pull-string alarms, pressure sensor mat alarms, and motion sensor alarms. Each offers unique features to suit different caregiving needs and preferences. These alarms can be strategically placed on clothing, furniture, or within the environment to monitor movement and ensure prompt response to any signs of distress or instability.
Dementia Fall Prevention Interventions
There are several different types of alarms to help prevent Dementia falls, on the market. Alarms are designed to let you know your family member with Dementia is up and moving and is at a risk for falling.
Pull string alarm clips to their clothes and onto the furniture. When they stand up the alarm separates and will sound. These are useful for someone who may sit in several different places. They are easy to reposition
During the day I prefer the chair pressure sensor mat alarm. It is a pad that goes on the chair and when they start to stand it alarms. As soon as their bottom lifts up it will alarm, some people will immediately sit back down. There is an alarm just like this one for the bed also. They are very sensitive. As soon as someone tries to get up out of bed it will alarm.
At night I prefer a motion sensor alarm. It works best when set low in the room and aimed across the floor in front of the bed. If they swing their feet over the bed or start to walk in the room, the alarm will sound letting you know they are out of bed. This one works well for those with Dementia who are still able to walk around, and you just want to know when they are out of bed.
Another type of alarm used at night is the pressure sensor alarm for the bed. It is just like the chair alarm only larger. It is very sensitive and can alarm when someone is just shifting their position in bed. This alarm is best used for someone who doesn’t get out of bed on their own anymore, but you are worried they may get too close to the bed and roll out.
Nightime Dementia Fall Prevention
Nights can be tricky, especially when navigating to the bathroom. Keep those pathways well-lit and the bathroom door open with a light on – it’s all about making their journey easier and safer. Also, positioning the bed against a wall can provide extra security, and choosing chairs with armrests helps them sit and stand with ease.
Well-Lit Pathways to the Bathroom
Maintain well-lit pathways from the bedroom to the bathroom to facilitate safe navigation during nighttime trips. Ensure that hallways, corridors, and staircases are well-lit to provide clear visibility and reduce the risk of tripping or stumbling over obstacles. Keeping the bathroom door open with a light inside helps them quickly locate the toilet and other fixtures, minimizing the risk of falls or accidents.
Positioning the Bed Against a Wall
Positioning the bed against a wall can help reduce the risk of falling from multiple sides, providing individuals with a stable and secure sleeping environment. Placing the bed against a solid wall prevents individuals from rolling out of bed or accidentally falling off the sides during sleep, particularly if they experience nighttime confusion or restlessness. Adding bed rails or safety bumpers can increase bed safety by providing physical barriers to prevent falls and promote a sense of security while sleeping.
By implementing these nighttime precautions, caregivers can create a safer and more secure environment for individuals with dementia during nighttime hours, reducing the risk of falls and promoting restful sleep and overall well-being. Regularly assessing and adjusting these precautions based on individual needs and preferences ensures continued safety and peace of mind for both caregivers and their loved ones.
After a Fall: Checking for Injuries and Ensuring Safety
Even with the best precautions in place, falls can still happen. It’s essential to know what to do in the aftermath to ensure the safety and well-being of your loved one. Here’s what you need to know:
Checking for Injuries
After a fall, the first step is to assess for any injuries. Take a moment to carefully examine your loved one for any signs of pain, swelling, or bruising. Check for tenderness or deformity in areas such as the arms, legs, hips, and head. If you notice any signs of injury, it’s essential to seek medical attention promptly.
How to Check for a Hip Fracture
Hip fractures are a common and serious injury that can occur as a result of a fall, especially in older adults. Not all hip fractures are immediately noticeable. To check for a possible hip fracture, look for the following signs and symptoms:
- Pain or tenderness in the hip or groin area. (Learn more about assessing Pain with Dementia HERE)
- Difficulty or inability to bear weight on the affected leg.
- Swelling, bruising, or deformity around the hip joint.
- Limited range of motion in the hip or difficulty moving the leg.
- External rotation and shortening of the affected leg.
If you suspect a hip fracture, it’s crucial to seek medical attention immediately. A healthcare professional can perform diagnostic tests, such as X-rays or MRI scans, to confirm the diagnosis and determine the best course of treatment.
Watching for Signs of Concussion or Brain Bleed
If your loved one hit their head during the fall, it’s essential to monitor them closely for any signs of concussion or a brain bleed. Symptoms of a concussion or brain injury may include:
- Headache or pressure in the head.
- Nausea or vomiting.
- Dizziness or loss of balance.
- Confusion or disorientation.
- Slurred speech or difficulty speaking.
- Changes in vision, such as blurred or double vision.
- Loss of consciousness, even briefly.
If you notice any of these symptoms or if your loved one’s condition worsens after a fall, seek immediate medical attention. In most nursing homes, if a patient falls and hits their head, they are sent to the emergency room for an evaluation. Concussions and brain bleeds can have serious consequences in a short amount of time if left untreated. So it’s essential to err on the side of caution and get them evaluated by a healthcare professional as soon as possible.
Learn more about other possible Dementia complications HERE
Post-Fall Assessment:
If your loved one has a fall, don’t panic! Take a moment to investigate what happened and look for any contributing factors. It’s important to consult with healthcare professionals, like doctors or physical therapists, to address any underlying issues, like weakness, balance problems, or a change in their cognition, such as increased confusion. Together, you’ll find ways to improve things and reduce the risk of future falls.
Investigate the Fall
Following a fall, it’s crucial to promptly investigate the event to determine the cause and any contributing factors. Caregivers should document details such as the time and location of the fall, what led up to the incident, and any environmental hazards or conditions that may have played a role. Investigating the why behind this fall will help you know which interventions you can add to prevent future falls.
Collaboration with Healthcare Professionals
Healthcare professionals can conduct comprehensive assessments to evaluate physical function, balance, gait, and medication management, identifying any areas of concern or areas for improvement. Based on their findings, they can recommend personalized interventions, such as strength and balance exercises, assistive devices, or medication adjustments, to address underlying issues and reduce the risk of falls. FYI, increased confusion and falls can be a sign your loved one has a UTI. This is the first thing nurses & doctors look at when there is a change like this.
Implementation of Preventive Measures
Based on the findings of the post-fall assessment, you can implement preventive measures to reduce the risk of future falls. This may include modifications to the home environment to remove hazards and improve safety, such as installing grab bars, improving lighting, or rearranging furniture. You can also provide ongoing support and supervision, encourage regular physical activity and mobility exercises, and ensure proper medication management to minimize the risk of falls and promote overall well-being.
Conclusion:
By implementing these dementia fall prevention strategies and remaining vigilant, caregivers can significantly reduce the risk of falls and enhance the safety and well-being of their loved ones living with dementia. Regular reassessment and adjustment of preventive measures also ensure ongoing protection and peace of mind for both caregivers and their loved ones. Remember, prevention is key to ensuring a safe environment for those with dementia.
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