The Falls of Dementia

Here’s something I noticed many years ago: “The further advanced dementia becomes, the closer their feet will stay to the ground.”

What I mean by this is, people who are living from a dementia-related disease most likely develop an unsteady gait, hardly lifting their feet. Instead they will develop a shuffle and this creates a higher risk of falling. My advice is this: before they reach this point, as a safety precaution, discard all of the throw rugs in their homes.

However, this is only one of the concerns to consider. There are many other hazards that may need to be addressed.

Statistics show us that 30% of all senior citizens fall each year. That percentage becomes much greater if they develop dementia. This is the primary reason that I’m asking all hospitals that are now implementing the Alzheimer’s/Dementia Hospital Wristband Program, to also include their “Fall Risk” program with all patients that are at risk for cognitive impairment.

Being cognitively impaired can also affect such patients’ sense of perception. Just like that warning sign on the side view mirror of your vehicle, for many objects may appear closer than they actually are. Sometimes, when they’re approaching a step or a curb, they may make the mistake of lifting a foot way too early, throwing them off balance.

Anxiety levels and a state of confusion may also become a factor. Many times, I witnessed my dad attempting to get himself out of his chair and not quite making it, causing him to fall backward into his seat. Although he did not get hurt, when he finally did make it to his feet, he would remain exceptionally unsteady and full of trepidation. Even the fear of falling itself can become hazardous for these folks.

Medications are another major concern. One of the dementia medications my father was prescribed threw off his equilibrium. Every day I was afraid he was going to fall! After his doctor finally rescinded that prescription, Dad recovered most of his balance.

There are many things, large and small, that we can do to help our loved ones to stay safe at home. One of my favorites is keeping their houses well lit. Even at night, when everyone is asleep, keep those lights burning!

Caregivers should help their patients to stay strong by encouraging them to exercise. Leg lifts are great. Join in with them and they may think it’s helping you as well. (Maybe it is!) These can even be done while they’re sitting in a chair.

Speaking of chairs, rocking chairs are a great tool for maintaining good circulation in patients’ legs. Without them even knowing it, every time they pump their feet to create the back and forth motion, they are strengthening their legs and providing a better blood flow throughout their lower extremities. Also, the repetition and movement can be very soothing for them. The one thing I have to warn you about here, however, is that they may need assistance getting themselves out of the rockers.

Certain rooms can be made safe with simple adjustments. For example, in the kitchen, forget about using the top shelves altogether. Many falls occur while a person is stepping on a stool or climbing onto a chair to get something down that’s beyond “normal” reach.

Considering the bathrooms, there should be multiple grab bars by the toilet and in the bathtub/shower. Non-slip adhesive strips are essential. And if your patient will be using a shower chair, buy one that has a strong back on it so he or she won’t tip over backwards. In addition, a raised toilet seat (a “riser”) will help them and, really, any elder person to stand up easier.

Pay close attention to what your loved one wear on their feet. Those old fluffy slippers and flip flops need to go. If they’re having trouble with their shoelaces, it’s time to switch to Velcro straps or loafers.

The list continues! So, I will stop here for now. Just use your common sense. Take a slow walk around their houses with eyes wide open. Make certain that the street address is visible in case of an emergency. Too many times, first responders are called out to a home and end up circulating the neighborhood because the address was not well-marked. A quick response time could be crucial.

You can follow every rule in the book and accidents can still happen, problems can still occur. What we need to do is lower the odds and keep these folks from getting hurt.

Gary Joseph LeBlanc, CDCS
Director of Education
Dementia Spotlight Foundation