Today kicks off the fall season, and it is also Fall Prevention Awareness day. The National Council on Aging has many resources to help adults build a foundation for longevity and prevent falls. Currently, 1 in 3 adults 65+ falls each year. Fall risks are usually the product of a combination between physical condition and environment; however, individuals with dementia are actually 4-5 times more likely to experience falls than older people without the disease. There are many different types of brain disease that cause a wide range of physical and mental complications. Here are a few common ways that dementia increases the risk of a fall and what to watch for in a loved one with dementia:
- Disorientation: A large part of our stability involves awareness of surroundings, judging distances, knowing where we are and what we can expect from our environment. When individuals with dementia become disoriented not only can they lose their ability to judge an environment properly, their increased anxiety puts them at greater risk.
- Changes in gait and mobility: As the parts of the brain that coordinate our fine and gross motor skills are impacted by dementia, the way we walk and move changes dramatically. Some types of dementia such as Parkinson’s can have a greater impact on ambulation and coordinating movement. These changes may occur slowly over time and often a fall will alert family to the extent of the changes.
- Changes in vision, hearing, and balance: Our senses naturally decline with age; however for those with a dementia, the parts of the brain that coordinate our hearing, vision, and balance can be greatly impacted very quickly. Any one of these senses contributes to our stability as we make our way through our homes and communities.
- No memory of present condition/ mobility limits: One of the greatest risks associated with the mid to end stages of dementia is there is no memory of their present condition. Muscle weakness from the disease and reduced mobility can be easily forgotten by the individual. They may try to do activities that are outside of their physical capacity putting them at high risk for falls or other injuries.
- Difficult behaviors such as wandering and agitation: The different types of dementia are often associated with a range of difficult behaviors. These may include yelling, unfiltered speech, repeating questions, refusal of care, etc. Wandering is quite common in those with dementia as well as a desire to return home for those in a memory care facility. This behavior uniquely impacts the risk of a fall as individuals can be so focused on getting where they are going that they are not able to take precautions in moving safely. Increased agitation can compound this situation as well.
- Dehydration: As we age, we naturally feel less thirsty. This can put seniors at risk for dehydration and range of other complications such as urinary tract infections. For those with dementia who are not able to remember their needs, this is particularly an issue. Dizziness or lightheadedness and headache from dehydration can greatly increase the risk of a fall in addition to these other complications.
- Difficulty problem solving and adapting to new environments: Many times families will rely on professional facilities to provide nursing and day-to-day care for a loved one with dementia, especially during the mid to end stages of the disease. Adapting to these new environments would be difficult for anyone, but especially for those with dementia. Confusion and an inability to problem solve can increase the risk of a fall as individuals with dementia lose their sense of what is safe or not safe to do in a particular environment.
- Hallucinations/ delusions: Some types of dementia can cause individuals to have hallucinations or delusions. These types of experiences can erroneously heighten their sense of danger and cause them to behave rashly. The increased anxiety and false sense of reality can increase the risk of a fall.
- Lack of judgment/ inhibition: The frontal lobe of the brain is the command center, filter, and brake pedal for our actions. It is the rational voice that says, you probably shouldn’t say that or do that action. When dementia impacts this part of the brain, those filters and brake pedals deteriorate and no longer inhibit individuals with the disease. This changed judgment and fading access to memory can greatly increase the risk of a fall as the individual may no longer be able to appropriately judge the limits of their environment and body.
If you are a caregiver providing or coordinating care for a loved one with dementia, we understand how complex and emotionally challenging the responsibility can be. Our well-being has many components. In fact, our lives are surrounded by a complex web of needs and desires. When a loved one is diagnosed with a type of dementia, it is common for a spouse or adult children to become the hub of care, managing several categories of needs. Professional Care Managers are pivotal in assisting families at the hub to simplify, coordinate, and proactively guide the care of a loved one.
You have Sound Options after a diagnosis with dementia. Begin your journey with a one hour consultation with a RN or MSW Geriatric Care Manager. With a professional nurse or social worker who specializes in the care of older adults, families can lean on their expertise and insight as they lay plans for the future and secure solutions for quality memory care. Give us a call to learn your options in dementia care in the Puget Sound region at 800.628.7649.
Published on September 24, 2015.