It is important to be aware that people living with Dementia conditions, such as Alzheimer’s, have a greater propensity to fall. This means they are three times more likely to fracture a hip, as falls are the cause of 95% of hip fractures (VeryWell, Medical Health Board, 2018).
The death rate following a hip fracture is known to increase due to the need for surgery and the fact the faller will be immobile for a long time afterward while in recovery. Falls prevention is particularly important for people living with dementia to safeguard their health and quality of life.
To help reduce the propensity of falling it is important to understand the reason whys. There can be many factors such as footwear, rugs, trailing wires or awkward steps. By assessing and acknowledging these factors, the correct preventative measures can be put in place to decrease the regularity of a fall occurring.
During the early stages of Dementia people will react differently in terms of being able to stay active. Some people are in good physical shape and can walk for miles, whereas others can develop difficulties with gait even before the memory problems occur.
Research has shown that adults with Alzheimer’s disease (AD) have gait and balance deficits (J Geriatr Phys Ther, 2015) and this decline can be an early indicator of a decline in cognition. As Alzheimer’s continues to progress into the middle and later stages, it causes a decline in muscle strength, walking, and balance. These aspects, therefore, contribute to the person having a higher propensity to fall.
The National Institute of Aging recommends if someone is having difficulties walking then they may be able to do the following with the help of a caregiver to keep themselves active;
- Do simple tasks around the home, such as sweeping and dusting.
- Use a stationary bike.
- Use soft rubber exercise balls or balloons for stretching or throwing back and forth.
- Use stretching bands, which you can buy in sporting goods stores. Be sure to follow the instructions.
- Lift weights or household items such as soup cans.
Visuospatial abilities can also be affected by the neurological diseases and a person can misinterpret what they see. This can result in misjudging uneven terrain, shiny floors, and steps. It may be a good idea to have the person’s vision checked regularly, as eyesight can decline in the aging process. It’s also a good idea to keep clutter to a minimum because having too much to navigate around can easily turn into trip hazards.
It is also advised to keep an eye on medication side effects, as antipsychotic medications can sometimes cause the side effect of orthostatic hypotension where a person experiences a sudden drop in blood pressure if they were to stand up too quickly.
Other medications, such as hypnotics (medications that facilitate sleep) can also cause lingering drowsiness that can increase the chances of falls. (VeryWell, Medical Health Board, 2018).
These proactive approaches to falls prevention is an important aspect of providing a high standard of care for people living with dementia and Alzheimer’s. By looking at the various causes of falls, it can help to increase awareness and hopefully prevent certain falls from happening in the future.
“Falls prevention is the first line of defense however the reality is not all falls can be prevented. The second line of defense is to prevent long lie times after the fall which lead to serious health complications, which can negatively impact the quality of life for the faller.” (Kate Sheehan, OT Service, 2018)
If there is no evidence of a serious injury, to prevent long lie times from increasing you need to lift the faller off the floor and into a safe and comfortable position, either back into bed or onto a chair.
It’s essential to ensure that you’re using safe moving and handling techniques and appropriate lifting equipment, such as the Camel Lifting Cushion, so you’re not causing injury or strain to your back. Even if the person you are lifting isn’t very heavy, repetitive strain injury (RSI) can still occur without correct lifting procedures in place.