Dementia’s Impact on Fall Risks

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 increase anxiety puts them at greater risk.

Changes in gait and mobility:  As 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:  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 judgement/ 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 judgement 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 love one.

Side note from the blogger:  This is an article I found from a publication put out for seniors in my community.  The publication is produced by our sheriff’s office and is called S.A.L.T. (Seniors and Law Enforcement Together) Times.  The only notation as to it’s original source is Sound Options.  I would like to give proper credit to the original writer of this article, if anyone can help me find the author I will make sure they’re given credit where credit is due.

 

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Sometimes only a fellow veteran can help

This wonderfully touching story happened here locally.  A dementia patient who was reverting back to his time in Vietnam with the Air Force – he thought he needed to report back to duty and nothing the family or staff told him helped.

So a plea was put out on social media for a hail mary pass, was there someone who could show up in uniform to let him know his service was over?

Read here for the outcome of the hail mary pass: The war is over

Christmas Traditions

good memory

When I saw this meme I was taken back to my childhood and my memories of Christmas.  We had wonderful traditions that centered around time spent with family.   Sure, as kids we got presents from grandparents, aunts, uncles, our parents and Santa, but if you ask me about the presents I couldn’t really give you specifics.  I can tell you about the time spent making memories with my whole extended family.

Our Christmas would start by going to a midnight church service on Christmas Eve.  After church we would migrate to our dad’s parent’s house for a potato pancake breakfast.  There we would play with our cousins, rough house with Grandpa and perhaps watch Christmas specials on VHS.  There would be lots of laughter and fun.

Around 3 AM we would stagger home with our parents telling us that we were not allowed to get them up before 7 AM.  (They, of course, still had to play Santa.)

Seven AM on the dot would have us sending the youngest in to wake Mom and Dad.  We would have our own Christmas at home with us four kids and Mom and Dad.  Eventually Mom and Dad would go to have a nap and we would spend a blissful morning and early afternoon playing together.

About mid afternoon we would head over to Mom’s parent’s house for an early dinner.  Once again there was lots of laughter and fun.  We would play with our cousins.  Aunts and uncles would often join in with the insanity.  There were presents, but mostly I remember the boisterous antics of the time spent together as a family.

I used to look forward to Christmas for those times.  I still look forward to it because it offers a chance for me to make this time special for the next generation the way it was for me.

I have since lost all of my grandparents, sometimes I wish we could have just one more Christmas together.  Since we cannot, I take solace in the good memories they left and work to follow in their example.

Dementia friendly activity … plus something yummy to eat!

Looking for a healthy but yummy snack?  Want something easy that you can involve your loved one in preparing?  Need a dementia friendly activity?  Need a way to encourage an appetite? Have fun making these delicious

Chocolate Peanut Butter Oatmeal

No-Bake Cookies

pnut butter choc cookies

Sugar-Free Chocolate Oat Cookies

Yield: 3 dozen

Ingredients

  • 3 cups quick-cooking oats
  • 3/4 cup honey
  • 2/3 cup natural peanut butter, optional
  • 1/2 cup coconut oil
  • 1/3 cup unsweetened cocoa powder
  • 1 1/2 teaspoon vanilla extract
  • 1/4 teaspoon salt

Directions

  1. Line 2 baking sheets with parchment paper.
  2. In a medium saucepan over medium-high heat, combine honey, peanut butter and coconut oil, stirring until everything blends together smoothly.
  3. Stir in oats, cocoa powder, vanilla and salt and mix until everything is fully incorporated and coated.
  4. Use a spoon or small ice cream scoop to drop cookies down onto parchment-lined baking sheets, then place in freezer for at least 15 minutes to set.
  5. Store in an airtight container either in the fridge or freezer (depending on how you like them) and enjoy!

Recipe adapted from 12 Tomatoes http://12tomatoes.com/2015/04/healthy-sugarfree-cookies-nobake-chocolate-oat-cookies.html

90 going on 3 …

90 going on 3 … what does that mean?

There is a fine line for caregivers to take as their loved one’s dementia progresses.  To honor and respect the person  you want to treat them as an adult, capable of making decisions for themselves.  Reality often comes to bite you when you realize their choices aren’t best decisions for their safety and welfare.  You honestly can’t allow them to go out in a snowstorm in shorts and a t-shirt, nor is eating candy for every meal a good option.

So, in reality what 90 going on 3 means is you have an adult (parent, grandparent, spouse …) who because of their disease now has the reasoning capacity of a 3 year old.

How do you continue to honor and respect your loved one, keep them safe, and allow them to have a say in their daily life?

The first thing is to give them simple choices and keep it to a minimum of 2 (maybe 3) options to choose from.  By giving them completely open options you will overwhelm them and will not get a positive outcome.

Pick out clothes that are weather appropriate – grab two tops of different colors and ask which they’d prefer.

Ask them if they’d prefer ham or turkey on their sandwich.  Or if they’d prefer green beans or peas with the meatloaf.

Would they prefer milk or tea?

Would they like to visit a park or a go listen to a concert?

Sometimes when trying to give my grandpa a choice of restaurant I would tell him “We can go to X – they have (a dish he liked at X) or we can go to Y – they have (a dish he liked at Y)”.

If we were going to a restaurant he’d never eaten at (or hadn’t been to in a long time), he would look at the huge menus and couldn’t make heads or tails of it. He would get so overwhelmed that he’d simply order whatever I ordered – even if it wasn’t something he liked.  I would usually take the menu and start by finding the drinks and ask him if he wanted something hot or cold to drink.  We would start there.  Then I would ask him if he was in the mood for fish, poultry or beef.  Then I would help him narrow down the menu to a couple of selections.  Once we got to that point he would be able to make his decision about what he wanted to eat.

Keep these to things that are immediately relevant, they won’t necessarily remember their choices hours later.  (E.g.: They won’t remember in the morning that the night before they wanted to wear a blue shirt.)

Now you are allowing your loved one some control over their daily life AND keeping them safe.  By following this technique you will usually find that there are fewer conflicts.

Take a deep breath …

If you’ve spent any time caring for someone with dementia you’ve had that time where you have the same conversation over and over and over again.  You’ve listened to the same story, or answered the same question 500 times in the last hour.

There are ways to keep from feeling like you’d prefer to run head first into a brick wall.

Distract/Redirect:

  • Play some favorite music or a TV show
  • Ask them a question about something completely unrelated
  • Ask for their help with a task
  • Excuse yourself to take care of a task (or go to the bathroom)

Offer reminder assistance:

If your loved one constantly asks you what is going to happen today, or when a particular event will take place, or when was the last time they … (fill in the blank), here are some suggestions that may help.

  • A basic month-at-a-glance calendar with all appointments and events written down.
  • A white board hung in a prominent place (like the fridge) with either a day’s or full week’s worth of activities.
  • A printed week’s calendar to keep near a favorite chair or posted in their room.

All in all it is important to remember that your loved one isn’t trying to drive you bonkers and take a deep breath.