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.

 

WATER!!!

July 1991 – I was in LA and a friend asked me to tag along to make a quick repair on another friends’ car. So off we went to the middle of nowhere for a short auto repair. Neither of us thought to bring water.

The short repair took us over 8 hours in over 100 degree temperature without any water. I came down with heat stroke and probably should have gone to the hospital.

I realized just how close I came to dying that day and have been a stickler for staying hydrated ever since.

Every system in your body relies on water to function properly.

If you feel a headache coming on, you’re probably dehydrated. Chronic dehydration can lead to organ failure.

This is true for everyone, but especially the elderly. I would constantly urge Grandpa to drink more water. If he told me he had a headache I would have him drink at least a full glass of water before getting him a Tylenol.

I had water bottles placed in all the places where Grandpa spent time. He got to be pretty good about drinking enough water.

As the weather warms up it is time to make sure we all get the fluids we need to stay healthy.

Make regular water consumption a part of your daily routine and encourage others to do the same.

Supplement Danger

There are literally thousands of dietary supplements on the market today.  These over the counter aids boast to be remedies for low energy, obesity, hair loss, virility and any other health complaint you may have.  Whether they are plant based aids or one of dozens of vitamin and mineral supplements they are out there.

I’m not saying that they’re bad, or that they don’t do what they claim. (Although with some I am highly skeptical, but as I’m not a pharmacist or doctor I shall keep my opinions to myself.)

What I am saying is that they need to be taken properly, just like any other medication that you get prescribed by a doctor.  Right time, right dose, right method.

You should work with your doctor to determine which supplements will help you and which supplements will cause bad reactions in conjunction with your prescription medications.

A simple blood test at your doctor’s office will help reveal any vitamin or mineral deficiencies you may have.  Then your doctor will be able to tell you what you need to take and at what levels.  A far better method and approach to supplements than taking a bunch of stuff that you don’t really need.  (Not to mention that it may save you a lot of money in the long run.)

The misuse and uninformed taking of supplements has become such a concern that it has caused the CDC to look into supplement based ER visits.

CDC Studies Supplement Based ER Visits

Caregiver dilemma: I’m scared of doing it wrong

Becoming a caregiver for someone you love can be a wonderful, but terrifying experience.  If you approach the experience with a deep love for your family member and the determination to make sure they are safe, loved and fulfilled as a human being should be then you will be wonderful as a caregiver!integrity

My most terrifying moment as a caregiver was the day we brought Dad back home.  He’d arrived via medical transportation and shortly afterwards I was alone with him for the first time.  I stood there scared beyond everything.

I was completely responsible for Dad’s health and well-being.  I had completed the coursework, testing and clinical experience required by my state to do this work.  I even had the little piece of paper to prove it!

But as I stood by Dad’s bedside that fateful afternoon I was nearly paralyzed with fear.  I was scared that I would do something wrong.  I was worried that I would cause him unnecessary harm with my ineptitude.

I took a deep breath.  I exhaled.  I did it a few more times – just to make sure I could.  I decided to start with the basics of caregiving.

I took Dad’s hand, told him that I was going to do my best for him and that I may have a bit of a learning curve.  I let him know that everything was going to be ok.  I spent several minutes talking to him, holding his hand and comforting him.

In comforting Dad I found that I was also comforted.  In telling him everything would be ok I felt that it would be ok.

I began to relax.  The fear that had frozen me dissipated and I was able to begin providing the personal care Dad needed.

There were times I made some mistakes, those mistakes didn’t make his condition worse.  The mistakes were a part of my learning curve and I did learn from them.  I used these lessons to provide even better care for Dad.

In the end I knew I had done everything I could to honor my father.  I had given him the care he needed.  I had ensured that his final days, weeks and months had been spent surrounded by love.  I do not regret forcing myself through my paralyzing fear – I would do it a thousand times over.

Sharing … yes or no?

People who care for a loved one with dementia often have to make hard decisions.

One of those difficult choices is whether or not to inform your loved one with dementia that another loved one has passed away (whether that’s recently or sometime in the past).

I’ve seen videos posted where a family member tells their loved one with dementia that their spouse is dead (apparently had died some time ago) and you watched as this person with dementia goes through the grieving process all over again.  To me this is cruelty in the extreme!  Whenever I am faced with a dementia patient asking about someone who’s passed I say they’re out somewhere (work, school, running errands) and distract them from the topic.

There are times however, where telling a loved one with dementia the same news over and over is a really sweet thing to do.   This woman lets her mother know she’s going to be a grandma over and over again … the change in the loved one with dementia’s mood each time is wonderful and precious!  Watch this video and let me know if you agree!

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