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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Home safety

I have spoken about home safety in the past, but I’d like to bring up a couple of specific things today.

Today more and more seniors choose to remain in their own homes for as long as possible.  There are many good reasons for this, first it can be less expensive than moving into retirement or nursing facilities.  Second, when they are in a familiar environment they are able to feel more comfortable and are less likely to become depressed.

The most important thing to remember when making the decision to age in place is whether the home is physically safe to be in.  I’m not referring to structural issues, although that is also a consideration.  I’m talking about fall risks.

Any items piled around on the floors can cause an elderly person to potentially trip and fall.  Even if they’ve always had that pile of stuff there as we age our depth perception and balance start to fade.  So the pile they’ve always stepped over will one day trip them up.

Making sure that all walk ways are free and clear of all debris and clutter is one step to making the home safer.

Another important potential trip hazard to clear away are throw rugs or area rugs.  Your elderly loved one may not be able to lift their feet properly when walking and get tripped up by the rug.

If there are tears or rips in carpeting or if the transition area between tile or laminate and carpeting isn’t secured down, these need to be repaired or the whole carpet replaced.  Once again, these are tripping points.

A large number of falls in the home happen in the bathroom.  Look into installing grab bars near the toilet and in the shower.  These should be properly mounted in order to safely take the weight of your loved one.

Transfer poles are also helpful.  These floor to ceiling poles offer support for standing.  They are helpful next to the bed and/or next to a favorite chair.

Electric lift chairs are very handy in getting a senior citizen to the point of standing.  They also recline via the electric motor.  There are many different styles both on the decor side of things and how many bells and whistles come with it, many even include heat and massage.

If there are any steps or stairs in the house it is important to make sure there are secure handrails to use.  At no point in time should anything be left on a step, they should always be clear of any clutter.

If climbing a flight of stairs is physically too taxing it may become necessary to convert a room on the main level into a bedroom or invest in one of the stair chair lifts.

In the kitchen, make sure that plates, cups, bowls and other such eating implements are within easy reach.  As we age we loose muscle tone and reaching above our head becomes more difficult.  At the same time our knees and circulatory system won’t accept bending over for more than at most a few moments.

Once everything is as safe as possible in the physical home, it may be helpful to hire a service to come to provide companionship, housekeeping help, meal preparation and assistance running errands.  Depending on the level of independence of your loved one this may only need to be once or twice a week for a couple of hours.   By starting this kind of light assistance early it may help them accept more help if they need additional help with activities of daily living (aka: ADL’s) in the future.

Another good investment of money is for a emergency call button service.  This way if your love one is alone in their home they will have a reliable method to reach out for assistance, especially if they’re unable to reach a phone.

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.

 

Facing the final days, with Hospice at your side

I held Dad’s hand when he passed.

I held Grandpa’s hand when he passed.

Hospice held my hand during their last days.

I can’t say enough about how wonderful Hospice has been to our family!  The old stereotypes of Hospice care are no longer true.  Back in the mid 80’s when Grandma was dying of ovarian cancer they provided her with pain medication and tried to keep her comfortable.  That’s good, but today they provide more.

The doctors and nurses work with the patient and family to ensure comfort and quality of life.  Nursing assistants will come out a couple of times a week to help with bathing.  Chaplains come over to provide spiritual support and a sympathetic ear.  Social workers help you find the resources you need while caring for your loved one.  Volunteers come on board to provide respite care so you can run errands or just take a break.

Hospice will provide durable medical equipment (eg: hospital beds, wheelchairs, oxygen concentrators, bedside commodes …) and disposable supplies (eg: adult briefs, some medications, special pillows to prevent bedsores …)

They spend the time necessary to help you learn how to provide needed care.

Many doctors are hesitant to bring up the concept of starting Hospice care.  This stems from the idea that by suggesting Hospice they are acknowledging that they have failed to find a cure.

There comes a time where a decision must be made; continue to seek treatments that aren’t effective anymore or make the most out of each day.  Hospice is all about making the most out of each day.

If you feel you are at this point (or your loved one feels this way), speak with your doctor.

Grandpa was on Hospice for almost a year.  Until the last two months of that time he was able to; visit with family, go out for a meal, attend church services, and do many other things he enjoyed.  During his time on Hospice we held a huge party for his 95th birthday at an historic venue.  The only concession we had to make for his declining health was to bring his lift recliner so he could sit and be comfortable.

When we had questions, either about Dad or Grandpa, we could call the nurse helpline 24/7.  If we needed a nurse in the middle of the night, one was available to come to help.

When they passed, Hospice was there to provide support and care for our family.

Once your loved one passes, Hospice continues to offer support for the family.  They offer bereavement counseling and support groups for any family member.

To find out more about Hospice care click here.