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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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.

 

Special Deal!

I published my first book and I want to offer everyone a special deal!

I’m letting you who follow my blog have a free copy!

Until October 9th if you go to Smashwords and enter this code: RM52F (not case-sensitive).  You will receive a free copy of my book Who Are You? (Surviving Dementia from One Caregiver to Another)

Here’s the link to my book on Smashwords:

All I ask in return is that you leave an honest review and if you enjoyed it, let others know!

911 operator goes above and beyond the call of duty!

This is a great story of one human helping another in a time of need.  This 911 operator deserves plenty of kudos for her care.  She should be held up as what it means to have compassion for your fellow man.

As glad as I was to hear about the 911 operator’s actions, I was angry that the hospital discharged this man without asking about his support at home.  They knew what he could and could not do for himself.  They knew how long he’d been hospitalized and that he wouldn’t have any food at home.  After long-term hospitalizations they are supposed to make sure you have some sort of support at home, whether it’s family members or hired-in caregivers.

If this man hadn’t decided to call 911 and if the operator hadn’t been a good person, this man would’ve wound up back in the hospital or dead.  I don’t know which hospital he was in or who was in charge of processing his discharge, but they failed him in a very serious manner.

Please read the wonderful story of the 911 operator with a big heart here.

Senior Protection – Sometimes they need protecting from their caregivers

I was just forwarded an article about a senior citizen who died under appalling conditions.  She was under the care of a family member and was found to have been left in the same position for about six months.  The authorities are investigating the family member for neglectful homicide.

I will be the first to admit that caring for a senior citizen with health issues is challenging and requires a lot of patience.  If you can’t deal with all it may entail then this job isn’t the one for you.  I’ll lay things on the line for you.  You will need to help with medications, keep up on doctor appointments, encourage healthy eating and exercise, that’s the easy stuff.  You will need to help with transferring from bed to chairs to toilets to shower chairs, support while walking, push wheelchairs, help dressing, help shower or bathe, help them clean themselves after toileting and eventually change their adult diapers.  Then there’s all the common household chores to tackle with laundry doubling.

When someone I am caring for accidentally spills something or is incontinent I NEVER reprimand them, NEVER belittle them!  I just look at them, smile warmly and let them know it’s OK.  I would also NEVER leave them sitting in their own mess, that is inhumane.

The fact that someone spent six month sitting in a chair and was so covered by her own fecal matter that the EMT’s had to turn on high-powered fans to be able to handle being in the room while they prepared to remove her body is unthinkable.

Don’t get me wrong, I’m all for keeping a loved one at home and letting them live their days someplace they feel comfortable!  I just don’t want to see that become an opportunity for abuse and neglect.

We need to find a better way to protect our senior citizens.  There are civic organizations and citizen groups out there who are trying to help, but there needs to be more action.

When I heard about the poor woman left to sit in her own mess for six months my first thought was; it’s a shame no one was able to check up on the home situation for her.

My brain is a weird place … I hear of a problem, turn it over and over, weigh the pros and cons of all possible solutions, until I come up with a possible answer.  I do this all the time.

So, when I was wondering about how this situation could have been changed I came up with this possible solution:

I thought to myself, “What if doctors asked their elderly patients if they lived at home or in some nursing facility?”  “What if there was a group of specifically trained LPN’s and/or CNA’s who would work as a kind of social worker for seniors living alone or with family?”

In this concept in my mind it would work a bit like home health nurses who come out to a home to help with physical therapy or wound care.  The doctor would ‘prescribe’ this type of ongoing home visit assistance.

This group of LPN’s and/or CNA’s would be tasked with visiting their charges at least once a month.  They would spend some time visiting with the senior citizen and their caregiver.  During these visits they would offer support and instruction on how to provide personal care as care needs change.  They would help find the resources available to the caregivers and the senior citizens.  They would also keep an eye out for signs of abuse and neglect.

As someone who spent considerable time caring for family members at home I can tell you that I would not have had any problem with someone coming to my home in this capacity.  I would have appreciated the help.

So, let me know what you all think.  Give me feedback on this idea.  Perhaps if anyone out there is in an official capacity we could give the idea a run and see if it is an effective way of preventing elder abuse and neglect.