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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Shocking and unbelievable

I must admit that social media came into my life at a time where I had already learned some understanding of what should and should not be publicly shared.  I also had learned from a young age to follow the golden rule.

So, when I read about the idea of nursing home caregivers posting pictures to social media showing seniors in their care in deplorable conditions or being abused I was beside myself in outrage.  This level of cruelty and depravity cannot be understood or explained away.

Sadly, it is also a symptom of the nursing home industrial complex we have here in the United States.   In a country where the monthly costs of such care can run as much as $10,000 and there are little to no regulations as to caregiver to resident ratios it is unsurprising that those caregivers who really care about the seniors in their care burnout and quit the field entirely.  This leaves behind those who could care less about those in their charge allowing such heinous acts to be committed.

While corporate big-wigs reap huge salaries, overworked and understaffed the caregivers can barely make a living wage.  They often do not have the supplies on hand to provide proper care (gloves, cleaning supplies, adult briefs to mention a few).

Imagine the pain in the heart of a good, caring caregiver who has to show up to work day after day knowing they will never be able to interact with their charges as the human beings they are.  That they will never be able to adequately provide even the minimal amount of daily care because they are stretched so thin among all their charges.  While doing your job you will be barely earning enough to keep yourself housed and fed with your heart being torn out with each moment of heartbreaking toil there is little wonder that they burn out.

The regulations regarding the posting of demeaning photos on social media by caregivers are sadly necessary at this time, but I feel that it would be a better use of Congress’ time to search out what is causing the climate of unfeeling caregivers to propagate.  Perhaps requiring higher staffing levels and allowing the resident to caregiver ratios be based upon resident needs rather than straight numbers will allow the good caregivers to wish to remain in the industry and weed out the bad apples in the bunch.

Here is an article in NPR regarding the posting of demeaning photos on social media:

Exploitation on social media is a form of abuse

How can you do a job like that? I could NEVER do something like that!

love best medicine

When I began my journey as a caregiver I had people asking me how I could do such a thing, that they would never be able to do that.  They wanted to know how I could stand to see to the most personal needs of my father and then grandfather.  They couldn’t understand how I could find the compassion and patience to spend 30 to 45 minutes feeding my dad four or five times a day.

The simple answer is they’re family and that’s what family does.  The deeper explanation is, they did it for me.  From the time I was born my family has been there caring for me.  THEY changed my diapers.  THEY fed me.  THEY dressed me.  THEY bathed me.  I spit up and threw up on THEM.  I bled on THEM.  When I cried THEY comforted me.  THEY taught me, loved me and encouraged me.  How can I not reciprocate when THEIR time of need comes?

To that people will often concede the point but now that I have lost both Dad and Grandpa they ask why I continue to do this for strangers.

The honest truth is two-fold.  First of all, once I meet the people I am charged with providing care for they are no longer strangers.  They become surrogate family members.  I care for who they are as a person.  I try to learn about who they are, what makes them happy and how to encourage them.   They often have as much of a positive influence on my life as I hopefully have on theirs.

Second, I think of all the people outside of my family who had an impact on who I am today … teachers, neighbors, family friends, camp counselors, clergy, and random strangers providing random acts of kindness.  Most of these people are no longer in my life, but each of the people I care for were the teachers, neighbors, family friend, camp counselor, clergy or random stranger providing random acts of kindness for someone else.  So in my mind, in some odd concept of karma or whatever way you’d put it, I am returning the favor to a stranger in hopes that someone else is doing the same for those non-family members who had a positive influence on my life.

I have another reason for doing what I do.  I have seven wonderful nephews and four awesome nieces.   I believe the best way to show the future generation how to be compassionate, active, caring adults is by example.  I hope that by demonstrating to them how we should care for our family and strangers that I will have done my part to make the future just that much brighter.

So, to answer the question “How can I do something like what I do?”

I do it joyfully with hope, compassion and love.

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.