The Dementia Patient: 3 Step Fall Prevention Plan
Perhaps your parent has just been diagnosed with dementia. You feel relieved that at least there is a medical diagnosis for the complex array of symptoms that your mom has been exhibiting. However, lately she seems more prone to falls and you're concerned for her safety. What's behind the falls? Is it related to her dementia diagnosis?
Research indicates that having Dementia is a major risk factor for falls. Causes for the increase risk of falls in the Dementia patient stem from many factors including: diminished mobility and balance, certain prescription drugs and impaired judgment. While it's impossible to eliminate the risk of falling, a thorough assessment of your loved one's particular risk factors can help you take action to minimize the risk.
Organize your assessment and prevention measures into the following 3 categories:
Step 1 : Make a trip to your physician.
Falls should be reported to your loved one's physician for follow-up. Your doctor will want to consider whether factors other than dementia are responsible for the fall. For example, common problems like underlying illness (such as urinary tract infection),anemia, poor eyesight, balance issues, arthritis, muscle weakness or neurological problems may also exist and require treatment. Ask your physician whether Vitamin D deficiency is a potential culprit. Treating Vitamin D deficiencies has been shown to reduce the risk of falls.
Ask whether any medications your loved one is taking could be causing increased confusion or balance problems. This is especially important if he/she is taking any of the following:
Step 2: Consult Other Experts.
- Medications for blood pressure or heart disease (may result in blood pressure dropping too quickly when going from sitting to standing).
- Medications from the Anticholinergics class, such as those used to treat overactive bladder.
- Opiate pain medications, especially if recently started.
- Other pyschoactive drugs (sedatives, tranquilizers), antipsychotics (Haldol, Risperdal) and antidepressants.
Consider asking for a referral to a physical therapist or occupational therapist. These experts will develop an exercise plan to build strength and shore up weak areas. They can evaluate whether mobility aids are appropriate and provide training on the proper usage.
Since impaired vision is a major risk factor for falls, a annual eye exam is recommended to screen for vision problems including cataracts. Be cautious with bifocal glasses as the ability to gauge depth and distance is diminished.
Foot care, particularly nail trimming, is often overlooked. Poor foot care can lead to pain and potentially balance problems. Consult a Podiatrist for assistance with nail care and foot pain or gait issues.
Step 3: Assess the Home Environment.
Take a tour of your loved one's home with a critical eye for hazards. Consider the following potential problems......scatter rugs, cluttered pathways, extension cords, small pets that can get underfoot, pet/children's toys, poor lighting, and the absence of grab bars in key areas like showers/tubs/toilet. Additionally, make certain that shoes and slippers are safe and stable. Discourage walking around in socks, loose slippers or flip flops.
It's likely that a thorough assessment of the home will reveal other hidden hazards other than those idenified above. Do not delay in fixing these items.
Hopefully, you found these ideas helpful in organzing yourself to do everything possible in preventing a dangerous fall. A future blog post will discuss how to quickly assess serious injury should the worst happen; your loved one experiences a serious fall.
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