Wednesday, May 15, 2019

Falls and dementia

Dementia is a syndrome (a group of related symptoms) that is associated with an ongoing decline of the brain and its abilities. Some of these symptoms include memory loss and difficulties with thinking, problem solving, communication and language.
Risk of falling

Falls aren't an inevitable part of living with dementia, however, some symptoms can make people with dementia more at risk of falls. People with dementia can also have the same health conditions that increase the risk of falls as people who don't have dementia.

Risk factors with dementia

  1. There are different personal risk factors that cause people to fall, however, people with dementia are at greater risk because they:
  2. are more likely to experience problems with mobility, balance and muscle weakness
  3. can have difficulties with their memory and finding their way around
  4. can have difficulties processing what they see and reacting to situations
  5. may take medicines that make them drowsy, dizzy or lower their blood pressure
  6. are at greater risk of feeling depressed
  7. may find it difficult to communicate their worries, needs or feelings
  8. Each person will experience dementia in their own way, and may experience all or none of these risk factors.
Your mobility

If you have problems with mobility, balance and muscle strength, it's important to remain physically active and get the right support to enable you to do this if you're having difficulties. Physical activity may also help in avoiding, delaying or reducing some of the mobility problems associated with dementia.

Alzheimer Scotland has produced an Activities Guide for Carers of People with Dementia (PDF, 608KB), with suggestions for keeping active.

How to keep active and exercise

  1. Some people with dementia walk (sometimes referred to as “wandering”) that can put you at higher risk of fatigue, falls or getting lost.
  2. Alzheimer Scotland has produced When People with Dementia Walk – Guidance for Carers (PDF, 104KB), offering some useful advice.

your medicationAntipsychotic, benzodiazepine and anti-depressant medications are sometimes used to treat the symptoms of dementia. These medications can put you at risk of falling as they're known to cause:

  1. drowsiness
  2. dizziness
  3. a drop in blood pressure when you stand up (postural hypotension)
  4. If you think you're experiencing any of these symptoms, speak to your GP as soon as possible.

How to manage your medication
Your vision

Dementia can affect the way we perceive and process information from our eyes. This can lead to sight loss, however, eye conditions that cause sight loss, and normal ageing of the eye, can also occur alongside dementia and could be the cause of this.

Loss of sight makes it more difficult to spot hazards and move around safely which puts you at risk of falls.

The RNIB have produced a Dementia and Sight Loss Leaflet (PDF, 2MB) with a checklist for identifying sight loss. 

If dementia has affected your sight, the University of Stirling has produced guidance for designing homes and living spaces for people with dementia and sight loss (external link)

How to look after your vision and hearing
Your environment

Environments that are dementia-friendly – meaning they're easy to navigate and free from hazards – can also help prevent falls. To make an environment safe:
invest in bright bulbs and regular lighting
add signage to doors and walkways to help you find your way around
use contrasting colours to make things more visible. Chairs, beds or toilet seats that are a different colour to the floor are easier to see

The University of Stirling, in partnership with the Chartered Institute of Housing and Joint Improvement Team, have produced an Improving the Design of Housing to Assist People with Dementia Guide (PDF, 995KB), giving practical advice for creating a dementia-friendly living space.

How to make your house safe
Your thoughts and feelings

People with dementia are at higher risk of depression, which can make you less active, and affect how well you eat, drink and sleep, leading to an increased risk of falls. If you feel your mood is low, you should speak to your GP or other health or care professional.

Anything that makes you stressed, distressed or restless can also increase your risk of falls. Some common triggers include:

  • being in pain
  • being hungry or thirsty
  • needing to use the bathroom
  • being frightened, bored or lonely

It's important for those who support you to try to understand what triggers these feelings.

Alzheimer Scotland has produced a Behaviour that Challenges - Understanding and Coping information sheet (PDF, 266KB), to help you identify these triggers.
Useful resources

Alzheimer Scotland have produced a Healthy Living with Dementia information sheet (PDF,120KB), offering advice on keeping active, eating well and staying socially and mentally active if you have dementia.

Telecare Self-Check online tool

Visit the Telecare Self-Check online tool to find the right support for you in your area. This easy to use online tool allows you to find helpful information on telecare services that could help you live independently at home for longer.

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