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How To Prevent Falls In Elderly With Dementia

Tips To Prevent Falls For Dementia Patients

Falls Prevention in People with Dementia | David Ganz, MD | UCLAMDChat

There are many things you can do to protect a patient or loved one with dementia to help keep them safe.

  • Check lighting. To help improve perception and heighten sight, make sure that the room is well lit but doesnt have a lot of glare. Try to provide enough lighting to eliminate shadows, which can cause a single surface to appear like a 2 completely different ones and even at different heights.
  • Create contrast. Another way to improve perception and heighten vision capabilities is to improve contrast in a room. For example, furniture should be a different color than the floor and the background. Choose solid colors over patterns. And try to avoid black in a space because it may be confusing and appear like a black hole.
  • Remove clutter. As with any senior who is at risk of falling, you should help eliminate clutter in the home. This can help them avoid accidental trips and falls. Pick up clothes or toys on the floor and pay careful attention to high-traffic walkways. And dont forget about outdoors! Make sure walkways and driveways are clear. For ideas on how to keep the home clutter-free, review our 43-point home safety assessment.
  • Focus on communication: Seniors with dementia may struggle to communicate and understand effectively. As you care for someone with dementia, pay attention to your language. If there is a risk of falling, help them understand by speaking in short sentences with simple language. And always remain positive.
  • Reducing Risk Of Falls For People With Dementia

    People with dementia are four to five times more likely to fall than older people who do not have cognitive impairment. People with dementia fall more often than cognitively healthy older adults, but their risk factors are not well understood.

    Teepa Snow has created a one-hour program on reducing falls for the dementia patient. This program is appropriate as part of your continuing education under the NH requirement for annual on-going Dementia Care Training.

    For people living with dementia, this could lead to muscle atrophy and increase the risk for falls, potentially leading to avoidable hospitalization. Staff must remain vigilant while trying to reduce the number of falls.

    Dementia care expert Teepa Snow discussed:

    • Risk factors for falling in people living with dementia
    • Best practices and practical interventions to reduce falls
    • Strategies to help increase mobility in people living with dementia

    This presentation will advise caregivers on promoting regular physical activity and movement to maintain strength and balance which does the risk of falling. Teepa will demonstrate how you can make movement and mobility part of everyones daily routine, as well as provide exercise programs that promote balance, stability and endurance: lifting weights, tai chi, chair exercises, or walking programs.

    Registration available now:
    Objectives:

    S To Reduce Fall Risk

    Falls in older people are almost always multifactorial. This means there are usually several factors that are contributing to a fall, or to a persons fall risk.

    It can be hard to try to address every single factor. And some, such as slower reflexes, may be impossible to reverse.

    Still, its often useful to go through them and try to spot a few that are either easy to fix, or potentially offer a big reduction in fall risk.

    As a geriatrician, heres what I do:

    • Create a list of factors contributing to an individual older persons fall risk.
    • Identify risk factors and triggers related to recent or recurrent falls.
    • Identify the factors that are easiest to modify or change. This is partly about the factor itself, and partly about whats feasible for my patient to try to change.
    • Implement practical strategies to address modifiable fall risk factors.

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    Prevent Falls And Fractures

    A simple thing can change your lifelike tripping on a rug or slipping on a wet floor. If you fall, you could break a bone, like thousands of older men and women do each year. For older people, a break can be the start of more serious problems, such as a trip to the hospital, injury, or even disability.

    If you or an older person you know has fallen, you’re not alone. More than one in three people age 65 years or older falls each year. The risk of fallingand fall-related problemsrises with age.

    Special Mattress Cover: A Cost

    Ways to prevent a fall in 2020

    If you want something similar to a concave mattress but dont have the budget, you can opt for a safety mattress cover. For instance, this model from Drive Medical with defined perimeter is a reliable choice for most standard beds. Its easy to install and clean and features bolsters to improve safety and stop seniors from falling out of the bed.

    Using a special mattress cover is really a great solution if you want something more robust than pool noodles but cheaper than a concave mattress. It can also be a great alternative to bed rails. A mattress cover can be a more affordable solution than buying a new mattress and has pretty much the same efficacy.

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    Study Selection And Characteristics

    A total of 215 unique abstracts were identified, and after screening 38 full-text articles were kept for detailed analysis. Seventeen studies met the inclusion criteria . Eight studies evaluated an ID populationspecifically, a hospital psychogeriatric ward, Alzheimer care units, nursing home or residential care,,, and group homes for people with dementia. Nine studies included CD older adults 5 studies recruited exclusively from hospital outpatient settings, and the others used a variety of settings to recruit CD people with dementia or cognitive impairment.,

    Flow diagram of literature search.

    Pool Noodles: A Subtle Way To Prevent Rolling Off The Bed

    You might never have thought of using pool noodles to protect seniors from falls. The truth is, in many cases, simple pool noodles can help seniors stay on the bed during sleeping because they can serve as bumpers on both sides of the bed.

    How to use them?

    Its very simple: all you need to do is place one pool noodle inside each side of the mattress pad or under the sheet. So you will need two pool noodles altogether. You can also use duct tape to connect them together.

    Pool noodles serve as small and subtle barriers that indicate the edges of the bed and can prevent rolling off while sleeping. When used properly, they can be an affordable and effective way to protect your elderly loved ones.

    What type of pool noodle should you use?

    Well, I recommend you use long or extra long pool noodles that have a diameter of at least 3.5 inches . Short and thin pool noodles are not suitable for use as bed bolsters.

    If youre more of a visual type of person, heres a brief video that shows you how to use pool noodles to prevent falls out of bed:

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    Body Pillows: Quick And Cheap Solution To Keep Seniors In Bed

    One of the most budget-friendly solutions is placing one or two thick body pillows on the sides of the bed. Sometimes they can do the job pretty well, so its worth trying. I know many elderly patients who successfully applied this simple method to prevent roll-off.

    However, if falls are frequent, I recommend that you opt for a solution that includes fixed barriers instead.

    If you want to know how you can make the whole bedroom much safer for seniors, dont forget to check our all-in-one guide on bedroom safety.

    SEE ALSO:

    Researchers Test New Approaches To Prevent Delirium In Older Adults

    SafeWander: preventing falls in patients with dementia

    Making cognition a vital sign

    Delirium a state of sudden, acute confusion affects millions of hospitalized older adults each year. It is a common, troubling problem that can lead to many other problems. To protect older adults from this distressing condition, researchers are testing new ways to prevent it and striving to make proven methods more widespread.

    Years of research have revealed a lot about delirium who is at risk, how long it lasts, and related complications but much about the condition remains unknown. We dont truly understand what happens in the brain during delirium, which occurs in 25% or more of hospitalized adults age 65 and older after major surgery or acute illness, and in more than 80% of older patients in the intensive care unit . We do know that it is associated with serious, sometimes long-lasting cognitive dysfunction.

    Delirium is more likely to happen in patients with dementia and can worsen their cognitive decline. Conversely, delirium in cognitively normal patients may signify their risk for developing cognitive impairment, said Luci Roberts, Ph.D., a program director in NIAs Division of Neuroscience.

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    Primary Outcome: Falls Rate

    Falls rate, that is, number of falls over a defined period, was the primary outcome in seven studies . Self-report methods using monthly falls calendars or diaries were used to report on falls rate, number of falls, time to first fall, proportion of fallers and proportion of multiple fallers. This diversity of assessment methods made comparison across the studies challenging. Two trials reported lateral balance and foot pain as the primary outcome with falls as a secondary or exploratory outcome. However, it was possible to calculate rate ratios for falls across multiple component podiatry interventions , multifactorial multi-disciplinary interventions and for one single component podiatry intervention. Findings are reported below with the forest plot in Figure . Falls rates for individual studies and absolute differences are reported separately in Appendix 5.

    Forest plot: pooled results of single, multifaceted, and multifactorial interventions versus usual care: falls rate.

    Single component podiatry interventions

    Falls rate data were available only for one trial for a single component podiatry intervention , and showed no significant effect on falls rate .

    Multifaceted podiatry interventions

    Pooling data from the three multifaceted podiatry interventions , demonstrated a significant benefit for falls rate . The absolute difference in falls rate ranged from 0.13 to 0.39 . Overall heterogeneity was low .

    Multifactorial interventions

    Falls prevention in care homes

    Injury data

    Give Your Brain Sleep

    A study by Maiken Nedergaard found that sleep is when your brain cleans up. During sleep, your brain clears amyloid-beta protein, which contributes to the plaque that is often found in the brains of people with dementia. Without adequate amounts of sleep, your brain may start to suffer from toxic buildup.

    Action Strategy: Make a date with sleep. Figure out when your best sleep hours are in a 24-hour period and commit to being in bed for those times. Get yourself ready for sleep an hour before you meet your pillow. Promote high-quality sleep by:

    • Turning off electronics
    • Having a relaxing shower or bath
    • Practicing meditation or light reading

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    Dementia And Falls: Causes And Remedies To Prevent Falls In Seniors

    Written byDr. Victor MarchionePublished onOctober 6, 2016

    Although dementia can affect a persons memory, it can also increase their risk of experiencing falls. As dementia progresses, a persons ability to walk or move diminishes, which eventually turns sturdy steps into more of a shuffle movement. The risk of falling increases if there are obstacles in a patients way, so its important to remove any potential cause of fall.

    Statistics show that every year 30 percent of seniors fall, but the rate is much higher among seniors with dementia.

    Dementia can negatively impact a persons perception, meaning they may not properly take a step or may be unable to notice objects or people in their peripherals.

    Furthermore, anxiety due to confusion can worsen the risk of falls. Having a fear of fall can add to the confusion and instability as well.

    Common Causes Of Falls In People With Dementia

    Preventing Falls Infographic

    People with Alzheimers and other types of dementia tend to be at a high risk of falling. They are more than three times more likely to fracture their hip when they fall, which leads to surgery and immobility. The rate of death following a hip fracture for those with Alzheimer’s is also increased. Thus, fall prevention for people with dementia is critical.

    One way to reduce falls in people with dementia is to understand why they fall. If we know what makes our loved ones more likely to fall, we can try to anticipate those needs and decrease falls.

    Laura Porter / Verywell

    These factors are the most common causes of falls in people with dementia.

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    Keep Your Brain Flexible

    Neuroplasticity is a big word for the brain’s ability to continue changing and growing. A study in the JAMA Psychiatry journal suggests that a flexible brain can slow dementia. The thought is that when you have more brain connections, you are less likely to suffer from dementia because your brain is more able to adapt and create new connections.

    Action Strategy: Make a goal to use your brain every day. Whether it is learning a new language or figuring out your new phone. The more you continue to use your brain, the healthier your brain stays.

    Data Extraction And Examination

    The following information was extracted from the articles selected for full review: authors, country, date of publication, inclusion and exclusion criteria, demographic information, sample size at baseline and follow-up, population type, history of falls at baseline, fall definition, method of fall ascertainment, type of fall outcome , method for diagnosing dementia or cognitive impairment, and percentage of sample sustaining a fall. Data extracted for examination were adjusted risk estimates obtained from multi-variable regression analysis reported in the articles. For any given risk factor, if all risk estimates were in the same metric and from a unique study sample, a meta-analysis was performed to generate a summary risk estimate. Fixed-effects methodology was performed on the adjusted estimates to generate summary values. Statistical tests of homogeneity were performed on the summary estimates obtained from the fixed-effects methodology using Cochran’s 2 test for homogeneity and the percentage of total variation across studies attributable to heterogeneity .

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    Paint The Home With Contrasting Colors

    The colors and hues perceived by older adults with dementia differ compared to unaffected seniors. Thus, floors, walls, and furnishings must be significantly different in color. Floors should be solid in color and not have confusing patterns. However, contrasting colors can be used on stairs to denote each step. Avoid black surfaces, which are often interpreted as holes.

    Risk Factors For Falls

    Preventing Falls in Older Adults

    Cognitively intact and cognitively impaired older adults share some well-established risk factors for falls, such as fall history, environmental hazards, motor impairments, and visual impairments . However, there are other fall risk factors that are more specific to people living with dementia.

    We categorise the factors relating to falls in this review as medical, environmental, physical and sensory, cognitive, and psychological factors . The underlined factors in Figure 1 are specifically relevant to older adults with dementia.

    Fig. 1.

    Risk factors for falls in older adults with dementia .

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    Theme : Ensuring That The Circumstances Of Rehabilitation Are Optimised For People With Dementia

    This theme concerns the ways in which broader contextual factors, such as setting and comorbidities, can affect the engagement of people with dementia in interventions. The outcomes of the consensus survey and operationalisation of each CMOc are shown in Table .

    CMOc1: managing pain

    Pain is associated with impaired mobility and physical functioning and increased agitation and aggression in people with cognitive impairment or dementia. Sleeping and mood disorders in people with dementia have also been linked to higher pain levels . People with dementia who are in pain may therefore find it more difficult to engage fully with an intervention. However, recognising pain in people with dementia can be challenging as they may be unable to verbally communicate their pain .

    The consensus panel agreed that identifying pain should be part of the DIFRID intervention. Stakeholders highlighted the complexities of assessing pain in people with dementia:

    There are so many different implications. It is not just about us scoring pain. If you are talking about pain assessment, you need to do it properly. That, again, is multi-factorial. You need to use the appropriate pain scoring. If you are talking about people who have got moderate dementia who are cognitively impaired, you need to be thinking about something like the Abbey Pain Scale or something like that. It is not verbal. It is behavioural, body language, facial expressions, all that sort of stuff.

    CMOc3: adopting a holistic approach

    Collation Of Results And Development Of A Logic Model

    We collated the findings of the final round of the Delphi survey, consensus panel discussion, and stakeholder feedback to finalise the protocol for the feasibility study and model the intervention. The logic model was developed by the qualitative team informed by existing logic model templates and was discussed by the Trial Oversight Committee .

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    What Are The Facts About Fall Risk

    The Centers for Disease Control and Prevention paint a grim picture by telling us that more than one out of four older people falls each year, but less than half tell their doctor. Falling once doubles your chances of falling again.”

    And unfortunately, there is more. The WHO report shares even more alarming statistics relating to elderly falls:

    Use A Bed With The Right Height

    Senior Care Graphics

    The appropriate height of the bed is your elderly loved ones knee level. Getting off from a high bed can easily result in a sudden fall because of losing balance.

    On the other hand, rising from a too low bed can be exhausting for seniors with weak muscles. Bottom line: make sure the bed is neither too high nor too low.

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