Making Changes To The Environment
Theme : Equipping The Workforce With The Necessary Skills And Information To Care For People With Dementia
This theme concerns both the training needs of staff and the practical organisation of interventions to improve information gathering and communication. The outcomes of the consensus survey and operationalisation of each CMOc are shown in Table .
Table 4 Equipping the workforce with the necessary skills and information to care for people with dementia: CMOcs, consensus statements and outcomes
CMOc7: developing a detailed understanding of the patient
A detailed understanding of the patient is fundamental providing tailored, person-centred care in dementia. As people with dementia may struggle with giving full and accurate medical histories , direct observation of the patient in the environment in which they fell was recommended by professionals in the initial qualitative study . Additional context or confirmation can be provided by carers or patients GPs . Drawing on carer expertise to facilitate the care of people with dementia in hospital has been shown to be effective in reducing agitation and distress and improving carer satisfaction, though levels of patient satisfaction were not reported .
Stakeholder feedback about this aspect of the intervention was positive, particularly around using carers as information sources. Professionals also agreed that assessment by observation was important, particularly with regard to how participants get around the house.
CMOc8: equipping staff members with appropriate skills
CMOc9: improving pathways and referral
Information & Reminders In A Common Place
Create a single place for any notes or reminders that can easily be accessed and read by a person with dementia. This can be a cork bulletin board or a dry erase board. Using a single location simplifies the process and provides for an organized system, preventing the need for a senior to walk around looking for information.
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Taking Care Of Dementia Patients With Memory Care
A senior with dementia is dependent on others. In the early stages, you may be able to take care of your loved ones. But as the situation worsens, you will need professional help.
That is where we come in. Our memory care advisors assign caregivers for the best care to dementia patients. This way, the caregivers can ensure that the patients have a better and safer standard of living.
You can also consider other services that our advisors provide. For example, dementia patients may also need assisted living facilities. And what better option you have when you can find every service under one umbrella!
Preventing Falls In Older Adults: Multiple Strategies Are Better
- By Brad Manor, PhD, Contributor
Despite considerable research and clinical effort, falls among people 65 and older are on the rise. An older adult is treated in the emergency room for a fall every 11 seconds, with injuries ranging from simple cuts and bruises to broken bones. Hip fractures are the most serious injury from falls, and more than half of older adults hospitalized for hip fractures after a fall never regain their previous levels of mobility or quality of life. Further, falls are a leading cause of death among older adults. According to the Centers for Disease Control and Prevention, an older adult dies from a fall every 19 minutes. Despite these sobering statistics, falls are not an inescapable part of aging on the contrary, most falls are largely preventable.
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Consequences Of Falls In The Elderly
Above, we mentioned that 25 percent of the elderly will fall each year, so its a pretty common problem. Some of them will be lucky enough to bounce back without harm. But for most, after a fall, the likelihood of future falls doubles. This can be scary for older adults to think about, and the fear may, unfortunately, prohibit them from living an active independent lifestyle.
There are many consequences that may happen when an elderly person falls. Most injuries are the result of weak muscles, brittle bones, and fragile joints. Hips and wrists are the most common broken bones in the elderly.
When a senior falls down, they may hit their heads, causing head trauma and concussions. Brain damage from a fall can bring on or worsen dementia.
To make matters worse, many seniors live alone, or are alone for the majority of the day. If they were to fall and no one was around, there is a danger of them not getting help when they need it.
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.
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How To Keep Elderly From Falling
The good news is that a great number of senior falls can be prevented when seniors begin a regular exercise program and commit to doing it a few times per week. When the body moves, it helps keep the circulation going and strengthens the muscles that keep us more stable when we stand or walk.
Exercises dont have to strenuous. Seniors can build muscle strength through a gentle exercise program such as chair yoga or tia chi. Caution be sure the senior has a physical examination first, to be sure there are no underlying conditions that would keep them from taking part in an exercise program.
Having the proper footwear and walking assistance tools, such as a cane or walker, will help an older person get off on the right foot and give them confidence in their balance. Treating neuropathy or other foot issues is recommended. Theyll be more likely to get into physical activity if their feet feel comfortable and they are pain-free.
Getting regular check-ups with an eye doctor. Adjustments with glasses or other needed treatments will make the world a clearer and safer place. Vision problems, poor depth perception, and poor eyesight can be a major issue for seniors. Not only has the world gotten harder to see, but vision impairments also contribute to falling.
A healthy diet will provide the necessary nutrients and vitamins seniors need for fuel. This includes drinking plenty of water to prevent the lightheadedness that can result from dehydration.
Tips For Preventing People Living With Dementia From Falling Out Of Bed
People who are living with dementia are prone to falling out of bed. In fact, 28% of severe falls in memory care communities happen when a resident is rolling out of bed or transferring to or from a bed.
There are a number of factors that contribute to people living with dementia falling out of bed. Those living with cognitive impairment may become unaware of their physical limitations. They often will attempt to get out of bed even though they may lack the ability to walk on their own, leading to a fall or roll out of bed onto the floor.
In addition, incontinence is very common in people living with dementia however, the instinct to get up and go to the bathroom remains. This very often causes people to try to get up on their own and try to navigate to the restroom in a darkened room while sleepy.
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Whats Next With Dementia Prevention Research
More research is needed to find ways to help prevent Alzheimers and related dementias. Future research may determine that specific interventions are needed to prevent or delay the disease in some people, but others may need a combination of treatments based on their individual risk factors. Understanding risk factors and choices you can make now is important for both your present and future health. In addition to this website, consider the resources listed below to learn more.
You can also help researchers learn more about preventing dementia by participating in clinical trials and studies. Search the Alzheimers.gov Clinical Trials Finder to find studies that need volunteers.
What Do We Know About Reducing Risk For Dementia
The number of older Americans is rising, so the number of people with dementia is predicted to increase. However, some studies have shown that incidence rates of dementia meaning new cases in a population over a certain period of time have decreased in some locations, including in the United States. Based on observational studies, factors such as healthy lifestyle behaviors and higher levels of education may be contributing to such a decline. But the cause and effect is uncertain, and such factors need to be tested in a clinical trial to prove whether they can prevent dementia.
A review of published research evaluated the evidence from clinical trials on behavior and lifestyle changes to prevent or delay Alzheimers or age-related cognitive decline. The review found encouraging but inconclusive evidence for three types of behavioral changes : physical activity, blood pressure control, and cognitive training. The findings mean that interventions in these areas are promising enough that researchers should keep studying them to learn more. Researchers continue to explore these and other interventions to determine whether and in what amounts or forms they might prevent dementia.
Watch a video below that highlights conclusions and recommendations from the research review.
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Tips To Prevent Falls For Dementia Patients
There are many things you can do to protect a patient or loved one with dementia to help keep them safe.
Preparation Of Intervention Resources
Three specific resources needed to implement the intervention were identified from the protocol and logic modelling process: an assessment document, a manual and a staff training programme. These were developed by the study team with reference to the final consensus statements, protocol, and logic model and were further discussed by the TOC and all co-investigators.
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Physical Weakness Gait Changes And Poor Balance
Some people in the early stages of Alzheimers are in excellent physical shape and walk for miles every day, while others seem to develop difficulties almost before memory problems begin. Some research even suggests that a or balance can be an early indicator of a decline in cognition. As Alzheimer’s progresses into the middle stages and later stages, it causes a decline in muscle strength, walking, and balance.
Dementia And Falling Out Of Bed: Understanding Why
To help prevent memory care residents from falling out of bed, it is important to understand why they are restless or why they are attempting to get up.
- Do they need a different bedtime? Examine the number of hours in bed you may find residents are going to bed too early.
- Are their medications being given to them at the appropriate time?
- Are their continence care needs being met effectively and frequently enough?
- Is the lighting appropriate for sleep?
- Is the environment too loud? Consider noise in the hallways, televisions etc.
- Is their bed comfortable? Examine the mattress, pillows, blankets, etc.
- Examine the level of engagement throughout the day and monitor for frequent napping or excessive time in bed during daytime hours.
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Reduce Any Noise Pollution
Dementia patients are sensitive to noise. Any loud noise can cause them to lose concentration. As a result, they can fall over and hurt themselves.
Your task is to ensure that there is no unnecessary loud noise inside the house. Remove any object that can cause loud noise. If there is any construction work going on nearby, be beside them to avoid nervousness and anxiety.
Tips On Reducing Falls In Dementia Patients
The person with dementia may experience changes that increase their risk of falling.
Changes may occur in:
- insight, which affects judgment and the ability to reason
- recognition of sensory input, such as sight, sound, touch
- communication: ability to understand and express needs
- coordination of movement: the brains inability to communicate with the muscles and carry out day-today functions despite having the physical ability
- interpretation of their environment, causing illusions and misperceptions e.g., depth, light intensity, color, pattern, temperature
- retention of information: loss of memory, difficulty with new learning
- initiation of tasks, leading to immobility
Things to consider when a person falls:
- Is there a reversible cause or is it related to another medical condition?
- Is the person taking multiple medications?
- Is the person experiencing medication side-effects or interactions?
- Are medications being taken as prescribed?
- Does the person have changes in vision?
- Has the persons mobility changed?
- Is the person restless?
- Is the person in pain but unable to recognize or communicate their discomfort?
Communication
How the caregiver communicates with the person they are assisting is an important factor in reducing the risk of falls for people with dementia.
Remember to:
- Falls, Wandering and Physical Therapy Alzheimers Association
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Elderly Falls And Dementia
Dementia is one of the leading conditions affecting senior citizens millions of new cases are reported each year. With dementia, two of the biggest risk factors for falls are a loss of brain function and/or a loss of bodily function.
Dont take the fall risk lightly, either. A study from the U.K. found that having dementia doubles the risk of falls. This is because:
- Dementia patients often suffer from weak muscles and a lack of energy, making it difficult to get around. As the disease progresses, there may be changes in the way the person carries their body, which may affect the way they walk.
- Changes such as shuffling their feet and hunching over when they walk paired with disorientation can lead to an increased risk of falls and injuries.
- Dementia patients often struggle with brain/vision issues, such as comprehending what they are seeing in front of them. The eye and the brain are not communicating as clearly as they once did, and this can increase fall risk.
Proper footwear and removing potential hazards around the home will make it easier for a senior with dementia or Alzheimers to get around. Should they need further assistance, a cane, walker, wheelchair, or scooter may be needed.
Keeping a regular eating and medication routine is important for a dementia patient and they may need more help with these tasks as time passes. As their memory fades, they may get disoriented and forget where they were going, or why.
Keep Reminders & Everyday Items In One Location
Forgetfulness and confusion are both dangerous symptoms of memory loss and can also lead to falls in seniors with Alzheimers. Designating a common location in the home for notes, reminders, and everyday items can help redirect wandering caused by this confusion. Some popular places for a reminder homebase include on the bedside table or the dining room table. Be sure to pick a familiar location that is free of obstacles.
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Trusted Advice From Homewatch Caregivers
According to the Centers for Disease Control and Prevention , falls are the leading cause of injury-related deaths for older adults. Those who live with dementia are especially at risk. Impaired judgment, a decline in sensory perception over time, and an inability tell others about their needs can contribute to an increased fall risk for people living with Alzheimers disease and other dementia-related disorders.
Ourdementia care team has compiled a 10-point guide that provides easy-to-follow tips to help family members reduce fall risks for their loved ones with dementia.