Dealing With Dementia - Falls Can Be Devastating

One of the most common questions I hear from clients is, “How quickly can dementia progress?” A person with Alzheimer’s disease can live 10+ years after being diagnosed, but it’s often not the disease itself that causes the most rapid decline. Complications like falls, pneumonia, or other health issues related to dementia are frequently what leads to significant setbacks and, ultimately, the end.

My mom is incredibly healthy overall. Yes, she has osteoporosis and arthritis in her back, which cause her some pain, but otherwise, she’s remarkably strong. She’s one of the most energetic, determined women I know. She moves fast, talks quickly, and barely takes a moment to rest. The Alzheimer’s disease, while undeniably challenging, hasn’t slowed her down much. My mom’s high level of mobility combined with her poor safety awareness and short attention span makes her a very high fall risk.  I have always had the fear that a serious fall for my mom could change her life forever.  I guess fear comes from facts.  Many of the patients I have worked with as an occupational therapist have sustained some sort of fall which resulted in a major setback. Anesthesia, trauma, and lack of mobility made a full rehabilitation difficult to attain. So, when I got that call at 6 am on a Sunday that my mom fell, that fear immediately set in.

A Fall Can Be Devastating

My mom had suffered a traumatic fall resulting in lacerations to her legs and a fractured wrist. Seeing her in the emergency room, clearly shaken and injured, was heartbreaking. The fall caused a significant setback for her. She spent three days in a hospital bed, and when she returned to her community, she could no longer walk on her own or manage her daily activities. A wheelchair became necessary, and she needed physical assistance to transfer in and out of bed. It was a deeply traumatic time for her and our family. 

Mom with dementia fell and broke her wrist

How To Handle A Fall

I knew immediately that we needed to act fast to help her regain her strength and independence. The memory care community arranged for a caregiver, and we started physical and occupational therapy right away. I made extra visits to keep her motivated and worked closely with the staff to ensure she was receiving the care and encouragement she needed to get back on her feet.

It was a challenging process, and for a time, we weren’t sure if she would ever return to her prior level of functioning. After eight weeks, her cast was removed, and she started using her wrist again. With continued therapy and unwavering support, she made incredible progress. She began walking again and resumed daily tasks, including feeding, dressing, and toileting. However, the longterm impact of this trauma is that she now requires 1:1 assistance for almost everything. 

Through my work with individuals with dementia, I’ve seen countless times how a traumatic fall can drastically impact a person’s quality of life and accelerate the progression of their disease. My mom’s journey reinforced how vital it is to prioritize fall prevention and swift recovery efforts. While she has regained some mobility and engages in daily activities with support, the reality is that her dementia has progressed. She now relies on assistance for most aspects of her daily routine, and full independence is no longer within reach. It’s a sobering reminder of how fragile this balance is. For those caring for loved ones with dementia, vigilance and proactive care are essential—not just for recovery but for preserving dignity and quality of life as the disease advances.

Education: Common Causes of Falls in Dementia

Falls are a significant risk for individuals with dementia, and understanding the underlying causes can help in prevention. Here are the most common factors:

  • Physical Weakness and Poor Balance: Dementia often leads to muscle weakness and balance issues, making falls more likely. Regular exercise can improve strength and reduce risks.
  • Cognitive Impairments: Memory loss and poor judgment mean your loved one may not remember safety precautions or recognize dangers like stairs or slippery floors.
  • Visual-Spatial Challenges: Misinterpreting their surroundings, such as shiny floors or uneven surfaces, can cause missteps. Routine vision checks are essential.
  • Environmental Factors: Clutter, poor lighting, and uneven flooring in the home increase risks. A safe, organized space is key.
  • Medications and Health: Some medications, like those for blood pressure or sleep, can cause dizziness or drowsiness, heightening fall risks. Monitor side effects closely.
  • Unmet Needs: Hunger, thirst, or needing the bathroom may drive unsafe behavior, like attempting to stand without assistance. Ensure their needs are regularly met.
  • Emotional States: Restlessness, boredom, or loneliness can lead to wandering and falls. Engage them with meaningful activities and social interaction.

Awareness of these causes can guide better care and fall prevention. By identifying risks early, you can help protect your loved one’s safety and well-being.

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