Ask any family with a senior loved one, and you’ll probably hear the same general guidelines around how best to prevent falls. Make sure pathways in the home are clear. Promote good footwear. Keep people active so they maintain mobility. Dementia doesn’t usually make it onto the radar, though.
“We thought we had fall prevention covered,” explains Rachel. She’s been managing her mother’s dementia care over the last six months — up to and including a recent fall. “My mom has a cane and a walker. She lives on one floor. No steps at all. I thought we’d cut down her risk of falling. I had no idea her dementia might actually increase her chances of taking a spill.”
The day she did, Rachel was shocked. “I was on my way to visit mom, and she must have gotten impatient. She left the house without her cane, got disoriented and eventually tripped. We searched for almost an hour before finding her lying at the edge of someone’s lawn. I can’t get that image out of my mind.”
Risk of falls increases among seniors living with dementia
In the weeks since the incident, Rachel’s learned a lot about why people with dementia are more likely to fall. By the numbers, falls are the leading cause of injury-related hospitalizations and injury-related deaths among Canadians aged 65 or older. But, according to the Canadian Institute for Health Information, seniors with dementia have a higher risk of falls, in long-term care and the community, compared to other seniors. For example, some 16% of hospital admissions by seniors living with dementia are related to a fall. That numbers drops to just with just 7% among other seniors.
“It turns out that some of her dementia-related restlessness and agitation may be driving her to keep moving, pace the floor and take on other high-risk behaviours,” Rachel says. “Dementia can also affect mobility and balance, which we knew. We just didn’t realize how physically unstable my mom had become.”
That’s a common theme among families that Chuck Terlesky works with. As General Manager of TheKey Calgary, his team has provided elder and in-home senior care across the region for years. Falls are often the reason a family reaches out about caregiving support for a senior.
“A fall is sometimes the starting point for caregiving. Someone’s taken a tumble and either injured themselves or ended up in the hospital. Even in cases where no one is injured, a fall usually triggers the family to start thinking about whether their loved one needs more support in order to stay safe,” Terlesky says. “Sadly, a fall can lead to all kinds of lingering complications. When families come to us, they may be looking for help while someone recovers from a fall, or ongoing care to limit the risk of future falls.”
In Rachel’s case, the fall was a sign her mother needed more supervision and companionship. Terlesky says he sees cases like this across TheKey’s client base in Calgary. His team works with clients and their families to continually adapt and realign care as needs change. Through regular caregiving, Terlesky’s caregivers also build relationships with clients. This helps them understand how a person’s physical capabilities might be changing and what else can be done to help prevent a fall.
“For seniors, including those with dementia, we really take a holistic approach to caregiving. We call this our Balanced Care MethodTM, and it means we consider the whole person, including physical, mental and emotional wellbeing. This allows us to work with families on risks like potential falls, and just about any other aspect of health and safety that might come into play.”
In Rachel’s case, her mom no longer leaves home alone. Regular caregiver support helps the family balance her mother’s desire to be out in the world with her mobility and dementia-related limitations.
“I still have nightmares about the day she fell,” Rachel adds. “But logically, I know we’ve adapted her care plan to make sure she’s not alone as much as possible. That really helps ease my mind.”