Is Falling an Early Indication of Alzheimer’s?
There are many reasons why persons with Alzheimer’s disease (AD) are at risk of falling, including the effects of medications, changes in walking and balance, impaired vision, hazardous environmental conditions, lack of understanding and awareness of the potential for falls, etc.
Caregivers play a pivotal role in helping family members remain fall-free. Here are 6 preventive strategies to get caregivers started:
(1) Recognize the Problem
It’s important to first identify the specific risk factors for falling in your loved one with AD. This information is crucial to planning for needed care. Scheduling a visit with your family medical doctor is usually the best way to start. In addition to assessing risk, the doctor can assist in helping put together a plan of action specific for your family member and provide resources that can help you.
Before visiting the doctor, it is helpful for you (and the person affected, if able) to make list of all activities and behaviors that cause concern about risk of falling. The list, as well as details or circumstances of any recent falls or near falls (i.e., episode of balance loss but a fall to the floor is avoided by grabbing hold of furnishings/walls for balance support) can help the doctor in coming up with a plan.
(2) Monitor Health
Monitoring the health of your loved one with AD is vital; the onset of unfavorable health events (e.g., illness, medication side effects, behavioral flare-ups, worsening of cognition, impaired balance or walking, etc.) can increase the likelihood of falling.
It’s important to notify the doctor and keep him or her informed of your family member’s condition; the doctor may want to schedule an office visit for your loved one. It’s especially helpful to inform the doctor of any falls so as to discover what caused the fall and to prevent another fall from occurring.
(3) Monitor Medications
Persons with AD typically take a number of drugs to manage symptoms associated with AD (e.g., depression, delusions, hallucinations, agitation, sleepiness, etc.) and other health conditions (e.g., high blood pressure, heart problem, etc.). While medications can help, they can also produce a host of side effects, which can increase the risk of falling.
As a caregiver, it’s important to know about the medications that your loved one is taking and to be alert to possible adverse reactions. Begin be asking the doctor to review all medications, both prescription and over-the-counter drugs. Find out as much as possible about every medication, including name, purpose, dosage, frequency and possible side effects.
Observe for typical symptoms of drug side effects, such as drowsiness, dizziness, unstable balance, and worsening confusion. If serious side effects occur, report them to the doctor.
Importantly, observe family members on new medications and watch for any side effects that may lead to falls.
(4) Maintain Safe Mobility
People with AD, even in the early stages, will display subtle changes in walking and balance that will become more severe with time. This can increase the likelihood of falling. If the person has other illnesses, the risk of a fall may be more severe. Therefore, it’s crucial to engage your family member with AD in physical activity so that they remain as active and flexible as possible.
Ask your doctor to evaluate the physical health of your loved one; ask for recommendations about which activities to implement. Walking, light aerobics and tai chi are all simple ways to improve balance, flexibility and coordination, which help to reduce fall risk. It’s important to offer exercises that match your family member’s abilities (i.e., choose exercises that are not beyond their cognitive and physical capabilities).
(5) Managing Behavioral Disturbances
Several behavioral problems are associated with fall risk, including agitation and anger, wandering, restlessness, catastrophic reactions, etc.
Try to figure out what is causing the behavior. Understanding why your loved one is behaving in a certain way can point to better ways of dealing with that behavior.
The ABC method (the antecedent or what came before, the behavior itself, the consequences of the behavior) is a good way of managing behavioral disturbances.
The idea is to observe what is going on (the antecedent) shortly before the behavior to determine possible causes. For example, agitation or wandering might be caused by too much excitement, stress, or activity in the environment. Altering the environment (i.e., decrease stimulation; simplify activities) may reduce the behavior. Also, observe what happens after a particular behavior has occurred. Consequences sometimes act as reinforcement for problem behaviors. If the AD person gains something from a particular behavior, such as receiving more attention or avoiding a specific activity, the likelihood of that behavior occurring again is increased.
Lastly, the antecedent of certain behaviors, such as agitation or sleep disturbances, can be due to underlying physical illness (e.g., pain, urinary tract infection, constipation, etc.). Always inform your doctor about behavioral disturbances; he or she may want to check out your family member.
(6) Maintain a Safe Environment
Environmental hazards in the home, such as lack of lighting, slippery rugs/floor surfaces, clutter, etc., are associated with increased fall risk. Changes in balance and coordination combined with poor memory can make it difficult for a person with AD to avoid hazardous conditions.
Caregivers play an essential role in identifying and modifying potential fall hazards. There are numerous hazards and important considerations to keep in mind when caring for a family member with AD; October’s blog will be devoted entirely to the topic of AD and home safety.
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