Fall Prevention Strategies for People Living with Dementia-Related Illnesses

Falls are one of the most common—and preventable—risks for individuals living with Alzheimer’s and other dementia-related illnesses. In this episode, Lisa dives into the critical topic of fall prevention and how caregivers can create safer, more supportive environments for their loved ones.

Drawing insights from the Fall Prevention Foundation, Lisa explores why people with dementia are more prone to falls, what environmental changes can make the biggest impact, and how physical health, medication management, and cognitive support all play vital roles in maintaining safety and independence.

Listeners will gain practical, real-world strategies to reduce fall risk—covering everything from home setup and lighting to daily routines, balance exercises, and communication techniques that keep those living with dementia calm and confident.

Key Takeaways:

• Why dementia increases fall risk and what caregivers can do about it
• Simple home modifications that dramatically reduce hazards
• How exercise, balance, and physical therapy support mobility and confidence
• The importance of reviewing medications regularly
• Cognitive and behavioral strategies to guide safe movement
• How to design a personalized fall-prevention plan that evolves with disease progression

Quote from Lisa: “Fall prevention isn’t just about safety—it’s about preserving dignity and independence for the person living with dementia.”

Resource Mentioned: This episode was inspired by the article “Fall Prevention Strategies for Dementia Patients: A Comprehensive Approach to Safety and Support” published by the Fall Prevention Foundation

Listen now to learn how to make the home—and the caregiving journey—safer, calmer, and more compassionate

About the Host:

Author Lisa Skinner is a behavioral specialist with expertise in Alzheimer’s disease and related dementia. In her 30+year career working with family members and caregivers, Lisa has taught them how to successfully navigate the many challenges that accompany this heartbreaking disease. Lisa is both a Certified Dementia Practitioner and is also a certified dementia care trainer through the Alzheimer’s Association. She also holds a degree in Human Behavior.

Her latest book, “Truth, Lies & Alzheimer’s – Its Secret Faces” continues Lisa’s quest of working with dementia-related illnesses and teaching families and caregivers how to better understand the daunting challenges of brain disease. Her #1 Best-seller book “Not All Who Wander Need Be Lost,” was written at their urging. As someone who has had eight family members diagnosed with dementia, Lisa Skinner has found her calling in helping others through the struggle so they can have a better-quality relationship with their loved ones through education and through her workshops on counter-intuitive solutions and tools to help people effectively manage the symptoms of brain disease. Lisa Skinner has appeared on many national and regional media broadcasts. Lisa helps explain behaviors caused by dementia, encourages those who feel burdened, and gives practical advice for how to respond.

So many people today are heavily impacted by Alzheimer's disease and related dementia. The Alzheimer's Association and the World Health Organization have projected that the number of people who will develop Alzheimer's disease by the year 2050 worldwide will triple if a treatment or cure is not found. Society is not prepared to care for the projected increase of people who will develop this devastating disease. In her 30 years of working with family members and caregivers who suffer from dementia, Lisa has recognized how little people really understand the complexities of what living with this

Episode Transcript

Lisa Skinner (00:00):
Lisa, hello everybody. Welcome to another
new episode of the truth lies inAlzheimer's show. I'm Lisa
Skinner, your host, and as weare entering the winter season,
I wanted to share with you fallprevention strategies, and this

(00:23):
really is specific to peopleliving with dementia. They are
at a much, much higher fall riskthan their counterparts who are
not living with dementia. Andthis is from an article that I
found that was published at fallprevention foundation.org, so

(00:49):
you can find it there if you'reinterested. So I want it starts
off by saying, understanding thelink between dementia and fall
risk. As we know, dementia is aprogressive condition that
affects memory, cognition,behavior and physical

(01:11):
functioning. Now, as the braindeteriorates, people may have
difficulty with spatialawareness, decision making and
balance these cognitiveimpairments significantly raise
the likelihood of falls,particularly in unfamiliar
environments or duringtransitions such as standing up

(01:36):
or walking, some of the factorsthat contribute to fall risk and
people living with dementiainclude that they have poor
depth perception and are goingthrough visual changes, that
they have impaired judgment orimpulsive behavior. They have a

(01:58):
difficulty interpreting theirsurroundings, they typically
have weak muscles and poorcoordination, and then you have
to factor in the side effectsfrom medications they may be on,
for example, sedatives or antihypertensives. They also tend to
wander or become quite restless,and a lot of folks living with

(02:26):
dementia are incontinent, whichleads to frequent, hurried
bathroom trips. So understandingthese underlying factors can
help family members andcaregivers implement targeted
fall prevention strategiestailored to each individual
stage of dementia and theirpersonal physical condition.

(02:52):
Creating a safe and navigableenvironment is one of the most
effective steps in preventingfalls since dementia often
impairs the ability to perceivehazards or respond
appropriately, proactiveadjustments in the living space
become essential. So these aresome things that you should pay

(03:16):
attention to and take care of ifthey exist in your person's
environment. So you want toremove clutter and hazards, you
can clear the hallways and roomsof low objects, electrical
cords, throw rugs and items thatmay cause tripping. Keep the
furniture layout consistent andpredictable to reduce confusion,

(03:42):
secure carpets and floorboardsto prevent uneven walking
surfaces. Number two, improvethe lighting in their
environment. Install bright, nonglare lighting throughout the
home, especially in thehallways, bathrooms and
staircases. Use night lights toguide the way to the bathroom or

(04:08):
the kitchen at night. MotionActivated lights can help reduce
disorientation during nighttimemovement. Use visual cues and
signage. You can label doorswith both text and pictograms to
reduce confusion. For example,label the door to the bathroom

(04:30):
bathroom with an icon. You wantto contrast the colors on the
walls, floors and furniture,because this can improve depth
perception and make obstaclesmore noticeable and avoid busy
patterns on carpets or furniturethat may appear distorted or

(04:52):
confusing to somebody withdementia. You can also install
assistive features.Temperatures, like handrails and
they're best used along hallwaysand stairs, providing support
during movement. Grab bars aregreat in the bathroom near the
toilet and in the shower, thiscan prevent slipping. Non Slip.

(05:17):
Mats and tubs and showers doreduce the risk of falls during
hygiene routines and raisedtoilet seats or shower chairs
can definitely help those withbalance difficulties. And then
the last thing is organized,daily use items strategically.

(05:40):
What does that mean? Well, youcan keep essential items like
glasses, medications andfrequently worn clothing within
easy reach, reduce the need toclimb, bend or search all of
these which can increase theirfall risk, maintaining physical

(06:04):
strength, coordination andbalance also plays a central
role in fall preventionstrategies for people living
with dementia, even modestexercise can improve the
stability and confidence inmovement. So encourage daily
movement activities such aswalking, stretching or seated

(06:29):
exercises, helps preserve muscletone, short, regular walks
around the home or garden,support balance and circulation.
Simple balance movements such asstanding on one foot while
holding a chair, can be adaptedfor safety chair yoga or tai

(06:51):
chi, offered in modifiedformats. Of course, can improve
coordination in people livingwith dementia. Therapists can
design individualized mobilityplans based on the person's
current abilities and theirmedical history. They may
suggest equipment like walkersor foot orthotics to support

(07:16):
safe movement. So you also wantto monitor nutrition and
hydration, you want to make surethat they're getting adequate
protein, calcium and vitamin Dintake, because this is vital
for muscle and bone strength.Dehydration, which is extremely
common in the elderlypopulation, leads to dizziness,

(07:40):
increasing the likelihood offalls. And then, of course,
address vision and hearingimpairments. You can schedule
regular eye exams to correctvision problems with glasses or
other treatments, and, mostimportantly, ensure hearing aids

(08:01):
are functioning as poor hearingcan affect spatial awareness and
response to environmental cues.Medication management, critical
for fall prevention, many peopleliving with dementia take
multiple multi medications tomanage symptoms of memory loss,

(08:24):
also mood changes and otherchronic conditions. Some
medications, particularlysedatives or antipsychotics and
blood pressure drugs increasefall risk. So what you want to
do is review their medicationsregularly and consult with their

(08:45):
healthcare provider orpharmacist, and they can conduct
routine medication reviews toidentify combinations or dosages
that might contribute todizziness or instability
minimize their high riskmedications where possible,

(09:07):
reduce reliance on medicationswith sedating or cognitive side
effects, monitor closely whenintroducing new prescriptions,
and then establish a routineadminister medications at
consistent times to avoidskipped or doubled doses, which

(09:27):
can cause confusion or balanceissues, and then store the
medication securely to avoidaccidental ingestion or
mismanagement. Now, somethingelse that I read very recently,
and of course, it reoccurred tome that this population

(09:49):
typically has more than onephysician. They've got, you
know, cardiovascular doctors andother specialists.
That they're seeing to manageother health conditions that
they have, besides the dementia.So the point to that is, you've

(10:10):
got a handful or multipledoctors prescribing a multitude
of medications. So one of thethings that I wanted to point
out is, if that's the case withyour loved one or the person
you're caring for, make surethat all the doctors are aware
of the other medications theother doctors are prescribing,

(10:33):
and then make sure that they'renot on too many that do cause
dizziness and balance problemsand maybe they need to be
readjusted. So just food forthought. There. Here are some
cognitive strategies to helpprevent falls, because dementia

(10:55):
does affect decision making andbehavior. Fall prevention
strategies must also includecognitive support and behavioral
reinforcement. So how do youapproach that? Well, one of the
ways is to establish predictableroutines, so consistent

(11:17):
schedules for waking, meals,activities and bedtime reduce
confusion and wandering, and asI've mentioned before, in
previous episodes, consistentschedules also work best for
behavioral Management.Familiarity can help the

(11:40):
individual move through theirday with less stress and fewer
unexpected hazards. That's truefor behaviors too supervised
transitions assist them duringhigher risk activities like
getting in and out of bed, usingthe bathroom or walking
outdoors, consider usingtransfer belts for safer

(12:04):
assistance during movement, andthen you can use visual prompts
and visual verbal cues tominimize fall risk. You can do
this by guiding the persongently with a calm voice, using
instructions or visual promptswhen encouraging the movement,

(12:27):
avoid startling or rushing theindividual as this can lead to
panic or sudden unsafe movement.People living with dementia do
not like to be approached frombehind. It's frightening to
them, and it startles them.Always approach from the front

(12:50):
and then implement technologyaids, which some of them include
door alarms, motion sensors andfall detection devices. These
can alert caregivers if theperson wanders or falls, and the

(13:10):
GPS enabled wearables are reallyhelpful if the person has a
tendency to walk offunsupervised. I'm going to go
over the best practices for fallprevention by caregivers. And we
all know that caregivers arecritical and essential to

(13:35):
implementing and maintainingfall prevention strategies for
people living with dementia,their knowledge, preparation and
awareness can make a substantialdifference in safety outcomes.
So here are the same things thatare recommended that they pay
attention to and implement thatthey conduct daily risk

(14:00):
assessments, you want to observethe signs of fatigue, dizziness,
unsteadiness or noticeablebehavioral changes. Note
variations in their gait, theirposture, even their facial
expressions that may signaldiscomfort or disorientation.

(14:27):
Stay calm and encouraging. Use avery patient reassuring tone
when guiding their movement orredirecting them. Reacting with
frustration or urgency canincrease the person's agitation
and lead to risky behaviors. Whyis that? Because they will

(14:50):
absorb and mirror yourfrustration, your nervousness,
your urgency, you. Monitor theirfootwear and clothing. Shoes
should be well fitting with nonslip soles, and please avoid
slippers or flip flops. Looseclothing that drags on the floor

(15:12):
can also pose a trip hazard, andthen pay attention to
overstimulation that includesloud noises, a cluttered
environment, even too manypeople around can confuse or
startle a dementia patient,increasing the likelihood of an

(15:33):
unsafe reaction keep spaces calmand simple, especially during
transitions or caregiving tasksprovide them with mental and
emotional support. You can dothis by engaging in
conversation, playing music andor gentle activities to reduce

(15:55):
agitation and restlessnessemotional distress can trigger
impulsive actions or attempts toleave the home unsupervised. Now
here are some of the ways thatyou can design a fall prevention
plan for your Dementia Care.Every person living with

(16:19):
dementia is a unique individual.So the most effective fall
prevention plans are those thatcombine personalized observation
with expert input. So step onewould be to consult a medical
professional, involve theprimary care doctor, the

(16:41):
neurologist or the geriatrician,in assessing physical and
cognitive health of your person,get a home safety evaluation.
Occupational therapists or agingin place specialists can
identify hazards in the home andsuggest modifications, things
that you might not even areaware that are a safety hazard.

(17:06):
Again, create a daily routineand include time for meals,
rest, exercise, personal hygieneand safe recreational activities
and then document changes thatyou see and notice. Keep a diary

(17:27):
or a fall even just a specificfall diary to record near misses
or incidences, noting whathappened, where, and the
possible causes of that nearincident and train all of the
caregivers who are involved inthis person's life, whether

(17:47):
professional or family, allcaregivers should understand the
individual's specific needs andhow to prevent unsafe situations
as dementia progresses, fallprevention strategies will need
regular reevaluation. It standsto reason because it's forever

(18:12):
changing as the diseaseprogresses through the stages.
What works during the earlystages may no longer be
effective in the mid to latterstages of the condition,
consider assistive technologiessuch as hospital beds with side
rails or full body harnesses forthose with severe instability,

(18:37):
environments may need To shiftfrom home to assisted living
facilities with specializeddementia, friendly
neighborhoods. Caregivingschedules may expand to include
nighttime support or additionaltrained personnel. In
conclusion, implementing fallprevention strategies for people

(19:01):
living with dementia is amultifaceted effort that
combines environmental safety,physical health, cognitive
support and caregiverattentiveness, while the risk of
falls can never be entirelyeliminated, taking proactive

(19:22):
steps can significantly reducethe frequency as well as the
severity of the accidents, morethan just physical safety, these
strategies foster dignity,independence and peace of mind
for both the individual livingwith dementia and those who care

(19:45):
for them through compassionatecare and thoughtful planning,
the home or care environment canbe a secure space where mobility
can be encouraged and.
Also falls are minimized. Thatwas some great, great helpful

(20:07):
information. Thanks again forfall prevention foundation.org,
for publishing that veryinformative article. For those
of you who are interested inchecking it out, you can go to
their website, fall preventionfoundation.org, so that

(20:33):
concludes this episode for thetruth, lies and Alzheimer's
show. I just want to mention oneother thing, because this is
really important, and I forgotto mention it. This is something
that geriatric medicine hasknown for decades. So I think

(21:00):
this is really going to behelpful for all of you to be
aware of this, 10 plusmedications. If you're the
person you're caring for or yourloved one is on 10 plus
medications that increases theirfall risk seven times medication

(21:20):
factors cause 30 to 40% ofsenior falls. Yet medication
review happens in fewer than 15%of their assessments. So another
reason to make sure thosemedications, especially if they

(21:42):
have multiple doctors andspecialists managing their care,
to be aware of what that to makesure that the other doctors are
aware of all of theprescriptions that are being
prescribed. So just wanted toremind you all that if you want

(22:04):
to check us, check out ourwebsite. You can find us at
minding dementia.com we'realways putting up new resources
and helpful information to makeyour life through this dementia
journey much easier to navigate,so that'll do it for today.

(22:28):
Thanks again for being here. Ialways appreciate you showing up
and being involved in my show,the truth, lies and Alzheimer's.
I'm Lisa Skinner, your host, andas always, I will be back next
week with another new episode.So I wish everybody a happy and

(22:51):
healthy week ahead, and I willsee you back here next week.