Care Partner Information Sheet

Dementia - Home Safety Issues Part 1: Dementia & Falls

Falls are common among older people, and can be very serious. Falls may cause fractures or other injuries, and people who fall often become very afraid of falling again. Falls can result in a decrease in mobility, loss of independence, and death. People with dementia are at a high risk of falls. Although falls can't always be prevented, there are things to do to decrease falls.

First, it's important to follow the general tips for preventing falls. Then, it's helpful to know how the changes of dementia make falls more common, and what to do to specifically reduce the risk of falls in people with dementia. Also, remember that a person's abilities will change over time as the dementia worsens.

General Tips for Preventing Falls and Injuries

Most falls in older adults are due to a combination of things, such as medications and balance problems. Therefore, most of the time, it takes several changes in order to prevent falls. The table below lists the things to do to reduce the risk of falls and injuries in all older adults.

Risk of Falls and What to Do
Encourage regular exercise, including strength and balance training. Community fall programs are available through your local area agency on aging.
Safe Home Environment
Keep areas well lit. Use night-lights. Remove small rugs, long cords, and other tripping hazards from floors and stairs. Put grab bars in the bathroom by the toilet and shower.  A nurse or occupational therapist can help with a home safety check.
Strong Bones
Discuss calcium and vitamin D treatment with the doctor. Also, ask the doctor about osteoporosis.
Foot Care
Foot pain, long nails, and numb or burning feet can cause falls. Wear shoes in the home.
Eye Care
Poor vision can cause falls. See an eye doctor at least each year. Wear glasses if needed.
Many medications can cause dizziness, weakness, and poor balance. Talk with the doctor.
Changing Positions
Many people get lightheaded when standing up. Change positions slowly. Give the person time to adjust.

Specific Tips for Preventing Falls in People with Dementia

It is important to learn how and why the changes of dementia make falls more common. Then you will be more aware, understand what's going on, and know how to help decrease falls.

Reasons for Falls in People with Dementia
Condition or Symptom
How it May Increase Risk of Falling and What to Do to Help
Physical Weakness
They may be frail, not able to routinely exercise, or weak from a past stroke. If able, walking regularly can help maintain strength.
Changes in Gait and Balance
They may have a shuffling walk with poor coordination. It's good if you can have someone walk with them.
Poor Judgment
They may try to walk down the steps alone, or outside on ice, or in the heat. It's good to have someone walk with them.
Trouble with Space and Vision
They may be unable to judge steps or uneven flooring. Reduce clutter and obstacles in the area. Lock or limit access to unsafe areas.
Medication Side Effects
They may be taking many medications due to cognitive or behavioral problems. Talk with the provider to reduce certain medications with side effects that can drop blood pressure, increase confusion, worsen balance, and increase fall risk.
Usually from aches and pains, hunger, thirst, or the need to use the bathroom. They may be unable to tell others, and get up quickly and urgently putting themselves at risk. Offer activity (moving around), food, and water regularly. If they have pain, work with the provider to treat it.
Boredom or Loneliness
They may be wandering around looking for something to do. Offer activities and arrange for visitors. Consider installing locks out of sight to reduce wandering outside.
Useful Websites
Fall Prevention Center of Excellence

Written by: Mindy J. Fain, MD, University of Arizona Center on Aging