As we age, physical changes and health conditions make falls more likely. In fact, falls are a leading cause of injury among older adults. And adults living with dementia fall at least four times per year — twice as often as adults without dementia. With National Fall Awareness Week upon us (Sept. 21-25), it’s a great time to consider some fall intervention strategies to help prevent fall-related injuries.
Designing a safe living space
Before a resident moves into a community, it is important to develop a bedroom checklist with the family and explain risks regarding specific furniture.
- Bed size (will dictate position in the room)
- Dresser (limit number of drawers)
- Bedside table <(address corners)
- Lamp (easy to turn on/off)
- TV and console table (viewing point)
- Chair with arms (appropriate for mobility)
- Accessible storage/shelving
- Mobility status influences design: Remember to factor in the range of mobility when designing a bedroom.
- No mobility aid: Reduce risk by making sure items are within reach of standing or sitting.
- Two- or four-wheeled walkers: Room should have more space for the pathway to exit, which means no bulky furniture and positioning the bed against a wall.
- Wheelchair: Ensure there is additional space for safe transfers from bed and chairs with multiple care staff in the room.
Fall prevention exercises
Exercises that focus on balance and strength training can reduce the risk of falling.
While they may have difficulty learning new activities, those living with dementia can benefit from going through the motions of balance and strength training.
Activities such as squatting, standing up from a chair, and walking may be difficult or cause many to feel unsteady, which increases their risk of falling. So, people living with dementia must practice balance and strength training with a professional to ensure their safety. The following links provide an easy guide for sit and stand, balance and seated chair exercises which can be adapted for those living with dementia:
- Fall Prevention Exercises: Simple Exercises Can Prevent Falls for People Living with Dementia
- Fall Prevention: Balance and Strength Exercises for Older Adults
- Seated Chair Exercise
Falling out of bed
If a resident is falling or rolling out of bed frequently, consider implementing the following measures:
- Lowering the bed
- Adding a fall mat to the floor at the bedside to prevent injury
- Providing transfer enablers, such as a bed cane, halo or transfer pole can be helpful for residents that are usually able to self-transfer
- Using a pool noodle under the sheet or adding bolsters on the sides of the bed to emphasize the edge of the bed can support residents who accidentally fall out of bed
- Using a perimeter mattress for those who roll out of bed
- Removing nightstands or other hazards from the bedside
Reducing transfer risks
Falls often happen when a resident tries to move from a wheelchair to a chair or bed or from a sitting to a standing position without help. When residents are assisted with transfers, they only fall 1% of the time. The following are great solutions for preventing transfer falls:
- Modify wheelchair: Add anti roll-back systems to wheelchairs.
- Transfer aids: Provide transfer poles, bed canes or halos to assist residents with transfers. A hospital bed with a half rail should be considered as safety a measure as well.
- Establish transfer technique policy: It is crucial to have 100% staff compliance on your community’s policy for proper transfer techniques, such as using gait belts when appropriate and transfer equipment when applicable (i.e. hoyer, sit-to-stand device, etc.).
- Training: There can never be enough training, so train and retrain the care staff on transfer techniques on a regular basis.
- Physical/Occupational Therapy: Leverage therapy referrals regularly to ensure residents have the appropriate mobility aids and transfer assistance for their changing condition.
For more details on preventing falls, please download the whitepaper, Best Practices for Fall Prevention.