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 disease is really like. For Lisa, it starts with knowledge, education, and training.

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Lisa, hello everybody. Welcome to another

new episode of the truth lies in Alzheimer's show. I'm Lisa

Skinner, your host, and as we are entering the winter season,

I wanted to share with you fall prevention strategies, and this

really is specific to people living with dementia. They are

at a much, much higher fall risk than their counterparts who are

not living with dementia. And this is from an article that I

found that was published at fall prevention foundation.org, so

you can find it there if you're interested. So I want it starts

off by saying, understanding the link between dementia and fall

risk. As we know, dementia is a progressive condition that

affects memory, cognition, behavior and physical

functioning. Now, as the brain deteriorates, people may have

difficulty with spatial awareness, decision making and

balance these cognitive impairments significantly raise

the likelihood of falls, particularly in unfamiliar

environments or during transitions such as standing up

or walking, some of the factors that contribute to fall risk and

people living with dementia include that they have poor

depth perception and are going through visual changes, that

they have impaired judgment or impulsive behavior. They have a

difficulty interpreting their surroundings, they typically

have weak muscles and poor coordination, and then you have

to factor in the side effects from medications they may be on,

for example, sedatives or anti hypertensives. They also tend to

wander or become quite restless, and a lot of folks living with

dementia are incontinent, which leads to frequent, hurried

bathroom trips. So understanding these underlying factors can

help family members and caregivers implement targeted

fall prevention strategies tailored to each individual

stage of dementia and their personal physical condition.

Creating a safe and navigable environment is one of the most

effective steps in preventing falls since dementia often

impairs the ability to perceive hazards or respond

appropriately, proactive adjustments in the living space

become essential. So these are some things that you should pay

attention to and take care of if they exist in your person's

environment. So you want to remove clutter and hazards, you

can clear the hallways and rooms of low objects, electrical

cords, throw rugs and items that may cause tripping. Keep the

furniture layout consistent and predictable to reduce confusion,

secure carpets and floorboards to prevent uneven walking

surfaces. Number two, improve the lighting in their

environment. Install bright, non glare lighting throughout the

home, especially in the hallways, bathrooms and

staircases. Use night lights to guide the way to the bathroom or

the kitchen at night. Motion Activated lights can help reduce

disorientation during nighttime movement. Use visual cues and

signage. You can label doors with both text and pictograms to

reduce confusion. For example, label the door to the bathroom

bathroom with an icon. You want to contrast the colors on the

walls, floors and furniture, because this can improve depth

perception and make obstacles more noticeable and avoid busy

patterns on carpets or furniture that may appear distorted or

confusing to somebody with dementia. You can also install

assistive features. Temperatures, like handrails and

they're best used along hallways and stairs, providing support

during movement. Grab bars are great in the bathroom near the

toilet and in the shower, this can prevent slipping. Non Slip.

Mats and tubs and showers do reduce the risk of falls during

hygiene routines and raised toilet seats or shower chairs

can definitely help those with balance difficulties. And then

the last thing is organized, daily use items strategically.

What does that mean? Well, you can keep essential items like

glasses, medications and frequently worn clothing within

easy reach, reduce the need to climb, bend or search all of

these which can increase their fall risk, maintaining physical

strength, coordination and balance also plays a central

role in fall prevention strategies for people living

with dementia, even modest exercise can improve the

stability and confidence in movement. So encourage daily

movement activities such as walking, stretching or seated

exercises, helps preserve muscle tone, short, regular walks

around the home or garden, support balance and circulation.

Simple balance movements such as standing on one foot while

holding a chair, can be adapted for safety chair yoga or tai

chi, offered in modified formats. Of course, can improve

coordination in people living with dementia. Therapists can

design individualized mobility plans based on the person's

current abilities and their medical history. They may

suggest equipment like walkers or foot orthotics to support

safe movement. So you also want to monitor nutrition and

hydration, you want to make sure that they're getting adequate

protein, calcium and vitamin D intake, because this is vital

for muscle and bone strength. Dehydration, which is extremely

common in the elderly population, leads to dizziness,

increasing the likelihood of falls. And then, of course,

address vision and hearing impairments. You can schedule

regular eye exams to correct vision problems with glasses or

other treatments, and, most importantly, ensure hearing aids

are functioning as poor hearing can affect spatial awareness and

response to environmental cues. Medication management, critical

for fall prevention, many people living with dementia take

multiple multi medications to manage symptoms of memory loss,

also mood changes and other chronic conditions. Some

medications, particularly sedatives or antipsychotics and

blood pressure drugs increase fall risk. So what you want to

do is review their medications regularly and consult with their

healthcare provider or pharmacist, and they can conduct

routine medication reviews to identify combinations or dosages

that might contribute to dizziness or instability

minimize their high risk medications where possible,

reduce reliance on medications with sedating or cognitive side

effects, monitor closely when introducing new prescriptions,

and then establish a routine administer medications at

consistent times to avoid skipped or doubled doses, which

can cause confusion or balance issues, and then store the

medication securely to avoid accidental ingestion or

mismanagement. Now, something else that I read very recently,

and of course, it reoccurred to me that this population

typically has more than one physician. They've got, you

know, cardiovascular doctors and other specialists.

That they're seeing to manage other health conditions that

they have, besides the dementia. So the point to that is, you've

got a handful or multiple doctors prescribing a multitude

of medications. So one of the things that I wanted to point

out is, if that's the case with your loved one or the person

you're caring for, make sure that all the doctors are aware

of the other medications the other doctors are prescribing,

and then make sure that they're not on too many that do cause

dizziness and balance problems and maybe they need to be

readjusted. So just food for thought. There. Here are some

cognitive strategies to help prevent falls, because dementia

does affect decision making and behavior. Fall prevention

strategies must also include cognitive support and behavioral

reinforcement. So how do you approach that? Well, one of the

ways is to establish predictable routines, so consistent

schedules for waking, meals, activities and bedtime reduce

confusion and wandering, and as I've mentioned before, in

previous episodes, consistent schedules also work best for

behavioral Management. Familiarity can help the

individual move through their day with less stress and fewer

unexpected hazards. That's true for behaviors too supervised

transitions assist them during higher risk activities like

getting in and out of bed, using the bathroom or walking

outdoors, consider using transfer belts for safer

assistance during movement, and then you can use visual prompts

and visual verbal cues to minimize fall risk. You can do

this by guiding the person gently with a calm voice, using

instructions or visual prompts when encouraging the movement,

avoid startling or rushing the individual as this can lead to

panic or sudden unsafe movement. People living with dementia do

not like to be approached from behind. It's frightening to

them, and it startles them. Always approach from the front

and then implement technology aids, which some of them include

door alarms, motion sensors and fall detection devices. These

can alert caregivers if the person wanders or falls, and the

GPS enabled wearables are really helpful if the person has a

tendency to walk off unsupervised. I'm going to go

over the best practices for fall prevention by caregivers. And we

all know that caregivers are critical and essential to

implementing and maintaining fall prevention strategies for

people living with dementia, their knowledge, preparation and

awareness can make a substantial difference in safety outcomes.

So here are the same things that are recommended that they pay

attention to and implement that they conduct daily risk

assessments, you want to observe the signs of fatigue, dizziness,

unsteadiness or noticeable behavioral changes. Note

variations in their gait, their posture, even their facial

expressions that may signal discomfort or disorientation.

Stay calm and encouraging. Use a very patient reassuring tone

when guiding their movement or redirecting them. Reacting with

frustration or urgency can increase the person's agitation

and lead to risky behaviors. Why is that? Because they will

absorb and mirror your frustration, your nervousness,

your urgency, you. Monitor their footwear and clothing. Shoes

should be well fitting with non slip soles, and please avoid

slippers or flip flops. Loose clothing that drags on the floor

can also pose a trip hazard, and then pay attention to

overstimulation that includes loud noises, a cluttered

environment, even too many people around can confuse or

startle a dementia patient, increasing the likelihood of an

unsafe reaction keep spaces calm and simple, especially during

transitions or caregiving tasks provide them with mental and

emotional support. You can do this by engaging in

conversation, playing music and or gentle activities to reduce

agitation and restlessness emotional distress can trigger

impulsive actions or attempts to leave the home unsupervised. Now

here are some of the ways that you can design a fall prevention

plan for your Dementia Care. Every person living with

dementia is a unique individual. So the most effective fall

prevention plans are those that combine personalized observation

with expert input. So step one would be to consult a medical

professional, involve the primary care doctor, the

neurologist or the geriatrician, in assessing physical and

cognitive health of your person, get a home safety evaluation.

Occupational therapists or aging in place specialists can

identify hazards in the home and suggest modifications, things

that you might not even are aware that are a safety hazard.

Again, create a daily routine and include time for meals,

rest, exercise, personal hygiene and safe recreational activities

and then document changes that you see and notice. Keep a diary

or a fall even just a specific fall diary to record near misses

or incidences, noting what happened, where, and the

possible causes of that near incident and train all of the

caregivers who are involved in this person's life, whether

professional or family, all caregivers should understand the

individual's specific needs and how to prevent unsafe situations

as dementia progresses, fall prevention strategies will need

regular reevaluation. It stands to reason because it's forever

changing as the disease progresses through the stages.

What works during the early stages may no longer be

effective in the mid to latter stages of the condition,

consider assistive technologies such as hospital beds with side

rails or full body harnesses for those with severe instability,

environments may need To shift from home to assisted living

facilities with specialized dementia, friendly

neighborhoods. Caregiving schedules may expand to include

nighttime support or additional trained personnel. In

conclusion, implementing fall prevention strategies for people

living with dementia is a multifaceted effort that

combines environmental safety, physical health, cognitive

support and caregiver attentiveness, while the risk of

falls can never be entirely eliminated, taking proactive

steps can significantly reduce the frequency as well as the

severity of the accidents, more than just physical safety, these

strategies foster dignity, independence and peace of mind

for both the individual living with dementia and those who care

for them through compassionate care and thoughtful planning,

the home or care environment can be a secure space where mobility

can be encouraged and.

Also falls are minimized. That was some great, great helpful

information. Thanks again for fall prevention foundation.org,

for publishing that very informative article. For those

of you who are interested in checking it out, you can go to

their website, fall prevention foundation.org, so that

concludes this episode for the truth, lies and Alzheimer's

show. I just want to mention one other thing, because this is

really important, and I forgot to mention it. This is something

that geriatric medicine has known for decades. So I think

this is really going to be helpful for all of you to be

aware of this, 10 plus medications. If you're the

person you're caring for or your loved one is on 10 plus

medications that increases their fall risk seven times medication

factors cause 30 to 40% of senior falls. Yet medication

review happens in fewer than 15% of their assessments. So another

reason to make sure those medications, especially if they

have multiple doctors and specialists managing their care,

to be aware of what that to make sure that the other doctors are

aware of all of the prescriptions that are being

prescribed. So just wanted to remind you all that if you want

to check us, check out our website. You can find us at

minding dementia.com we're always putting up new resources

and helpful information to make your life through this dementia

journey much easier to navigate, so that'll do it for today.

Thanks again for being here. I always appreciate you showing up

and being involved in my show, the truth, lies and Alzheimer's.

I'm Lisa Skinner, your host, and as always, I will be back next

week with another new episode. So I wish everybody a happy and

healthy week ahead, and I will see you back here next week.