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Preventing falls in the cognitively impaired

Long-Term Care Nursing Advisor, July 29, 2005

The current recommendation for preventing falls in the cognitively impaired is to take a practical apporach, making many of the same modifications required for those without cognitive impairment:

  • Even residents with severe dementia are often able to cooperate to a surprising degree with interventions. Never assume that a resident cannot comply with a recommendation just because he or she is cognitively impaired.
  • Consider a broad range of fall causes. The resident may not be able to give a reliable history, and witnesses to the fall may be unavailable.
  • Assess cognitively impaired residents to determine the direction in which they are most likely to fall and the body parts they are most likely to injure. Residents with degenerative dementias tend to develop distinctive fall patterns.
  • Orthostatic hypotension is common in older people who have dementia. Consider assessing it with continuous monitoring equipment, such as the noninvasive blood pressure monitor that continuously measures arterial blood pressure in the finger.
  • Small interventions can make big improvements in mobility. Changing a walking aid to something more appropriate or wearing suitable shoes may make a big difference.

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