Immediate Steps: What to Do After a Fall
When a person with dementia falls, the first moments are critical. Your priority is to ensure their safety and your own. It can be a frightening and disorienting experience, and the individual may be confused or agitated, which is a common symptom of dementia. Approach the situation with a calm, reassuring tone of voice.
Assess for Injury
Do not rush to move the person. Take a moment to check for visible signs of injury such as bleeding, bruising, or swelling. Ask simple, direct questions to check for pain. If they complain of severe pain, particularly in the head, neck, or back, or if you notice any signs of a fracture, do not move them. Call for emergency medical assistance immediately. Keep them warm and as comfortable as possible with blankets and pillows until help arrives.
Communicate and Reassure
Dementia can affect communication, so use simple language and a gentle, soothing tone. Explain what you are going to do in short, clear sentences. For example, “I’m going to help you sit up.” Avoid complex instructions or overwhelming them with too much information at once. Distraction can also be effective; talk about something familiar or comforting to redirect their attention away from their fear or discomfort.
The Two-Chair Method: Helping Someone Up Safely
If you have determined that the person is not seriously injured, you can use the following safe, step-by-step method to assist them. This technique minimizes the risk of back strain for the caregiver and empowers the person to participate in their own recovery.
- Find Two Sturdy Chairs: Select two chairs that are stable and will not roll or slip. Place one chair behind the person's head and the other chair near their feet.
- Roll onto Their Side: Gently instruct or guide the person to roll onto their side. For example, “Let’s roll over like we’re taking a nap.”
- Get into a Kneeling Position: Help them push up from their side and onto their hands and knees. This is often the most physically demanding part for the person, so provide support but let them use their own strength as much as possible.
- Move to the First Chair: Once on their hands and knees, help them crawl or shuffle towards the chair that is near their feet. Position this chair directly in front of them.
- Use the Chair for Support: Have the person place their hands on the seat of the chair in front of them for stability.
- Bring One Leg Forward: Gently assist the person in bringing their strongest leg forward and placing their foot flat on the floor, so they are in a kneeling lunge position.
- Pivot and Sit: Place the second chair directly behind the person. Instruct them to use their arms and leg to push themselves up. As they rise, gently guide them to pivot and sit down on the chair behind them. Your role is to provide balance and guidance, not to lift their full weight.
Comparison of Fall Recovery Equipment
For caregivers who frequently assist with falls, or for those who are physically unable to perform the two-chair method, several assistive devices are available. Each has its own benefits and considerations.
| Equipment Type | How It Works | Best For | Considerations |
|---|---|---|---|
| Gait Belt | A sturdy belt worn around the person's waist, providing secure handholds for the caregiver to guide and stabilize movements. | Transfers, partial assistance, and controlled movements. | Requires the person to have some strength and be able to participate. Not for full lifts. |
| Inflatable Lift | A device that inflates to slowly lift the person from the floor to a seated position. | Fall recovery when the person is too heavy or has limited mobility. | Can be expensive and requires training to use correctly. |
| Portable Floor Lift | A mechanical lift designed specifically for lifting people from the floor. | Heavy individuals or those with very limited or no mobility. | More expensive and larger than other options. Some models are very compact and portable. |
Communication During and After the Fall
The psychological impact of a fall on a person with dementia can be significant. They may feel embarrassed, frustrated, or frightened, and these feelings can manifest as agitation. Be patient and empathetic. Avoid scolding or showing your frustration. After they are safely up, monitor them closely. Look for any changes in behavior or signs of increased pain.
Prevention is Key: Reducing the Risk of Future Falls
The best way to manage a fall is to prevent it from happening in the first place. Create a safer environment and manage underlying health issues.
Home Safety Measures
- Clear Clutter: Remove loose rugs, electrical cords, and other trip hazards.
- Improve Lighting: Ensure all areas, especially hallways, stairways, and bathrooms, are well-lit.
- Install Handrails and Grab Bars: Add these in hallways, stairways, and near the toilet and shower.
- Non-Slip Surfaces: Use non-slip mats in the bathroom and on other slippery floors.
- Sturdy Furniture: Ensure chairs and tables are stable and won't tip over if leaned on.
Medical and Lifestyle Interventions
- Medication Review: Speak to a doctor or pharmacist about medications that might cause dizziness or unsteadiness. The Alzheimer's Association provides excellent resources on managing dementia-related health concerns.
- Physical Therapy: A physical therapist can help improve balance, strength, and mobility.
- Appropriate Footwear: Encourage the use of sturdy, well-fitting shoes with non-slip soles.
Conclusion
A fall is a stressful event for everyone involved, but knowing the right steps can make a difference. By focusing on safety first, using the two-chair method for assistance, and exploring helpful equipment, caregivers can confidently handle this common challenge. Most importantly, proactive prevention strategies will reduce the frequency of falls, ensuring a safer and more comfortable environment for your loved one with dementia.
