Fall Prevention

Understanding Falls and Dementia

Falls are one of the most common and dangerous problems for people with dementia. Research shows that about 60% of people with dementia fall at least once each year, nearly 8 times more often than older adults without dementia. Falls can lead to serious injuries, loss of independence, and fear of falling again.

The good news is that many falls can be prevented with the right strategies.

Why Do People with Dementia Fall More Often?

Falls happen when several factors come together:

  • Changes in thinking and judgment make it harder to recognize dangers or plan movements safely.
  • Balance and walking problems develop as dementia affects the brain areas that control movement.
  • Vision problems make it difficult to see obstacles or judge distances.
  • Medications can cause dizziness, drowsiness, or low blood pressure make one more prone to falls.
  • Home hazards like loose rugs, poor lighting, or clutter become more dangerous when combined with memory and balance problems.
  • Depression and low activity levels can weaken muscles and reduce confidence.

What You Can Do: Proven Strategies to Prevent Falls

Stay Active with Exercise

Exercise is one of the most effective ways to prevent falls. The best programs include:

  • Balance and strength exercises done at least 3 times per week for 12 weeks or longer.
  • Tai Chi classes designed for older adults.
  • Physical therapy with a therapist who can create a personalized program.

Important: Caregivers should be involved in helping with exercise programs. A physical therapist can teach you both safe exercises to do at home.

Make Your Home Safer

Simple changes can make a big difference:

In the bathroom:

  • Install grab bars next to the toilet and in the shower or tub.
  • Use non-slip bathmats.
  • Make sure the bathroom is well-lit, especially at night.

On stairs and steps:

  • Add handrails on both sides.
  • Put bright, non-slip strips on step edges.
  • Ensure good lighting at the top and bottom.

Throughout the home:

  • Remove throw rugs or secure them with non-slip backing.
  • Clear walkways of clutter, electrical cords, and obstacles.
  • Improve lighting in hallways, stairways, and entrances.
  • Keep frequently used items within easy reach to avoid climbing.
  • Consider motion-sensor nightlights for nighttime safety.

Review Medications and Supplements

Some medications increase fall risk. Talk with your provider or pharmacist about:

  • All prescription, supplements, and over-the-counter medications.
  • Whether any medications cause dizziness, drowsiness, or low blood pressure.
  • Safer alternatives if needed.

Medications that commonly increase fall risk include sleeping pills, anxiety medications, antidepressants, and some blood pressure medications.

Address Vision Problems

  • Have eyes checked regularly.
  • Wear glasses as prescribed.
  • Ensure good lighting throughout the home.
  • Be extra careful when moving between areas with different lighting.

Manage Dizziness and Blood Pressure

Some people feel dizzy when standing up (called orthostatic hypotension). To reduce this:

  • Stand up slowly from sitting or lying down.
  • Sit on the edge of the bed for a moment before standing.
  • Stay well-hydrated.
  • Talk to your doctor if dizziness is frequent.

Wear Safe Footwear

  • Choose shoes with non-slip soles and good support.
  • Avoid walking in socks, slippers, or shoes with smooth soles.
  • Make sure shoes fit properly.

Stay Engaged and Active

  • Depression and inactivity increase fall risk.
  • Encourage daily activities and social engagement.
  • Talk to your doctor if you notice signs of depression.

What to Do If a Fall Happens?

  • Stay calm and check for injuries.
  • If injured or unable to get up safely, call for help.
  • Tell your provider about all falls, even if there’s no injury.
  • Keep a record of when and where falls happen to identify patterns.

Working with Your Healthcare Team

Your doctor or healthcare provider can:

  • Assess fall risk and identify specific problems.
  • Refer you to physical therapy for a personalized exercise program.
  • Review medications and make adjustments as needed.
  • Check for medical conditions that increase fall risk.
  • Connect you with community resources and support services.

Remember

Fall prevention works best when multiple strategies are used together. Caregivers play a crucial role in helping implement these strategies and supervising exercise programs. Don’t wait for a fall to happen. Start prevention today.

Home Safety

Why Home Safety Matters?

Dementia affects memory, judgment, and the ability to recognize dangers. As the disease progresses, everyday activities like cooking, bathing, and moving around the home can become risky. The good news is that with some planning and simple changes, the home can remain a safe and comfortable place to live.

Kitchen Safety:

The kitchen is one of the most dangerous rooms in the home for someone with dementia. Kitchen fires and burns are a recognized risk.

  • Never leave cooking unattended. If the person with dementia cooks alone, consider switching to a microwave or unplugging the stove when not in use.
  • Install an automatic stove shut-off device that turns off the burner after a set time.
  • Remove or lock away sharp knives, scissors, and other dangerous utensils.
  • Store cleaning products and chemicals in a locked cabinet. A person with dementia may mistake them for food or drinks.
  • Set the water heater to 120°F (49°C) or lower to prevent scalding.
  • Keep a fire extinguisher in the kitchen and make sure caregivers know how to use it.
  • Use unbreakable dishes and cups to prevent injuries from broken glass.

Bathroom Safety:

  • Install grab bars next to the toilet and inside the shower or tub.
  • Use a non-slip bathmat inside and outside the tub or shower.
  • Consider a shower chair or bath bench for seated bathing.
  • Remove locks on the bathroom door so the person cannot accidentally lock themselves in.
  • Keep medications, razors, and cleaning products locked away or out of reach.
  • Use nightlights to make nighttime bathroom trips safer.
  • Supervise bathing as needed. Never leave a person with moderate to severe dementia alone in the bath.

Wandering Prevention:

Up to 60% of people with dementia may wander, which can lead to becoming lost, exhaustion, falls, or exposure to weather.

  • Install door alarms or chimes that sound when exterior doors are opened.
  • Use deadbolt locks placed high or low on doors, out of the person’s line of sight.
  • Place “STOP” signs or full-length dark mats in front of exit doors, which may discourage the person from leaving.
  • Consider a GPS tracking device. Wearable bracelets, clip-on trackers, or smartphone-based trackers can help locate someone quickly if they do wander.
  • Enroll in a safe return program (such as the MedicAlert + Alzheimer’s Association Safe Return program), which provides an ID bracelet and a 24-hour emergency response line.
  • Keep a recent photo and physical description of the person readily available in case they go missing.
  • Maintain a consistent daily routine. Wandering is often triggered by boredom, restlessness, or searching for something familiar.
  • Secure the yard with fencing and locked gates if possible.

Fire and Emergency Safety:

  • Install smoke detectors and carbon monoxide detectors on every floor and test them monthly.
  • Remove or lock away matches, lighters, and candles.
  • Do not allow unsupervised smoking. Consider fireproof aprons or switching to non-combustible alternatives.
  • Keep a fire extinguisher accessible and ensure caregivers know how to use it.
  • Create and practice a simple fire escape plan.
  • Place emergency contact numbers in large print near every phone.
  • Consider a medical alert system (wearable button) for emergencies.

Medication Safety:

People with dementia may forget to take medications, take them more than once, or take the wrong ones.

  • Use a pill organizer or electronic pill dispenser that provides reminders and dispenses the correct dose at the right time.
  • Lock away all medications. Keep only the current dose accessible.
  • A caregiver should supervise all medication taking when possible.
  • Keep an updated medication list and share it with all healthcare providers.
  • Dispose of expired or unused medications safely.

Preventing Poisoning and Harmful Ingestion:

A person with dementia may not recognize what is safe to eat or drink.

  • Lock away household cleaners, pesticides, gasoline, paint, and other toxic substances.
  • Remove or lock up alcohol if it interacts with medications or if the person drinks excessively.
  • Store vitamins and supplements with other locked medications.
  • Remove artificial fruits, decorative soaps, or other items that could be mistaken for food.

Firearm and Weapon Safety:

  • Remove firearms, ammunition, and other weapons from the home or store them in a locked safe that the person with dementia cannot access.

Reducing Confusion:

Dementia makes it harder to process information. A calm, organized environment helps.

  • Keep the home well-organized and avoid rearranging furniture or belongings.
  • Use labels with words and pictures on drawers, cabinets, and doors (e.g., “Bathroom,” “Socks”).
  • Place clocks and calendars in visible locations to help with orientation.
  • Reduce background noise (turn off the TV when not watching) to minimize confusion.
  • Use contrasting colors to help the person see important items. For example, a dark toilet seat on a white toilet, or a brightly colored plate on a white table.
  • Cover or remove mirrors if they cause confusion or fear (some people with dementia do not recognize their own reflection).

Technology That Can Help:

Several devices can improve safety at home:

  • GPS trackers (wearable or clip-on) for locating someone who wanders.
  • Automatic stove shut-off devices to prevent kitchen fires.
  • Electronic pill dispensers with alarms for medication reminders.
  • Motion-sensor lights for nighttime safety.
  • Door and window alarms to alert caregivers.
  • Video monitors or baby monitors to check on the person from another room.
  • Medical alert systems (wearable buttons) for emergencies.

Tips for Caregivers:

  • Make sure to do a home safety walk-through at least every few months. Safety needs change as dementia progresses.
  • Ask your provider for a referral to an occupational therapist who can do a professional home safety assessment.
  • Take care of yourself. Caregiver burnout is common and can affect the safety of both you and the person you care for.
  • Connect with support resources such as the Alzheimer’s Association (1-800-272-3900) or local caregiver support groups.
  • Plan ahead for advance directives and legal matters while the person can still participate in decisions.

When to Reassess Living Arrangements

It may be time to consider additional help or a care facility if:

  • Falls or injuries are happening frequently despite safety measures.
  • Wandering cannot be managed safely at home.
  • The person needs 24-hour supervision.
  • Caregiver health or well-being is seriously affected.

Talk with your healthcare team about options. There is no shame in asking for more help.

Remember

Home safety is not a one-time task. As dementia progresses, new risks will appear and new solutions will be needed. Regular check-ins with your healthcare team, an occupational therapist, and community resources can help keep the home safe and comfortable for as long as possible.

References

Effectiveness of a Home-Based Missing Incident Prevention Program for Community-Dwelling Elderly Patients With Dementia.
International Psychogeriatrics. 2019. Lau WM, Chan TY, Szeto SL.

Fall Prevention Interventions for Cognitively Impaired Older Adults: A Systematic Literature Review and Meta-Analysis.
Western Journal of Nursing Research. 2025. Choi H, Tak SH, Lee D.

Interventions for Preventing Falls in Older People in Care Facilities.
The Cochrane Database of Systematic Reviews. 2025. Dyer SM, Kwok WS, Suen J, et al.

Environmental Interventions for Preventing Falls in Older People Living in the Community.
The Cochrane Database of Systematic Reviews. 2023. Clemson L, Stark S, Pighills AC, et al.

Risk Assessment and Prevention of Falls in Older Community-Dwelling Adults: A Systematic Review.
The Journal of the American Medical Association. 2024. Colón-Emeric CS, McDermott CL, Lee DS, Berry SD.

Living With an Aging Parent: “It Was a Beautiful Invitation.”
The Journal of the American Medical Association. 2011. Ritchie CS, Roth DL, Allman RM.

Diagnosis and Management of Dementia: Review.
The Journal of the American Medical Association. 2019. Arvanitakis Z, Shah RC, Bennett DA.