Author: Swikruti Kar

Falls remain one of the biggest risks for older adults, particularly those living with dementia. In an attempt to keep loved ones safe, caregivers often limit independent walking—relying on wheelchairs or prolonged sitting. While this may feel protective in the short term, too much sitting can actually raise the risk of falls. Why? Because inactivity weakens the legs, reduces mobility, and makes injuries more likely. So let’s know more on why to encourage daily movement in people with dementia.

Why Movement Matters

For people with dementia, movement is more than physical activity—it’s a foundation for overall well-being. Even small amounts of exercise can bring significant benefits, such as:

• Strengthening muscles and joints – Regular activity preserves muscle mass and supports mobility.

• Boosting appetite – Movement encourages the body’s need for nourishment, leading to healthier eating habits.

• Improving mood and brain health – Physical activity naturally increases serotonin levels, supporting a better mental state.

• Slowing dementia progression – Staying active not only strengthens the body but also helps keep the mind more engaged.

Without strong legs, walking safely becomes harder, increasing the likelihood of falls. Prioritizing mobility is one of the most effective ways caregivers can protect both safety and quality of life.

Simple Ways to Keep People Moving

Supporting movement in dementia care doesn’t require complicated exercise programs. The simplest activities often have the biggest impact:

• Walking – Even a short daily walk supports both physical strength and mental stimulation.

• Sit-to-stand practice – Encouraging individuals to rise from a chair without assistance builds leg strength and balance.

The focus should be on consistency, not intensity. Small, daily movements help maintain strength, slow muscle loss, and lower fall risks.

Keeping the Mind and Body Engaged

The guiding principle for dementia care is simple: keep moving, keep active, keep the mind stimulated. Exercise strengthens more than the body—it fosters dignity, independence, and a sense of purpose. Strong legs provide stability, and stability helps prevent falls.

Encourage Daily Movement

Whenever it’s safe and appropriate, look for opportunities to include gentle strengthening exercises throughout the day. Simple changes, like replacing a wheelchair ride with a walk to meals or activities, can make a meaningful difference. These small habits maintain strength, balance, and independence.

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Falls are one of the leading causes of injury among older adults, and when it comes to dementia and fall risks, the chances are even higher due to health, environmental, and behavioral factors. Recognizing and addressing the factors that contribute to falls is essential in creating a safe environment and ensuring better quality of life.

Common Factors That Increase Fall Risk

Several factors can increase the likelihood of falls among older adults:

• Recent illness or weakness: Recovery from illness often leaves muscles weak, making balance and mobility harder.

• New medications: Some medicines can cause drowsiness or sudden changes in blood pressure, increasing the risk of falling.

• Vision problems: Poor eyesight reduces awareness of obstacles and hazards.

• Clutter: Items left around the home can become tripping hazards.

• History of falls: Individuals who have fallen before are at greater risk of falling again.

Dementia and Fall Risks

Older adults with dementia face additional challenges that heighten fall risks. They may:

• Be unfamiliar with a new care setting.

• Wander without awareness of their surroundings.

• Wear ill-fitting clothes or unsafe footwear.

• Experience exhaustion or physical tiredness.

• Have blood pressure drops when moving from sitting to standing.

• Struggle with poor balance, walking, or getting up from a chair.

• Take multiple medications that may interact.

Health-Related Factors

Underlying health conditions can also contribute to fall risks, such as:

• Increased confusion, agitation, or restlessness.

• Foot swelling due to edema.

• Diabetes and neuropathies causing loss of sensation.

• Anxiety or restlessness.

• Urgency from incontinence, leading to rushing to the bathroom.

Environmental Hazards

The living environment plays a major role in fall prevention and the common hazards include:

• Bedside rails and restraints, including alarms, which can cause tripping.

• Lack of stable furniture or handrails.

• Uneven, slippery, or glaring floors.

• Poor lighting in hallways and rooms.

• Weather-related risks like slippery surfaces or glare from sunlight.

• Poorly equipped bathrooms without grab bars or non-slip mats.

Nighttime Risks

Falls are particularly common at night due to:

• Sleepiness or disorientation when trying to find the bathroom.

• Dim or inadequate lighting.

• The urgency to toilet quickly.

• Walking barefoot or in socks without proper footwear.

• Not wearing glasses, hearing aids, or assistive devices.

Medicine Review

Medications are one of the biggest hidden contributors to falls. Both prescription and over-the-counter drugs can have side effects that impair balance or alertness. It is vital to ask a nurse, doctor, or pharmacist to review medications regularly to minimize risks.

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As Alzheimer’s disease progresses, the risk of falling changes dramatically. While aging alone makes falls more likely, dementia adds unique challenges that evolve with each stage of the disease. Understanding how these risks shift can help families and caregivers create safer environments and provide the right level of support.

Normal Thinking (No Dementia)

Even without dementia, age-related changes in the body—like weaker muscles, slower reflexes, or vision problems—make falls more common in older adults. At this stage, fall risk is largely related to the natural aging process.

Early-Stage Alzheimer’s

During the early stage, most people’s thinking and physical abilities are still quite strong. The risk of falling is only slightly higher than for others of the same age without dementia. However, it’s important to remember that subtle changes in memory, focus, or decision-making may start to appear, and these can eventually affect balance and movement.

Middle Stage Alzheimer’s

This is the stage where fall risks begin to increase more noticeably. Changes in perception and judgment make everyday situations harder to navigate. For example:

• A dark rug on the floor might be mistaken for a hole.

• A person may struggle to lift their foot high enough for a step.

• They might move impulsively—walking too quickly in a crowded hallway without adjusting their speed.

Physical challenges also become more pronounced. People may lose the ability to adapt their movements in response to their surroundings. Families should begin preparing for more frequent safety concerns at this stage, since understanding what’s coming can make it easier to adapt and provide support.

Late-Stage Alzheimer’s

Fall risk in the late stage is more complex and depends on mobility, balance, medications, and pain levels.

• Balance: If the person is still mobile, poor coordination becomes a serious issue. They may begin walking normally but be unable to recover if they lose balance, leading to falls. Obstacle awareness also declines, so keeping walkways clear is crucial.

• Mobility: As mobility decreases, people may try to stand or walk but struggle to control their movements, often resulting in falls.

• Bed Bound: In the final phase, when a person is largely confined to bed, fall risk is minimal—but not gone. There is still a chance of rolling or sliding out of bed.

Supporting Safety at Every Stage to Reduce the Risk of Falling

Falls can be frightening for both individuals with Alzheimer’s and their families. While the risks change over time, there are steps caregivers can take at every stage:

• Keep living spaces uncluttered and well-lit.

• Encourage safe movement and mobility exercises where possible.

• Use supportive equipment such as grab bars, walkers, or bed rails when appropriate.

• Maintain open conversations with healthcare providers about fall prevention strategies.

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Falls are a major concern for people living with dementia. Because changes in memory, perception, mobility, and overall health increase fall risks, it is vital for care teams to use structured assessments to identify risks early and prevent incidents. One of the most effective tools is a Falls Assessment, which helps caregivers monitor and understand the many factors that contribute to falls.

When Should a Falls Assessment Be Done?

A Falls Assessment should be conducted at key times, including:

• When a person is admitted as a new resident in a long-term care center

• After any change in condition (physical health, functional ability, or cognitive ability)

• Following hospitalization and return to the residence

• With changes in mobility

• With changes in continence, toileting, or elimination

Typically, a nurse completes the formal falls evaluation form, but every staff member should be familiar with it. Since caregivers and aides are often the first to notice changes, understanding the form helps ensure no signs go unnoticed.

Key Elements of a Falls Evaluation Form

1. Reason for the Assessment

It’s important to document the reason for the assessment—whether it’s a new admission, a change in condition, or post-hospitalization.

2. Date of Admission

Record not just the admission date but also whether the individual is being re-admitted after a hospital stay.

3. History of Falling (Past Six Months)

Patterns of falling provide valuable insight into future risk. Knowing when and how falls occurred can help prevent them.

4. Current Medications

Some medications—or combinations—can increase fall risk by causing dizziness, weakness, or confusion. Staff should monitor closely when a new medication is prescribed.

5. Memory/Recall Ability

People with dementia may forget that they need assistance, or forget to use walkers or canes, increasing fall risk.

6. Visual Ability or Perception Changes

Poor vision can make it difficult to avoid obstacles, navigate steps, or move safely in dim lighting.

7. Incontinence

Rushing to the toilet increases fall risk. Monitoring continence helps in planning safe support.

8. Behavioral Symptoms

Behaviors such as distress, wandering, or agitation can increase fall risks and should be noted.

9. Changes in Mobility

Any reduction in walking ability, transfers, or physical independence must be assessed to adjust support levels.

10. Blood Pressure

Sudden drops in blood pressure while standing up can cause dizziness, leading to falls.

11. Functional Gait Analysis

Observing how a person walks—whether they shuffle, sway, or lurch—helps identify the need for mobility aids or added supervision.

Final Thoughts

Falls can have serious consequences for people with dementia, but structured assessments and continuous observation can significantly reduce risks. Every member of the care team—nurses, aides, and support staff—plays a vital role. By staying alert, understanding assessment tools, and working together, care teams can help keep residents safer, more comfortable, and better supported in their daily lives.

Beyond the Falls Assessment: Continuous Evaluation

Assessment in dementia care should go beyond forms. The CARES® Approach emphasizes ongoing, in-the-moment assessment, which complements structured evaluations like the falls form. Continuous monitoring should include:

• Cognitive health

• Physical health

• Physical functioning

• Safety needs

• Behavioral status

• Sensory capabilities

• Decision-making capacity

• Communication abilities

• Cultural preferences

• Spiritual needs and preferences

Falls put older adults with dementia at serious risk, but proactive assessment and training can make all the difference. Enhance your caregiving skills with CARES® training and certification—now available at 10% off with promo code LaborDaySavings—offer ends September 30, 2025.

Falls are one of the most common and concerning risks for people living with dementia. While occasional falls may happen to anyone, in dementia care the risk is significantly higher—and often linked to both the person’s changing abilities and the environment around them. So, in dementia care, familiarity and safety help reduce falls and support confident movement. Let us learn more about this.

Why People with Dementia Are at Higher Risk

When someone has dementia, the brain struggles to communicate with the body and this can affect balance, coordination, and the ability to judge distances or navigate around objects. Combined with the normal changes that come with aging—like weaker muscles, slower reflexes, and poorer vision—these challenges make falls more likely.

As dementia progresses, falls often occur when:

• Getting out of bed

• Moving from bed to chair

• Walking around the home or care setting

Environmental Triggers That Lead to Falls

Many falls are caused not just by physical decline but by hazards in the environment. Common risks include:

• Loose rugs or carpets

• Slippery or uneven floors

• Floor mats that catch the feet

• Poor lighting

• Cluttered hallways

• Low furniture in walking paths

• Exposed cords

• Poor-fitting shoes

• Lack of proper bathroom grab bars (towel bars are not safe substitutes!)

These hazards can confuse or trip someone with dementia, especially when perception and balance are already compromised.

Familiarity and Safety in Fall Prevention

People with dementia depend on familiar surroundings and routines to navigate safely. Sudden changes in living space can cause confusion and increase fall risk.

Make their new living space feel like home by:

• Arranging furniture in a similar layout to their previous home.

• Keeping familiar objects, photos, and personal belongings visible.

Familiarity provides comfort, boosts confidence in movement, and reduces disorientation. While age-related muscle weakness or cognitive decline may be hard to reverse, environmental safety is within your control.

To make the space safer:

• Remove trip hazards such as loose rugs, cords, and clutter.

• Improve lighting in all walking areas.

• Install proper grab bars, especially in bathrooms.

• Support mobility with regular exercise, physiotherapy, or assistive devices.

A familiar, well-organized, and hazard-free environment can make all the difference in keeping people with dementia safe. By focusing on what you can change, you not only reduce the risk of falls but also create a space where they can move with comfort, confidence, and dignity.

Falls are a major concern for older adults with dementia, but with the right strategies, you can lower risks and protect their independence. Save 10% on any CARES® training or certification with promo code LaborDaySavings—offer ends September 30, 2025.

Falls are one of the leading causes of injury in older adults—and they’re not just “accidents.” As we age, our bodies go through changes that, while natural, can increase the risk of falling. Understanding these changes is the first step towards effective fall prevention and protecting your independence.

Common Age-Related Factors That Increase Fall Risk

1. Vision Changes Affect Balance
With age, our eyes adapt more slowly when moving between bright and dim lighting. This can make it harder to see clearly during nighttime bathroom trips or when entering darker rooms. Increased glare sensitivity, a reduced field of vision, and changes in depth perception may cause us to misjudge distances—like mistaking a floor pattern for an obstacle and tripping over it.

2. Joint Pain and Arthritis Limit Mobility
Arthritis and other joint problems can change the way we walk, making movements less stable. Stiffness and pain often cause shorter steps or uneven gait, increasing the likelihood of stumbling.

3. Reflexes Slow Down Over Time
Reflexes are our body’s quick-response system—but they slow with age. A younger person might quickly recover from catching their toe on a step, but older adults often cannot react fast enough to prevent a fall.

4. Muscle Strength Declines
Loss of muscle mass, especially in the legs, affects balance and coordination. Weak muscles make it harder to correct a misstep or maintain stability on uneven surfaces.

5. Footwear Matters More Than You Think
Poorly fitting shoes, oversized slippers, or walking in socks can turn a stable surface into a slipping hazard. Choosing supportive, non-slip footwear is an easy way to reduce fall risk.

6. Home Hazards Can Be Dangerous
Wet floors, clutter, and uneven flooring are common causes of elderly falls. Even small spills or misplaced objects can cause serious accidents for someone with slower reflexes or balance issues.

While aging brings inevitable changes, falls don’t have to be part of the process. By making simple lifestyle adjustments and creating a safer environment, you can protect your mobility, confidence, and independence well into your later years.

Falls are a leading concern for older adults with dementia, but the right knowledge can make a world of difference. With patience, proactive care, and proven strategies, you can reduce risks and protect your loved one’s independence.

Conclusion

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We know that something as simple as walking can become a daily challenge for individuals living with dementia. While many of us take walking for granted, it’s actually a complex process that requires the brain, muscles, and nerves to work together in perfect coordination.
And it’s important to remember—walking is not something we’re born knowing how to do. It’s a learned skill that takes time, practice, and healthy brain function to master.

The Brain-Body Connection

Every step starts with a signal from the brain. This signal travels down the spinal cord, through the hips, and into the leg muscles. As the leg moves, messages return to the brain confirming the action. Then, the brain sends the next signal to keep the body moving forward.
This continuous, two-way communication is what makes walking seem so effortless—until something disrupts it.

Movement Goes Beyond Just Walking

The same system that helps us walk also allows us to sit, turn, or safely move from a bed to a chair. The brain must constantly interpret signals from across the body to maintain posture and balance. It needs to know where the body is in space and where it’s trying to go.

When the System Fails

In people living with dementia, this communication system can be impaired. The brain may struggle to process signals correctly or respond quickly enough. As caregivers, we often see the effects: unsteady movements, loss of coordination, hesitation, and falls.
These aren’t just physical risks—they can also reduce confidence and independence, increasing fear of movement and the likelihood of future falls.

Supporting Safe Mobility with Person-Centered Care

Our approach to dementia care includes a deep understanding of how the brain and body work together. We use person-centered care principles, including the CARES® Approach, to ensure every resident receives thoughtful, supportive assistance that encourages safe movement and preserves dignity.

By recognizing the challenges behind every step, we help our residents move with greater confidence—and help families feel reassured that their loved ones are in good hands.

Older adults with dementia face a higher risk of falls—but you can help prevent them. Learn how to identify hazards, respond quickly, and create a safer environment with the CARES® Approach.

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Falls are among the most common and serious safety concerns in elder care and assisted living settings. Understanding what qualifies as a fall—and how to prevent them—can make a significant difference in protecting your residents or loved ones.

What Is Considered a Fall?

Falls aren’t always dramatic or obvious. In fact, a fall is defined as any unintentional movement to the ground or a lower surface, such as a chair or bed. While falling from a standing position is the most recognized scenario, there are many less apparent situations that also qualify.

For example:

• Sliding out of a chair unintentionally

• Losing balance and being caught by someone before hitting the ground

Even near-falls—where the person doesn’t actually land on the floor—are still categorized as falls and should be taken seriously.

Why Falls Matter

Not every fall results in injury, but the risks can be significant. Common outcomes include:

• Cuts and skin tears

• Bruising

• Broken bones

• Head injuries or concussions

• A lingering fear of falling, which can reduce mobility and independence

• In severe cases, death

For seniors especially, a single fall can trigger a chain reaction of complications affecting physical health, emotional well-being, and overall quality of life.

Responding to a Fall

When a fall occurs, prompt recognition and appropriate action are key. Caregivers and staff should:

• Assess the situation carefully: Has the person been injured?

• Determine the cause: Was it a slippery floor, poor lighting, or a medical issue?

• Document the incident clearly and report it according to protocol

• Take preventive measures to reduce the risk of repeat incidents

Preventing Falls Before They Happen

While not all falls are avoidable, many can be prevented with proactive safety measures. Technology such as smart visual monitoring and fall detection systems can help staff intervene faster and reduce risks—without requiring extra manpower.

The goal is not only to respond when falls occur but to create a safer environment where the likelihood of falls is minimized from the start.

Preventing falls is a vital part of person-centered care and methods like the CARES® Approach helps caregivers respond with empathy, safety, and respect.

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Pain is a deeply personal experience, and for people living with dementia, it can be especially challenging to communicate. As caregivers, loved ones, or healthcare professionals, it’s important to be attentive to the signs of discomfort—both verbal and nonverbal—and to take gentle, thoughtful steps to ease their suffering. This blog will guide you through recognizing pain symptoms in people with dementia and offer simple, compassionate ways to help them feel more comfortable.

Recognizing Pain When Words Fail

People with dementia may not always be able to say, “I’m hurting.” But their behavior often speaks volumes. Pain can show up in many subtle and not-so-subtle ways. Here are some signs to watch for:

Verbal Symptoms:

• Sighing, moaning, or groaning

• Crying or yelling

• New or repetitive swearing

• Saying “ouch” or other expressions of distress

Physical or Behavioral Symptoms:

• Grimacing or clenching teeth

• Guarding a specific body part

• Agitation, pacing, or wandering

• Increased confusion

• Resistance to care, even lashing out

• Rigid posture or slow movement

• Noisy breathing or changes in vital signs

• Withdrawal or depression

• Trouble sleeping

• Excessive sweating

• Noticeable changes in weight

It’s important to remember: these signs don’t always mean the person is in pain. But when you know them well, and you notice changes in how they behave, you’re in a better position to understand what they may be feeling.

Simple Ways to Comfort and Connect

Fortunately, easing discomfort doesn’t always require medication. In fact, small gestures of comfort—rooted in care and familiarity—can go a long way.

Here are a few ways you can help relieve pain and promote a sense of peace:

• Offer a warm (not too hot) cup of tea – A soothing routine and a comforting beverage can do wonders.

• Sing with them – Music taps into memory and emotion, often calming and uplifting at once.

• Comb their hair – A simple act of grooming can bring calm and connection.

• Play soft, familiar music – Music from their past can help them relax and feel safe.

• Move them gently to bed – If they seem restless or tired, help them get more comfortable.

• Offer a gentle hand massage – Touch can be reassuring, especially with warm hands and calm energy.

• Wrap them in a warm blanket – This helps both physically and emotionally, providing a sense of safety.

• Use scented lotions or oils – Calming scents like lavender can distract and soothe.

• Encourage light physical activity – A short walk or light stretching can release tension.

• Talk about happy memories – Reminiscing can reduce anxiety and shift focus from discomfort.

The Power of Personalization

No two people with dementia are the same. What comforts one may irritate another. That’s why it’s so important to think about who they are as a person. What did they enjoy before dementia? What soothes them now? What routines do they still recognize?

Whether it’s gardening, holding hands, listening to jazz, or watching birds out the window—let their preferences guide your actions. Knowing their history and personality is one of the most powerful tools you have in easing their pain.

Caring for someone with dementia calls for patience, meaningful connection, and the right techniques. As you continue learning how to recognize and ease pain, you can take your skills further with the CARES® Approach.

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In dementia, not all pain relief needs to come from medication; it can also be eased through everyday activities. These approaches are often called non-drug or nonpharmacologic therapies, and they can bring real comfort and a deeper sense of connection to people with dementia. While these activities don’t slow down the progression, they can help someone feel calmer, more engaged, and easier to support.

Some helpful activities include:

• Listening to music or playing an instrument

• Gardening or spending time with nature

• Doing word games or puzzles

• Cooking or baking together

• Looking through photos or other familiar items

• Interacting with pets, birds, or other animals

• Offering gentle touch like a respectful light massage, a warm hug, holding hands, stroking the shoulder, or rubbing the back.

These types of nonpharmacologic therapies can be deeply meaningful. They don’t just provide pain relief without medication—they offer moments of connection, comfort, and joy. Every person is different, so it helps to notice what feels soothing or familiar to them.

Though not a substitute for medicine, nonpharmacologic therapies can make daily life more peaceful for both the individual and those offering care. This gentle form of non-medical dementia support reminds us that simple moments often bring the greatest ease—and that comfort for people with dementia can come in many heartfelt forms.

Caring for someone with dementia goes beyond medication—simple, familiar activities can bring real comfort. From music to shared moments, nonpharmacologic therapies help ease pain and create connection in everyday life.

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