Author: Swikruti Kar

When supporting someone living with dementia, wandering is one of the most common—and often misunderstood—behaviors you may encounter. At first glance, it can feel confusing or even concerning. But here’s something important to remember: wandering, like all behavior, is a form of communication.
Instead of focusing on the movement itself, try asking: What is this person telling me through their actions?

Some possible reasons behind wandering include:

• Searching for a friend, family member, or familiar place

• Feeling unsafe or insecure in their surroundings

• Wanting companionship and connection

• Releasing restlessness or boredom through movement

• Meeting basic needs like hunger, thirst, or using the restroom

• Experiencing pain or discomfort

• Believing the care center is their home and looking for familiar items

• Simply craving variety after being in the same environment too long

When Does Wandering in People with Dementia Become a Concern?

Wandering is not always negative—in fact, it often promotes mobility, provides exercise, and can reduce restlessness. But safety is key. It becomes a concern when:

• A person leaves the care setting (sometimes called elopement)

• They enter unsafe or restricted areas

• They disturb another resident’s personal space

That’s why caregivers play such an important role: encouraging safe movement while protecting the person’s well-being.

Rethinking the Term “Wanderer”

You may have heard someone described as a wanderer. While common, this label can feel limiting—and even disrespectful. In person-centered care, we avoid labels that reduce someone to a single behavior.

Why? Because labels can stop us from asking deeper questions:

• Who is this person looking for?

• What emotions or needs are they expressing?

• When and where does this behavior happen most often?

The truth is, wandering is rarely aimless. It is usually purposeful, even if we don’t immediately understand the purpose.

A More Respectful Approach

Since the terms wandering and wanderer are so widely used, it’s not always easy to remove them from our vocabulary completely. But whenever possible, try to reframe the behavior in a more positive and respectful way:

• Instead of “wanderer,” say “someone who enjoys walking around.”

• Instead of “wandering,” try “exploring” or “looking around.”

Shifting our words helps us shift our view, allowing us to see the individual beyond the behavior towards wandering in people with dementia.

Falls are one of the greatest risks faced by people living with dementia, but with the right awareness and strategies, many falls can be prevented. Caregivers, families, and healthcare providers can work together to create safe, supportive environments and routines. Here’s how you can apply what you’ve learned about minimizing falls.

Know the Person

Every individual with dementia has unique needs, habits, and preferences. Taking the time to understand the person is the foundation of fall prevention. Families and caregivers can start by asking questions such as:

• What is (or was) their daily routine?

• What medications are they taking?

• What is their toileting schedule?

• How do they sleep? Do they nap? Are they used to sharing a bed?

• What are their bathing preferences?

• How is their vision?

• What is their mobility like? Do they use a walker or need extra assistance?

• Will they remember to ask for help, use a walker, or wait until dizziness passes before moving?

• What type of clothing do they prefer?

• What triggers frustration or agitation?

• What helps calm them?

• Have they fallen before? If so, what happened?

• How was their room or living space arranged at home?

Understanding these details helps caregivers predict risks and build routines that make daily activities safer.

Safety in the Environment

Beyond knowing the person, creating a safe environment is key to reducing falls. Small changes can make a big difference. Consider these strategies:

• Encourage safe movement by creating open, easy-to-navigate spaces.

• Keep important items within easy reach.

• Provide sturdy, comfortable chairs that are simple to get in and out of.

• Use assistive devices, such as walkers, canes, or hip protectors.

• Position beds closer to the floor.

• Consider padded flooring for added protection.

• Ensure furniture wheels are locked.

• Add slip-resistant strips and grab bars in bathrooms.

• Remove trip hazards like loose rugs or clutter.

• Improve lighting throughout the home.

• Use clear signs with words and pictures to guide bathroom use.

• Place “rest stops” in hallways with sturdy chairs.

• Choose cleaning products that leave non-glare floors.

Responding Appropriately

Simple adjustments in caregiving can go a long way in preventing falls. For example:

• Improve lighting and reduce glare from shiny surfaces.

• Encourage the person to sit for a moment before standing to avoid dizziness.

• Gently remind them to use walkers or call for help when needed.

• Respond calmly when they are upset, and provide reassurance to reduce anxiety-driven movements.

Fall-Prevention Skills That Make a Difference

Falls happen as people get older because of physical changes. People with dementia are at increased risk of falls because of the changes that are also happening to their thinking abilities. There are many fall-prevention skills and ways that you can keep people with dementia safe and mobile by minimizing the chance of falls.
Remember:

• Learn about people with dementia. Find out about daily routines, if they have a history of falls, and about their family and work routine. All of this will help you understand them and their risk of falling.

• Pay attention to the environment. Watch for things that could cause someone to fall.

• Help people with dementia remain as active as possible. Active people are less likely to be injured due to a fall.

• Help families understand the risk of falls for people with dementia, whether their relative is at risk, and how to reduce falls.

The risk of falling is one of the greatest concerns for older adults, especially those living with dementia. A fall can lead to serious injury, loss of independence, and fear of moving around—making everyday life even more challenging. But here’s the good news: caregivers can play a powerful role in reducing these risks. The CARES® Approach, a widely used framework in dementia care, offers simple, practical steps that make fall prevention more effective and compassionate. By focusing on connection, observation, and collaboration, this approach helps caregivers keep their loved ones safe while respecting their dignity.

Let’s explore how each step of the CARES® Approach can help prevent falls in people living with dementia.

C – Connect with the Person

The first step, Connect with the Person, is all about building trust and understanding. Taking time to connect helps you recognize a person’s needs and moods more easily. It also makes it smoother to step in and prevent a fall when you notice an unsafe situation. Connection is the foundation of safety.

A – Assess Behavior

The second step, Assess Behavior, means closely watching and learning from the person’s actions. Look for patterns: When, where, and how do potential falls happen? Does someone often get unsteady after mealtimes? Do they try to stand up suddenly when there’s too much noise? By identifying these triggers, you can anticipate risks and create a safer environment.

R – Respond Appropriately

Next comes Respond Appropriately. Use what you’ve learned about each person’s habits and needs to act in the moment. For example, if you know someone tends to get restless at a certain time of day, you can stay nearby or offer support before a fall happens. Responding appropriately is about tailoring your care to each individual.

If a person with dementia is at risk for falling, ask your supervisor to have the person’s vision checked by an eye doctor at least once a year. Imagine how difficult it would be to walk up the stairs or through a busy dining area if your vision were blurry because your glasses are the wrong prescription. This is what people experience when their eyesight isn’t clear. As dementia gets worse, a person’s vision changes. Their field of vision may shrink, and they may have difficulty judging height and depth.

E – Evaluate What Works

The fourth step, Evaluate What Works, is about reflection. Ask yourself: What strategies are keeping this person steady? Which ones aren’t helping? By paying attention and adjusting your approach, you can find the most effective ways to reduce fall risks for each individual.

S – Share With Others

Finally, Share With Others closes the loop. Caregiving is a team effort, and sharing what you’ve learned with family, staff, or other caregivers ensures consistency in care. When everyone understands a person’s risks and what strategies work best, the chances of preventing falls increase dramatically.

Final Thoughts

The CARES® Approach isn’t just a checklist—it’s a way of thinking about care that keeps people living with dementia safe, supported, and respected. By connecting, observing, responding, evaluating, and sharing, caregivers can make a real difference in reducing falls and improving quality of life for people living with dementia.

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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.

As dementia progresses, fall risks rise—but the right skills can help. 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 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.

Get started today with 10% OFF any training or certification program. Use promo code BeautifulAugust at checkout before Aug 31, 2025.