{"id":725906,"date":"2026-06-26T18:24:30","date_gmt":"2026-06-26T16:24:30","guid":{"rendered":"https:\/\/www.dynseo.com\/chutes-et-demence-adapter-la-prevention-aux-residents-alzheimer-en-ehpad-dynseo-2\/"},"modified":"2026-06-26T18:25:45","modified_gmt":"2026-06-26T16:25:45","slug":"falls-and-dementia-adapting-prevention-for-alzheimer-residents-in-nursing-homes-dynseo","status":"publish","type":"post","link":"https:\/\/www.dynseo.com\/en\/falls-and-dementia-adapting-prevention-for-alzheimer-residents-in-nursing-homes-dynseo\/","title":{"rendered":"Falls and Dementia: Adapting Prevention for Alzheimer Residents in Nursing Homes | DYNSEO"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;Article HTML&#8221; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;0px||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row admin_label=&#8221;Contenu&#8221; _builder_version=&#8221;4.16&#8243; width=&#8221;100%&#8221; 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{padding:30px 20px;}\n.dbi-art-99931d .cta-box .cta-buttons {flex-direction:column;max-width:260px;margin:0 auto;}\n.dbi-art-99931d .btn-cta-white, .dbi-art-99931d .btn-cta-outline {width:100%;text-align:center;}\n.dbi-art-99931d .internal-link {flex-direction:column;text-align:center;gap:12px;}\n}<\/p>\n<\/style>\n<p><script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"Article\",\"headline\":\"Chutes et d\u00e9mence : adapter la pr\u00e9vention aux r\u00e9sidents Alzheimer en EHPAD\",\"description\":\"Guide pratique sur la pr\u00e9vention des chutes chez les r\u00e9sidents d\u00e9ments \u2014 m\u00e9canismes sp\u00e9cifiques, environnement, approche non verbale, d\u00e9ambulation, contention, r\u00f4le des familles.\",\"author\":{\"@type\":\"Organization\",\"name\":\"DYNSEO\",\"url\":\"https:\/\/www.dynseo.com\"},\"publisher\":{\"@type\":\"Organization\",\"name\":\"DYNSEO\"},\"datePublished\":\"2026-03-06\",\"dateModified\":\"2026-03-06\"}<\/script><\/p>\n<div class=\"dbi-art-99931d\">\n<header class=\"article-hero\">\n<div class=\"article-hero-inner\">\n<nav class=\"article-breadcrumb\">\n      <a href=\"https:\/\/www.dynseo.com\/en\/\">Home<\/a> &rsaquo;<br \/>\n      <a href=\"https:\/\/www.dynseo.com\/en\/healthcare-professionals\/\">Professionals<\/a> &rsaquo;<br \/>\n      Falls and dementia Nursing home<br \/>\n    <\/nav>\n<p>    <span class=\"article-category\">\ud83e\uddba FALL PREVENTION<\/span><\/p>\n<h1>Falls and dementia: <span class=\"hl\">adapting prevention<\/span> for Alzheimer&#8217;s residents in Nursing home<\/h1>\n<div class=\"article-meta\">\n      <span>\ud83d\udcc5 March 2026<\/span><br \/>\n      <span>\u23f1 18 min read<\/span><br \/>\n      <span>\ud83e\uddd1\u200d\u2695\ufe0f By the DYNSEO team<\/span>\n    <\/div>\n<\/p><\/div>\n<div class=\"article-hero-curve\"><\/div>\n<\/header>\n<div class=\"container\">\n<article class=\"article-body\">\n<div class=\"toc\">\n<h4>\ud83d\udccb Table of contents<\/h4>\n<ol>\n<li><a href=\"#risque-multiplie\">A fall risk multiplied by 2 to 3<\/a><\/li>\n<li><a href=\"#mecanismes\">Why dementia significantly increases the risk of falling<\/a><\/li>\n<li><a href=\"#detection\">Detecting risk in residents with dementia<\/a><\/li>\n<li><a href=\"#prevention-environnement\">Securing the environment for residents with dementia<\/a><\/li>\n<li><a href=\"#approche-non-verbale\">The non-verbal approach: what works when words are no longer enough<\/a><\/li>\n<li><a href=\"#deambulation\">Wandering: between risk and necessity<\/a><\/li>\n<li><a href=\"#agitation\">Agitation, impulsivity, and falls<\/a><\/li>\n<li><a href=\"#contention\">Restraint: a false solution<\/a><\/li>\n<li><a href=\"#exercice-demence\">Physical exercise for residents with dementia<\/a><\/li>\n<li><a href=\"#famille-demence\">Supporting families in prevention<\/a><\/li>\n<\/ol>\n<\/div>\n<pee>Residents with Alzheimer&#8217;s disease or another form of dementia fall 2 to 3 times more often than residents without cognitive disorders. They are also more likely not to call for help after a fall, to be unable to describe what happened, and to not understand or remember the safety instructions given to them. Fall prevention for demented individuals cannot be the same as for other residents \u2014 it must be thought out differently, tailored to the specifics of dementia, and rely more on the environment and human presence than on the resident&#8217;s compliance.<\/pee>\n<h2 id=\"risque-multiplie\">1. A fall risk multiplied by 2 to 3<\/h2>\n<pee>This figure \u2014 two to three times more falls \u2014 deserves attention. It means that in a Nursing home where the average is 1.5 falls per resident per year, a demented resident may experience 3 to 5. And each of these falls exposes them to fractures, hospitalization, additional loss of autonomy, and worsening cognitive disorders due to the stress and disorientation that hospitalization entails.<\/pee>\n<pee>Understanding why this risk is so high \u2014 and not just accepting it as a fatality \u2014 is essential for building effective and tailored prevention.<\/pee>\n<h2 id=\"mecanismes\">2. Why dementia significantly increases the risk of falling<\/h2>\n<div class=\"mecanisme-grid\">\n<div class=\"mecanisme-card\">\n<h4>\ud83e\udde0 Impairment of judgment and risk awareness<\/h4>\n<pee>The demented person no longer perceives dangerous situations as such. They get up without assistance when they cannot stand alone. They cross obstacles without seeing them. They forget that they need to call for help before getting up.<\/pee>\n  <\/div>\n<div class=\"mecanisme-card\">\n<h4>\ud83d\udeb6 Gait disorders related to brain lesions<\/h4>\n<pee>Dementia directly alters gait \u2014 not small steps, wide gait, hesitations, freezing (sudden stopping of walking) particularly in Parkinson&#8217;s dementia. These disorders are independent of muscle strength.<\/pee>\n  <\/div>\n<div class=\"mecanisme-card\">\n<h4>\ud83d\udc8a Psychotropic medications<\/h4>\n<pee>Demented residents often receive antipsychotics, anxiolytics, or antidepressants to manage behavioral disorders \u2014 medications that all increase the risk of falling.<\/pee>\n  <\/div>\n<div class=\"mecanisme-card\">\n<h4>\ud83c\udf19 Nocturnal wandering and confusion<\/h4>\n<pee>The inversion of the night\/day rhythm, common in advanced dementias, drives residents to wander at night in a poorly secured environment and without sufficient supervision.<\/pee>\n  <\/div>\n<div class=\"mecanisme-card\">\n<h4>\ud83e\uddaf Inability to use technical aids<\/h4>\n<pee>The demented resident forgets to use their cane, walker, or bell. Even when trained, they do not remember the instruction. Conventional technical aids assume compliance that dementia makes impossible to maintain.<\/pee>\n  <\/div>\n<div class=\"mecanisme-card\">\n<h4>\u26a1 Impulsivity and risky behaviors<\/h4>\n<pee>Some demented residents exhibit increased impulsivity \u2014 they get up suddenly, react to internal stimuli (pain, agitation, hallucinations) without adaptation time, take risks without measuring the consequences.<\/pee>\n  <\/div>\n<\/div>\n<h2 id=\"detection\">3. Detecting risk in residents with dementia<\/h2>\n<pee>The standardized assessment of fall risk (Morse, Tinetti) remains useful for residents with dementia \u2014 but it must be complemented by careful observation of behaviors specific to dementia. Certain behavioral signals are short-term fall predictors that nearby caregivers are best positioned to identify.<\/pee>\n<div class=\"soft-box\">\n  <pee><strong>Behavioral signals preceding falls in residents with dementia:<\/strong> Sudden increase in agitation or wandering. Repeated attempts to get up alone despite demonstrated inability. Unexplained abandonment of normally used technical aids. Atypical complaints (pain, discomfort) that the resident cannot precisely locate. Changes in wandering habits (new frequency, new route). Signs of urinary infection (increased confusion, agitation) \u2014 the primary triggering factor for falls in demented residents. These observations must be immediately communicated to the nurse.<\/pee>\n<\/div>\n<h2 id=\"prevention-environnement\">4. Securing the environment for residents with dementia<\/h2>\n<pee>For residents with dementia, securing the environment is even more important than for other residents \u2014 because one cannot rely on their compliance with verbal instructions. The environment must be secured <em>by itself<\/em>, without the resident having to remember anything.<\/pee>\n<div class=\"key-points\">\n<h3>\u2726 Specific layout principles for residents with dementia<\/h3>\n<ul>\n<li><strong>Contrasting visual cues<\/strong> \u2014 signal the edge of the bed, the entrance to the bathroom, obstacles with color contrasts that even a disoriented person can perceive<\/li>\n<li><strong>Simplified environment<\/strong> \u2014 minimize objects on the floor and obstacles; the demented resident cannot anticipate or avoid them<\/li>\n<li><strong>Stable, non-wheeled furniture<\/strong> \u2014 anything that can serve as support must be able to bear the resident&#8217;s weight without moving<\/li>\n<li><strong>Bed exit sensors<\/strong> \u2014 alert the team as soon as the resident leaves their bed, allowing for preventive intervention before a fall<\/li>\n<li><strong>Soft permanent lighting<\/strong> at night \u2014 demented residents do not think to turn on lights; automatic or permanent lighting is essential<\/li>\n<li><strong>Securing high-risk areas<\/strong> \u2014 limited access to stairs, clear signage of dangerous areas with understandable cues even for a disoriented person<\/li>\n<\/ul>\n<\/div>\n<h2 id=\"approche-non-verbale\">5. The non-verbal approach: what works when words are no longer enough<\/h2>\n<pee>In the advanced stages of dementia, verbal safety instructions are no longer remembered or followed. What remains accessible is emotion, relationship, physical presence \u2014 and adapted communication methods such as the Montessori approach or the Humanitude method.<\/pee>\n<div class=\"strategie-card\">\n<h4>\ud83e\udd1d Contact and physical presence<\/h4>\n<pee>A hand gently placed on the shoulder, maintained eye contact, a calm and slow voice \u2014 these relational signals can be enough to slow down a resident who is about to get up impulsively, while a caregiver helps them do so safely. Human presence remains the primary technical aid.<\/pee>\n<\/div>\n<div class=\"strategie-card\">\n<h4>\ud83c\udfb5 Music and sensory cues<\/h4>\n<pee>Familiar and loved music can reduce agitation and anxious wandering \u2014 two precursors to falls. Olfactory cues (lavender, familiar perfume) in the room can help some demented residents feel safer and less inclined to wander.<\/pee>\n<\/div>\n<div class=\"strategie-card\">\n<h4>\ud83d\udccb Routine and predictability<\/h4>\n<pee>Demented residents are at lower risk in predictable environments \u2014 same schedules, same caregivers, same spaces. Changes in routine (different room, unknown caregiver, modified schedules) increase agitation and the risk of falling. Continuity is a preventive measure.<\/pee>\n<\/div>\n<h2 id=\"deambulation\">6. Wandering: between risk and necessity<\/h2>\n<pee>Wandering \u2014 continuous and repetitive movement, often without apparent purpose \u2014 is one of the most common behavioral symptoms in advanced dementias. It represents a real fall risk (fatigue, obstacles, falling during a turn). But it also responds to a need \u2014 the need for movement, sensory stimulation, security through walking.<\/pee>\n<pee>The response to wandering cannot be prohibition or restraint \u2014 beyond ethics, these measures increase agitation and ultimately the risk of falling. It must be <strong>secure accompaniment<\/strong>: dedicated spaces for wandering (secure walking circuits in Nursing home), appropriate supervision, and systematic investigation of the cause (unexpressed pain, need to urinate, anxiety) to address the source rather than the symptom.<\/pee>\n<h2 id=\"agitation\">7. Agitation, impulsivity, and falls<\/h2>\n<pee>Psychomotor agitation \u2014 a form of anxious hyperactivity common in dementias \u2014 is a major fall risk factor. The agitated resident gets up suddenly, walks quickly, changes direction without anticipating, and may bump into furniture. Each episode of agitation is a window of high risk.<\/pee>\n<div class=\"article-quote\">\n  <pee>\u201cWe have learned to read the precursor signs of agitation in Mrs. G. She starts rubbing her hands, looking towards the door. When we see that, we anticipate \u2014 we offer a accompanied walk or an activity. We avoid escalation. And falls have decreased.\u201d<\/pee>\n<div class=\"quote-author\">\u2014 Caregiver, Alzheimer&#8217;s unit, Nursing home Normandy<\/div>\n<\/div>\n<h2 id=\"contention\">8. Restraint: a false solution<\/h2>\n<pee>The temptation of restraint \u2014 tying the resident to their chair or bed to prevent them from falling \u2014 is understandable in exhausted teams facing residents at very high risk. However, it is counterproductive and ethically unacceptable. Restraint increases agitation and attempts to escape, worsens physical dependence through deconditioning, causes complications (pressure sores, sliding syndrome), and does not reduce the risk of falling \u2014 it may even increase it during attempts to free oneself.<\/pee>\n<pee>Alternatives to restraint exist and are effective: secured environment, bed exit sensors, increased human presence at risk moments, adapted activities, medication review. National and international recommendations are clear and consistent: restraint should not be used as a fall prevention measure.<\/pee>\n<h2 id=\"exercice-demence\">9. Physical exercise for residents with dementia<\/h2>\n<pee>Contrary to popular belief, demented residents can benefit from adapted physical exercises \u2014 even in advanced stages. These exercises cannot be the same as with cognitively intact residents \u2014 they must be short, repetitive, integrated into meaningful activities (walking to the dining room rather than walking for the sake of walking), and carried out in a strong relational context (physical presence of the caregiver, encouragement, appreciation).<\/pee>\n<div class=\"famille-box\">\n<div class=\"famille-box-label\">\ud83d\udc68\u200d\ud83d\udc69\u200d\ud83d\udc67 What families often experience<\/div>\n<div class=\"famille-box-title\">\u201cWe are afraid to let him walk alone since he fell.\u201d<\/div>\n<pee>This fear is legitimate \u2014 and at the same time, immobilizing him out of fear of falling worsens sarcopenia and future risk. Finding balance is difficult, and families need to be guided by the team on what their loved one can do safely.<\/pee>\n<div class=\"soignant-box\">\n<div class=\"soignant-box-title\">\u2726 What the team can tell families<\/div>\n<pee>Explain that moving \u2014 even with a residual risk \u2014 is less dangerous than not moving at all. Provide families with concrete instructions on how to assist their loved one during a walk (side, holding the arm, pace). Value their active role in maintaining mobility.<\/pee>\n  <\/div>\n<\/div>\n<h2 id=\"famille-demence\">10. Supporting families in prevention<\/h2>\n<pee>Families of residents with dementia often experience a double fear \u2014 the fear of falling, and the fear of restraint or immobilization. This tension deserves to be named and worked through with them. The team has an important educational role: to explain why certain measures that seem protective (tying, immobilizing, eliminating movement) are actually counterproductive, and what alternatives are in place.<\/pee>\n<pee>This explanation \u2014 honest, transparent, without minimizing the real risk \u2014 is the condition for a solid family alliance. A family that understands the team&#8217;s approach will be more inclined to cooperate, observe and report, and value preventive measures with their loved one \u2014 even when that loved one no longer understands why these measures are in place.<\/pee>\n<p><a href=\"https:\/\/www.dynseo.com\/en\/courses\/preventing-falls-identifying-risks-taking-daily-action-and-reorganizing-the-environment-en\/\" class=\"internal-link\"><\/p>\n<div class=\"internal-link-icon\">\ud83c\udf93<\/div>\n<div class=\"internal-link-content\">\n<div class=\"internal-link-label\">Certified training<\/div>\n<div class=\"internal-link-title\">Preventing falls: identifying risks, acting daily, and reorganizing the environment<\/div>\n<div class=\"internal-link-desc\">DYNSEO Qualiopi training \u2014 falls and dementia, non-verbal approach, wandering, restraint. For the entire Nursing home team.<\/div>\n<\/p><\/div>\n<div class=\"internal-link-arrow\">\u2192<\/div>\n<p><\/a><\/p>\n<div class=\"cta-box\">\n<h3>\ud83c\udf93 Train your team in specific dementia prevention<\/h3>\n<pee>The DYNSEO training \u201cPreventing falls\u201d includes a module dedicated to residents with dementia \u2014 adapted approach, environment, wandering, alternatives to restraint. Certified Qualiopi.<\/pee>\n<div class=\"cta-buttons\">\n    <a href=\"https:\/\/www.dynseo.com\/en\/courses\/preventing-falls-identifying-risks-taking-daily-action-and-reorganizing-the-environment-en\/\" class=\"btn-cta-white\">\ud83d\udccb View the program<\/a><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/formations\/\" class=\"btn-cta-outline\">All trainings \u2192<\/a>\n  <\/div>\n<\/div>\n<div class=\"article-tags\">\n  <a href=\"#\" class=\"article-tag\">falls dementia Alzheimer&#8217;s<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">fall prevention for demented residents<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">wandering Nursing home safety<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">restraint alternatives<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">agitation dementia falls<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">physical exercise dementia<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">DYNSEO training<\/a>\n<\/div>\n<\/article>\n<\/div>\n<\/div>\n<p>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":4,"featured_media":410101,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"[et_pb_section fb_built=\"1\" admin_label=\"Article HTML\" _builder_version=\"4.16\" custom_padding=\"0px||0px||false|false\" global_colors_info=\"{}\"][et_pb_row admin_label=\"Contenu\" _builder_version=\"4.16\" width=\"100%\" max_width=\"100%\" custom_padding=\"0px||0px||false|false\" global_colors_info=\"{}\"][et_pb_column type=\"4_4\" _builder_version=\"4.16\" global_colors_info=\"{}\"][et_pb_code admin_label=\"HTML import\u00e9\" _builder_version=\"4.16\" global_colors_info=\"{}\"]<style 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var(--violet);}\n.dbi-art-99931d .toc h4 {font-family:'Montserrat',sans-serif;font-size:14px;font-weight:800;color:var(--dark);margin-bottom:14px;}\n.dbi-art-99931d .toc ol {padding-left:20px;margin:0;}\n.dbi-art-99931d .toc li {margin:8px 0;font-size:13px;}\n.dbi-art-99931d .toc a {color:var(--violet);font-weight:600;}\n@media(max-width:600px) {\n.dbi-art-99931d .article-hero {padding:50px 16px 0;}\n.dbi-art-99931d .container {padding:0 16px;}\n.dbi-art-99931d .article-body p {font-size:14px;}\n.dbi-art-99931d .mecanisme-grid {grid-template-columns:1fr;}\n.dbi-art-99931d .cta-box {padding:30px 20px;}\n.dbi-art-99931d .cta-box .cta-buttons {flex-direction:column;max-width:260px;margin:0 auto;}\n.dbi-art-99931d .btn-cta-white, .dbi-art-99931d .btn-cta-outline {width:100%;text-align:center;}\n.dbi-art-99931d .internal-link {flex-direction:column;text-align:center;gap:12px;}\n}\n\n<\/style>\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"Article\",\"headline\":\"Chutes et d\u00e9mence : adapter la pr\u00e9vention aux r\u00e9sidents Alzheimer en EHPAD\",\"description\":\"Guide pratique sur la pr\u00e9vention des chutes chez les r\u00e9sidents d\u00e9ments \u2014 m\u00e9canismes sp\u00e9cifiques, environnement, approche non verbale, d\u00e9ambulation, contention, r\u00f4le des familles.\",\"author\":{\"@type\":\"Organization\",\"name\":\"DYNSEO\",\"url\":\"https:\/\/www.dynseo.com\"},\"publisher\":{\"@type\":\"Organization\",\"name\":\"DYNSEO\"},\"datePublished\":\"2026-03-06\",\"dateModified\":\"2026-03-06\"}<\/script>\n<div class=\"dbi-art-99931d\">\n<header class=\"article-hero\">\n  <div class=\"article-hero-inner\">\n    <nav class=\"article-breadcrumb\">\n      <a href=\"https:\/\/www.dynseo.com\/\">Home<\/a> &rsaquo;\n      <a href=\"https:\/\/www.dynseo.com\/professionnels-de-sante\/\">Professionals<\/a> &rsaquo;\n      Falls and dementia Nursing home\n    <\/nav>\n    <span class=\"article-category\">\ud83e\uddba FALL PREVENTION<\/span>\n    <h1>Falls and dementia: <span class=\"hl\">adapting prevention<\/span> for Alzheimer's residents in Nursing home<\/h1>\n    <div class=\"article-meta\">\n      <span>\ud83d\udcc5 March 2026<\/span>\n      <span>\u23f1 18 min read<\/span>\n      <span>\ud83e\uddd1\u200d\u2695\ufe0f By the DYNSEO team<\/span>\n    <\/div>\n  <\/div>\n  <div class=\"article-hero-curve\"><\/div>\n<\/header>\n\n<div class=\"container\">\n<article class=\"article-body\">\n\n<div class=\"toc\">\n  <h4>\ud83d\udccb Table of contents<\/h4>\n  <ol>\n    <li><a href=\"#risque-multiplie\">A fall risk multiplied by 2 to 3<\/a><\/li>\n    <li><a href=\"#mecanismes\">Why dementia significantly increases the risk of falling<\/a><\/li>\n    <li><a href=\"#detection\">Detecting risk in residents with dementia<\/a><\/li>\n    <li><a href=\"#prevention-environnement\">Securing the environment for residents with dementia<\/a><\/li>\n    <li><a href=\"#approche-non-verbale\">The non-verbal approach: what works when words are no longer enough<\/a><\/li>\n    <li><a href=\"#deambulation\">Wandering: between risk and necessity<\/a><\/li>\n    <li><a href=\"#agitation\">Agitation, impulsivity, and falls<\/a><\/li>\n    <li><a href=\"#contention\">Restraint: a false solution<\/a><\/li>\n    <li><a href=\"#exercice-demence\">Physical exercise for residents with dementia<\/a><\/li>\n    <li><a href=\"#famille-demence\">Supporting families in prevention<\/a><\/li>\n  <\/ol>\n<\/div>\n\n<p>Residents with Alzheimer's disease or another form of dementia fall 2 to 3 times more often than residents without cognitive disorders. They are also more likely not to call for help after a fall, to be unable to describe what happened, and to not understand or remember the safety instructions given to them. Fall prevention for demented individuals cannot be the same as for other residents \u2014 it must be thought out differently, tailored to the specifics of dementia, and rely more on the environment and human presence than on the resident's compliance.<\/p>\n\n<h2 id=\"risque-multiplie\">1. A fall risk multiplied by 2 to 3<\/h2>\n\n<p>This figure \u2014 two to three times more falls \u2014 deserves attention. It means that in a Nursing home where the average is 1.5 falls per resident per year, a demented resident may experience 3 to 5. And each of these falls exposes them to fractures, hospitalization, additional loss of autonomy, and worsening cognitive disorders due to the stress and disorientation that hospitalization entails.<\/p>\n\n<p>Understanding why this risk is so high \u2014 and not just accepting it as a fatality \u2014 is essential for building effective and tailored prevention.<\/p>\n\n<h2 id=\"mecanismes\">2. Why dementia significantly increases the risk of falling<\/h2>\n\n<div class=\"mecanisme-grid\">\n  <div class=\"mecanisme-card\">\n    <h4>\ud83e\udde0 Impairment of judgment and risk awareness<\/h4>\n    <p>The demented person no longer perceives dangerous situations as such. They get up without assistance when they cannot stand alone. They cross obstacles without seeing them. They forget that they need to call for help before getting up.<\/p>\n  <\/div>\n  <div class=\"mecanisme-card\">\n    <h4>\ud83d\udeb6 Gait disorders related to brain lesions<\/h4>\n    <p>Dementia directly alters gait \u2014 not small steps, wide gait, hesitations, freezing (sudden stopping of walking) particularly in Parkinson's dementia. These disorders are independent of muscle strength.<\/p>\n  <\/div>\n  <div class=\"mecanisme-card\">\n    <h4>\ud83d\udc8a Psychotropic medications<\/h4>\n    <p>Demented residents often receive antipsychotics, anxiolytics, or antidepressants to manage behavioral disorders \u2014 medications that all increase the risk of falling.<\/p>\n  <\/div>\n  <div class=\"mecanisme-card\">\n    <h4>\ud83c\udf19 Nocturnal wandering and confusion<\/h4>\n    <p>The inversion of the night\/day rhythm, common in advanced dementias, drives residents to wander at night in a poorly secured environment and without sufficient supervision.<\/p>\n  <\/div>\n  <div class=\"mecanisme-card\">\n    <h4>\ud83e\uddaf Inability to use technical aids<\/h4>\n    <p>The demented resident forgets to use their cane, walker, or bell. Even when trained, they do not remember the instruction. Conventional technical aids assume compliance that dementia makes impossible to maintain.<\/p>\n  <\/div>\n  <div class=\"mecanisme-card\">\n    <h4>\u26a1 Impulsivity and risky behaviors<\/h4>\n    <p>Some demented residents exhibit increased impulsivity \u2014 they get up suddenly, react to internal stimuli (pain, agitation, hallucinations) without adaptation time, take risks without measuring the consequences.<\/p>\n  <\/div>\n<\/div>\n\n<h2 id=\"detection\">3. Detecting risk in residents with dementia<\/h2>\n\n<p>The standardized assessment of fall risk (Morse, Tinetti) remains useful for residents with dementia \u2014 but it must be complemented by careful observation of behaviors specific to dementia. Certain behavioral signals are short-term fall predictors that nearby caregivers are best positioned to identify.<\/p>\n\n<div class=\"soft-box\">\n  <p><strong>Behavioral signals preceding falls in residents with dementia:<\/strong> Sudden increase in agitation or wandering. Repeated attempts to get up alone despite demonstrated inability. Unexplained abandonment of normally used technical aids. Atypical complaints (pain, discomfort) that the resident cannot precisely locate. Changes in wandering habits (new frequency, new route). Signs of urinary infection (increased confusion, agitation) \u2014 the primary triggering factor for falls in demented residents. These observations must be immediately communicated to the nurse.<\/p>\n<\/div>\n\n<h2 id=\"prevention-environnement\">4. Securing the environment for residents with dementia<\/h2>\n\n<p>For residents with dementia, securing the environment is even more important than for other residents \u2014 because one cannot rely on their compliance with verbal instructions. The environment must be secured <em>by itself<\/em>, without the resident having to remember anything.<\/p>\n\n<div class=\"key-points\">\n  <h3>\u2726 Specific layout principles for residents with dementia<\/h3>\n  <ul>\n    <li><strong>Contrasting visual cues<\/strong> \u2014 signal the edge of the bed, the entrance to the bathroom, obstacles with color contrasts that even a disoriented person can perceive<\/li>\n    <li><strong>Simplified environment<\/strong> \u2014 minimize objects on the floor and obstacles; the demented resident cannot anticipate or avoid them<\/li>\n    <li><strong>Stable, non-wheeled furniture<\/strong> \u2014 anything that can serve as support must be able to bear the resident's weight without moving<\/li>\n    <li><strong>Bed exit sensors<\/strong> \u2014 alert the team as soon as the resident leaves their bed, allowing for preventive intervention before a fall<\/li>\n    <li><strong>Soft permanent lighting<\/strong> at night \u2014 demented residents do not think to turn on lights; automatic or permanent lighting is essential<\/li>\n    <li><strong>Securing high-risk areas<\/strong> \u2014 limited access to stairs, clear signage of dangerous areas with understandable cues even for a disoriented person<\/li>\n  <\/ul>\n<\/div>\n\n<h2 id=\"approche-non-verbale\">5. The non-verbal approach: what works when words are no longer enough<\/h2>\n\n<p>In the advanced stages of dementia, verbal safety instructions are no longer remembered or followed. What remains accessible is emotion, relationship, physical presence \u2014 and adapted communication methods such as the Montessori approach or the Humanitude method.<\/p>\n\n<div class=\"strategie-card\">\n  <h4>\ud83e\udd1d Contact and physical presence<\/h4>\n  <p>A hand gently placed on the shoulder, maintained eye contact, a calm and slow voice \u2014 these relational signals can be enough to slow down a resident who is about to get up impulsively, while a caregiver helps them do so safely. Human presence remains the primary technical aid.<\/p>\n<\/div>\n\n<div class=\"strategie-card\">\n  <h4>\ud83c\udfb5 Music and sensory cues<\/h4>\n  <p>Familiar and loved music can reduce agitation and anxious wandering \u2014 two precursors to falls. Olfactory cues (lavender, familiar perfume) in the room can help some demented residents feel safer and less inclined to wander.<\/p>\n<\/div>\n\n<div class=\"strategie-card\">\n  <h4>\ud83d\udccb Routine and predictability<\/h4>\n  <p>Demented residents are at lower risk in predictable environments \u2014 same schedules, same caregivers, same spaces. Changes in routine (different room, unknown caregiver, modified schedules) increase agitation and the risk of falling. Continuity is a preventive measure.<\/p>\n<\/div>\n\n<h2 id=\"deambulation\">6. Wandering: between risk and necessity<\/h2>\n\n<p>Wandering \u2014 continuous and repetitive movement, often without apparent purpose \u2014 is one of the most common behavioral symptoms in advanced dementias. It represents a real fall risk (fatigue, obstacles, falling during a turn). But it also responds to a need \u2014 the need for movement, sensory stimulation, security through walking.<\/p>\n\n<p>The response to wandering cannot be prohibition or restraint \u2014 beyond ethics, these measures increase agitation and ultimately the risk of falling. It must be <strong>secure accompaniment<\/strong>: dedicated spaces for wandering (secure walking circuits in Nursing home), appropriate supervision, and systematic investigation of the cause (unexpressed pain, need to urinate, anxiety) to address the source rather than the symptom.<\/p>\n\n<h2 id=\"agitation\">7. Agitation, impulsivity, and falls<\/h2>\n\n<p>Psychomotor agitation \u2014 a form of anxious hyperactivity common in dementias \u2014 is a major fall risk factor. The agitated resident gets up suddenly, walks quickly, changes direction without anticipating, and may bump into furniture. Each episode of agitation is a window of high risk.<\/p>\n\n<div class=\"article-quote\">\n  <p>\u201cWe have learned to read the precursor signs of agitation in Mrs. G. She starts rubbing her hands, looking towards the door. When we see that, we anticipate \u2014 we offer a accompanied walk or an activity. We avoid escalation. And falls have decreased.\u201d<\/p>\n  <div class=\"quote-author\">\u2014 Caregiver, Alzheimer's unit, Nursing home Normandy<\/div>\n<\/div>\n\n<h2 id=\"contention\">8. Restraint: a false solution<\/h2>\n\n<p>The temptation of restraint \u2014 tying the resident to their chair or bed to prevent them from falling \u2014 is understandable in exhausted teams facing residents at very high risk. However, it is counterproductive and ethically unacceptable. Restraint increases agitation and attempts to escape, worsens physical dependence through deconditioning, causes complications (pressure sores, sliding syndrome), and does not reduce the risk of falling \u2014 it may even increase it during attempts to free oneself.<\/p>\n\n<p>Alternatives to restraint exist and are effective: secured environment, bed exit sensors, increased human presence at risk moments, adapted activities, medication review. National and international recommendations are clear and consistent: restraint should not be used as a fall prevention measure.<\/p>\n\n<h2 id=\"exercice-demence\">9. Physical exercise for residents with dementia<\/h2>\n\n<p>Contrary to popular belief, demented residents can benefit from adapted physical exercises \u2014 even in advanced stages. These exercises cannot be the same as with cognitively intact residents \u2014 they must be short, repetitive, integrated into meaningful activities (walking to the dining room rather than walking for the sake of walking), and carried out in a strong relational context (physical presence of the caregiver, encouragement, appreciation).<\/p>\n\n<div class=\"famille-box\">\n  <div class=\"famille-box-label\">\ud83d\udc68\u200d\ud83d\udc69\u200d\ud83d\udc67 What families often experience<\/div>\n  <div class=\"famille-box-title\">\u201cWe are afraid to let him walk alone since he fell.\u201d<\/div>\n  <p>This fear is legitimate \u2014 and at the same time, immobilizing him out of fear of falling worsens sarcopenia and future risk. Finding balance is difficult, and families need to be guided by the team on what their loved one can do safely.<\/p>\n  <div class=\"soignant-box\">\n    <div class=\"soignant-box-title\">\u2726 What the team can tell families<\/div>\n    <p>Explain that moving \u2014 even with a residual risk \u2014 is less dangerous than not moving at all. Provide families with concrete instructions on how to assist their loved one during a walk (side, holding the arm, pace). Value their active role in maintaining mobility.<\/p>\n  <\/div>\n<\/div>\n\n<h2 id=\"famille-demence\">10. Supporting families in prevention<\/h2>\n\n<p>Families of residents with dementia often experience a double fear \u2014 the fear of falling, and the fear of restraint or immobilization. This tension deserves to be named and worked through with them. The team has an important educational role: to explain why certain measures that seem protective (tying, immobilizing, eliminating movement) are actually counterproductive, and what alternatives are in place.<\/p>\n\n<p>This explanation \u2014 honest, transparent, without minimizing the real risk \u2014 is the condition for a solid family alliance. A family that understands the team's approach will be more inclined to cooperate, observe and report, and value preventive measures with their loved one \u2014 even when that loved one no longer understands why these measures are in place.<\/p>\n\n<a href=\"https:\/\/www.dynseo.com\/courses\/prevenir-les-chutes-reperer-les-risques-agir-au-quotidien-et-reorganiser-lenvironnement\/\" class=\"internal-link\">\n  <div class=\"internal-link-icon\">\ud83c\udf93<\/div>\n  <div class=\"internal-link-content\">\n    <div class=\"internal-link-label\">Certified training<\/div>\n    <div class=\"internal-link-title\">Preventing falls: identifying risks, acting daily, and reorganizing the environment<\/div>\n    <div class=\"internal-link-desc\">DYNSEO Qualiopi training \u2014 falls and dementia, non-verbal approach, wandering, restraint. For the entire Nursing home team.<\/div>\n  <\/div>\n  <div class=\"internal-link-arrow\">\u2192<\/div>\n<\/a>\n\n<div class=\"cta-box\">\n  <h3>\ud83c\udf93 Train your team in specific dementia prevention<\/h3>\n  <p>The DYNSEO training \u201cPreventing falls\u201d includes a module dedicated to residents with dementia \u2014 adapted approach, environment, wandering, alternatives to restraint. Certified Qualiopi.<\/p>\n  <div class=\"cta-buttons\">\n    <a href=\"https:\/\/www.dynseo.com\/courses\/prevenir-les-chutes-reperer-les-risques-agir-au-quotidien-et-reorganiser-lenvironnement\/\" class=\"btn-cta-white\">\ud83d\udccb View the program<\/a>\n    <a href=\"https:\/\/www.dynseo.com\/formations\/\" class=\"btn-cta-outline\">All trainings \u2192<\/a>\n  <\/div>\n<\/div>\n\n<div class=\"article-tags\">\n  <a href=\"#\" class=\"article-tag\">falls dementia Alzheimer's<\/a>\n  <a href=\"#\" class=\"article-tag\">fall prevention for demented residents<\/a>\n  <a href=\"#\" class=\"article-tag\">wandering Nursing home safety<\/a>\n  <a href=\"#\" class=\"article-tag\">restraint alternatives<\/a>\n  <a href=\"#\" class=\"article-tag\">agitation dementia falls<\/a>\n  <a href=\"#\" class=\"article-tag\">physical exercise dementia<\/a>\n  <a href=\"#\" class=\"article-tag\">DYNSEO training<\/a>\n<\/div>\n<\/article>\n<\/div>\n\n<\/div>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section]","_et_gb_content_width":"","footnotes":""},"categories":[2915],"tags":[],"class_list":["post-725906","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-les-conseils-des-coachs"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Falls and Dementia: Adapting Prevention for Alzheimer Residents in Nursing Homes | DYNSEO - DYNSEO - Educational apps &amp; 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