Whether diagnosing dementia with Lewy bodies (DLB) or Parkinson’s disease with dementia (PDD), increased risk of falling is a common problem in both subtypes of Lewy body dementia (LBD). Clinicians often ask if their patient has experienced any recent falls. One of the core symptoms of DLB, parkinsonism, can make a person move more slowly and stiffly, and have a stooped posture. Falls can be associated with other LBD symptoms as well. Loss of attention can slow reaction time and increase the chance that obstacles in the path aren’t noticed. Visual-spatial problems may impair a person’s depth perception. Even dizziness or fainting can occur due to a drop in blood pressure when standing. All of these put the person with LBD at an increased risk of falls and injury.
Here are some simple home safety improvements that may reduce the risk of falls.
- Put frequently used items in easily-accessible places
- Arrange furniture to ensure a clear path of travel
- Keep floors clean and clear of debris
- Clean up spills immediately
- Remove throw rugs and runners. Make sure other rugs are secured to the floor and have smooth surfaces
- Move any power cords out of the flow of traffic
- Remove chairs that swivel
- Stairs should have at least one handrail; two are better
- Ensure halls, stairways and entrances are well lit
- Use night lights in the bedroom, bathroom and hallway
- Add a tub rail, grab bars, bath seat and a rubber mat or non-skid decals for the bathtub
- Use only nonskid bathmats
- Install an elevated toilet seat and/or add grab bars for support
- Wear non-skid shoes; assess the gripping nature of rubber-soled shoes, which may be a tripping hazard because they sometimes ‘catch’ on the floor
- Consider assisted devices when walking alone becomes unsafe, like a cane, walker or wheelchair
Another important factor that supports fall prevention in LBD is maintaining physical health. Exercise can help build muscle and cardiovascular strength, flexibility and improve balance. Always consult a doctor before starting any exercise program, and inquire whether physical therapy may be helpful in your situation. Consider mixing exercise with social activity to make it more fun, such as walking, biking, or swimming with a friend, dancing, or attending a tai-chi class. This will increase the likelihood of exercising on a regular basis.