Falls associated with dementia: how can you tell?

In any practice setting, professional nurses must be skilled to assess and manage medical problems rapidly. Post-fall assessment among those with dementia is a daunting task. Emergent medical problems after a fall are difficult to detect among those with dementia, because impaired communication portrays a false reality that the older adult is uninjured. Furthermore, early detection of potential post-fall injuries may not occur within a health care system that relies on verbal communication and eyewitness accounts as the main source of fall occurrence information. Professional nurses must turn to other means of fall detection. One such strategy relies on observable changes in function and behavior, such as a recent decline in mobility, change in gait, level of consciousness, neurological function or vital signs. Those most susceptible exhibit prior observable signs of visual-spatial impairment such as impaired clock drawing, gait apraxia, and inability to negotiate their environment without falling.