Staying steady and independent with Dementia

picture of the handy guide This page has advice on steps you can take to help yourself to stay steady and independent with Dementia.

You can also download this advice as a handy booklet.

Staying Steady and Independent with Dementia (PDF, 1.7 MB).

You can find more information about support on the Dementia and Falls Prevention in the Toolkit.

Mozellosite: Dementia and Falls Prevention Toolkit.

picture of two people You might be nervous because you’ve had a fall already – or because you’ve noticed you’re starting to feel unsteady on your feet.

A fall can leave you feeling quite shaken – and even the thought of falling might affect your confidence.

It is common to think that feeling unsteady is an inevitable part of aging but that is not the case.

Falls can be prevented and we want to help you understand what you can do to help yourself.

Take a look at yourself in a photo from 30 years ago – goodness, how you have changed!

Not only on the outside, but on the inside too.

group of people exercising

Admitting things may have changed and doing something about it could help you stay independent for longer.

As a person living with Dementia, you are 4 times more likely to experience a trip or a fall.

Dementia can change the way you see things, and how you feel about things.

Have you noticed a difference in how you hear things? That’s dementia too.

But just like anyone else, you could also fall because of other health problems, you may be poorly or just need a nap.

Don’t be embarrassed if you have fallen – you are not alone and there are always people who are happy to help you.

If you do fall this could have a huge impact on your life, so here are some simple hints and tips that can help you to stay steady.

They should reduce the chance of you falling and how this makes you feel.

Seeing and hearing

Objects and patterns may change into something else in your mind.

If carpet or flooring is a different colour between rooms, it can look like steps.

Shiny flooring can appear wet.

Poor lighting can cause shadows and change the way things look.

A dark-coloured mat may appear to be a hole.

Loud or unexpected noise can really startle.

	Have your eyes tested every 12 months.
	Make sure your specs are kept clean and fit properly.
	Avoid stripes and strong patterns on furniture and flooring. Instead, have light plain flooring and try to colour contrast this with your furniture.
	Put away all rugs and mats.
	Make sure your home is well lit, especially in risky areas like on the stairs and in the kitchen/ bathroom.
	Have your hearing tested regularly. Make sure your hearing aids are working and worn correctly.
	Find out about Dementia friendly environments to help create a dementia friendly home.
	Look into Memory Techniques and have an ordered home to help you to know where to find things.

Medicines

As you get older you often have to take more medications and these might have side effects which may make you more likely to fall.

Some medications might make you need to go to the toilet more or have to rush to get there.

If your medication has changed, it may take a bit of time before everything settles down.

Your GP, Pharmacist or District Nurse can help if you are experiencing any problems or if you are worried.

	Always speak with a medical professional if: there are any changes to your health. any medicine makes you feel worse. you do not want to take your medicine. you cannot take your medications.
	It’s ok to ask questions about your medicines – don’t be afraid to do so.
	Take your medicine according to the directions.
	Keep a list of all medications including prescriptions, over the counter medications, vitamins, and herbals.
	Keep all your medicines in the same place.
	If possible, try to only use one pharmacy.
	A medication dispenser might help you to be more organised with your tablets and take them at the right time.
	Always get rid of any out of date medication or any medicines that you are no longer taking. You can take these back to your pharmacy.
	In the last 12 months, have your chatted with your GP surgery about your medication?
	Never stop taking prescribed medication suddenly.
	Alcohol and medications are not a great cocktail!

Eating well

Have you noticed a difference in how things taste, smell or the texture of your food? That’s dementia too. You may also get a sweet tooth!

If you don’t eat and drink properly, you may struggle to concentrate, feel weaker, more tired or light headed. This might increase the chances of you falling and hurting yourself.

You may notice that you get full more easily or your appetite reduces.

As you get older you won’t be able to tolerate alcohol as well as you may have done in the past.

Have you noticed that it is difficult to swallow certain foods and drinks?

Are your dentures becoming loose? This can make it more difficult to chew foods. Is food tasting unpleasant?

When did you last go to the dentist? It important to see the dentist regularly as this can affect what you are able to eat and drink.

Are you losing weight unexpectedly?

Your clothes might not fit correctly if you lose weight. Try not to trip over them!

Your GP, a dietitian, speech and language therapist, dentist or district nurse can help if you are experiencing any problems or if you are worried.

	Eat regularly – little and often may be preferable to large meals.
	Eat a healthy, balanced diet with calcium and protein - they are both really important for bone health.
	If you don’t look after your bones they may break more easily if you fall.
	Dairy products like milk, cheese and milky puddings as well as bony fish and green leafy vegetables are good for your bones.
	Plant based alternatives also contain lots of calcium.
	Let people know what foods you like or dislike – it’s important that they respect this.
	Your taste may change, so keep trying a variety of foods and drinks.
	Keep a list of your current food and drink preferences and re-try different tastes from time to time.
	You might like to add extra flavour to your savoury foods such as herbs, spices, sauces or honey and jam can make sweet foods more tasty.
	If you have a sweet tooth, that’s fine but be mindful of other health issues.
	Reduce your distractions (eg TV/radio) when eating.
	If others are around, why not eat together at the table?
	Breakfast or lunch clubs as well as dementia friendly cafes can make eating together more enjoyable.
	Aim for 6-8 glasses of fluid each day, and try fluid rich foods such as ice-lollies or yogurts.
	Good lighting and plain colourful plates such as plain blue, red, yellow or green, can help you to see the food more easily and increase appetite.
	There are many different types of feeding aids that you can buy such as big handled cutlery and deep lipped plates.
	You might find it more difficult to shop and prepare food yourself. Hopefully your family and friends would be willing to help you or carers can be arranged to make things easier for you. Also local and national food delivery services can be helpful.
	If you have lost weight, make sure your clothes fit properly. Shorten trousers if they are too long or use a belt/braces. Take time to fasten belts and dressing gown cords.
	Try not to drink too much caffeine or alcohol as this can cause unsteadiness and dehydration.

Staying active

• Being active can help you maintain your strength and flexibility and improve your energy levels, so that you can carry on doing the things you enjoy. Our bodies were made to move.

• Have you noticed a change in how you are walking? That’s Dementia too.

• We rely on our balance to stay upright but as we get older our balance could get a bit worse.

• Between the ages of 50 and 70 we lose 30% of our muscle strength.

• Bones naturally become more brittle as we age which makes a fracture more likely if we fall.

• Sitting still for a long period of time increases the risk of falls.

• Lack of exercise and activity can make us weaker. But be careful because too much exercise can result in you feeling over tired.

Your GP, a physiotherapist or Occupational Therapist can help if you are experiencing any problems or if you are worried.

	Find ways to try to move a bit more throughout the day – in whatever way works for you. Being active doesn’t have to mean doing vigorous exercise or even doing anything outside your normal routine. Remember “if you don’t use it, you lose it!”
	Use everyday activities like gardening, housework and walking to keep you moving. Even dancing or passing a balloon is good exercise. It’s easier to keep up an activity you enjoy – that’s when you’ll improve and begin to feel the benefits.
	Keep warm as cold muscles don’t work as well and may lead to accidents and injuries.
	Get up slowly after lying/sitting and pause a moment before you start walking.
	Regularly pop outside into the sunshine - Vitamin D is really important for bone health. If you don’t look after your bones they will break more easily if you fall. But use sunscreen if you are outside for any length of time.
	Limit or break up the length of time you spend sitting. When watching TV, try and move your limbs and get up to walk about during the adverts or between programmes.
	Don’t be embarrassed if you need to use a walking aid if it helps you to stay steady. You could always personalise it! Be sure to keep it close by.
	Ensure your walking aid has a rubber end (called a ferrule) to stop it slipping. You can buy a new one of these if it is worn down.

Looking after your feet

• As we get older our feet may feel painful, become swollen or start to tingle. Uncomfortable feet aren’t a natural part of growing old or something to put up with. A lot can be done to improve comfort and relieve pain.

• Our feet also change shape and can lose feeling as well as flexibility. The shoes we had 10 years ago may not be right any more.

Your GP, a Podiatrist, District Nurse or Occupational Therapist can help if you are experiencing any problems or if you are worried.

	Keeping active and on the move helps to keep feet healthy. It tones up muscles, helps to strengthen arches and stimulates blood circulation.
	Keeping your feet warm is important, but do not warm them too close to the fire! Warm stockings or socks can help, but avoid anything too tight which can restrict your circulation or cramp your toes.
	Trim or file your toenails regularly. Use a pumice stone or foot file on hard skin.
	Check your feet regularly and moisturise them (not between the toes) to help keep them supple and avoid painful cracking.
	Ask family or friends to help if you are struggling to reach your feet. It’s a long way down there and even further back up!
	Well cushioned shoes offer more comfort. Try to avoid shoes with high heels or sandals with little support.
	Make sure your shoes fit well and don’t have a tendency to slip off. You’ll find that a lace, strap, buckle or Velcro fastening shoe will give more support.
	Your shoes should be roomy enough, particularly if you intend to wear them every day. If you suffer with swollen feet, it’s a good idea to put your shoes on as soon as you wake up, before your feet have chance to swell.
	Comfy slippers can be like old friends but if they have holes in the soles, broken backs or if the fit is sloppy they should be considered as worn out.
	Slippers should ideally fasten, cover the whole foot and have a back on to make sure they stay on and provide grip. They should have a good sole. A long handled shoehorn might help to get them on your feet.
	Never walk in socks and tights on hard floors - it’s like ice-skating!

Your home

• As we get older, our homes get older too and we often don’t notice problems because we have lived with them for so long.

• Falls are more likely to happen in the kitchen and bathroom/toilet areas where floors can be wet and more serious injuries can be caused.

• Sometimes objects blend into the background if they are a similar colour so you may not notice them.

• Take a few minutes to look around your home, what could you slip or trip on?

• Some people feel unsteady getting on and off their:

Chair
Bed
Toilet

Are you finding any of these difficult?

• Some people also struggle getting in and out of the bath.

Your GP, or an Occupational Therapist can help if you are experiencing any problems or if you are worried.

	Remove all rugs, bath and pedestal mats and ask someone to secure loose carpets.
	Make sure there are no trailing wires/flexes or obstacles which might be in the way.
	Make sure your stairs and landings are totally clear of any ornaments and objects.
	Keep things tidy!
	Consider automatic sensor lights.
	Always put the lights on at dusk and never walk about in the dark.
	Always use your bedside lamp. Touch lamps can be easier to reach. Keep a good torch by your bed.
	Use brighter bulbs or extra lights, especially on the stairs and in the toilet.
	Make signs with one word and a simple picture to put on your doors to help you know which room it is. Or it can be easier to find your way round by leaving room doors open which you use regularly and closing the doors to rooms you don’t use.
	Try to fit rails on the stairs or grab rails around your home that are a contrasting colour to the wall so that you can see them more easily.
	Use a chair with a firm seat and arms as this is easier. Try not to get up and down from the chair too quickly and wait a moment until you set off.
	Rearrange cupboards in the kitchen and bathroom so that the things you use the most are within easy reach. Place photos of the cupboard contents on the outside of the doors.
	Use a non slip, colour contrast, plain, suction bath mat.
	Why not try having a colour contrast toilet seat?
	Keep the floors dry and clear up spills straight away.
	Buy pets a bright collar and a bell to wear which will let you know they are near by. A surprising number of pets can get under your feet!
	When you are going into your garden ensure the patio/path/flag stones are level and securely fixed.
	Make sure there is no moss, overgrown plants or obstacles which might be in the way. Keep things tidy!
	Avoid tasks such as cleaning windows or changing light bulbs if they make you feel dizzy or light-headed.

Out and about

	Take your time and don’t rush. It’s OK to be slower than you used to be. Try not to worry if you feel you are inconveniencing others, go at your own pace.
	You might find slopes more difficult than they used to be. Take it steady.
	Be aware if there are raised thresholds and colour changes at shop entrances.
	Take a moment to allow your eyes to adjust to the change in light between indoors and outdoors.
	Carrying shopping bags can affect your balance, trip you up and obstruct your view of the pavement. Could you use a rucksack instead?
	Have your bus pass/money ready in advance so you can concentrate when getting on and off the bus safely.
	Don’t be afraid to ask the bus driver to wait until you are seated before setting off moving.
	Your family or friends can help if you are experiencing any problems or feeling worried about going on your own.

Getting help if you fall

	If you do ever fall getting help is essential! If possible, carry a charged cordless landline or mobile phone with you, use your pendant alarm or bang on the wall, radiator or floor.
	If you can, as pain allows, keep moving your body gently to help with circulation and to keep warm.
	Try and stay warm by covering yourself with anything you can reach throw/blanket, duvet, coat.
	Put a cushion under your head or roll up an item of clothing.
	Try to move away from direct heat sources which could cause injury (such as a fire or radiator).
	If possible, reach for a drink and keep sipping fluids.
	If possible, have at least one telephone on a surface which can be reached from the floor.
	Personal alarms can be used around the clock, to call for help in the event of a fall.
	Voice activated digital assistants (such as Alexa) can help you make a phone call in the event of an emergency.
	There are different ways which you may be able to learn to help you know how to safely get up from the floor. Your GP, Physiotherapist or Occupational Therapist can help if you are experiencing any problems or if you are worried.

Further information

This advice has been produced as a Dementia friendly information guide by the Dementia Focused Occupational Therapist and the Commissioning Officer for Dementia from Sheffield City Council.

It can be used as a stand-alone document, or the relevant sections can be shared with people as part of a professional’s intervention to inform a person about Staying Steady and Independent with Dementia.

Request an occupational therapy assessment from Sheffield City council

Sheffield City Council: Request an occupational therapy assessment.

Useful links

Dementia Advice Sheffield – advice for professionals.

Age UK Sheffield: Dementia Advice Sheffield for professionals.

Call: 0114 250 2875.

Dementia Advice Sheffield – advice for the public.

Age UK Sheffield: Dementia Advice Sheffield for the public.

Call: 0114 250 2875.

Sheffield Directory advice on Dementia support.

Dementia Support in Sheffield.

References

Chartered Society of Physiotherapy: Get up and go leaflet (PDF, 2.65 MB).

Age UK: Staying Steady Guide (PDF, 4 MB).

Images

Some of the pictures used in this advice were created for the South Yorkshire Dementia Action Alliance, a group of organisations who are taking action to do more for people affected by Dementia.

South Yorkshire Dementia Action Alliance: Keeping People Living with Dementia Safe from Trips & Falls, Safe & Well.

Age UK Sheffield: Our Dementia Commitments (previously known as Sheffield Dementia Action Alliance).

Thanks also to Marney Walker (Independent Occupational Therapist and Lab 4 Living PhD Student), and Dementia Together Online.

Dementia Together Online: Connecting People, Connecting Support.

With thanks to

Ashley Bailey, Occupational Therapist, Equipment & Adaptations, Sheffield City Council.

Hints and tips to help reduce your chance of falling with Dementia

Seeing and hearing

Medicines

Eating well

Staying active

Looking after your feet

Your home

Out and about

Getting help if you fall

Further information

Next:
Dementia prevention.

Links and downloads

Hints and tips to help reduce your chance of falling with Dementia

Seeing and hearing

Medicines

Eating well

Staying active

Looking after your feet

Your home

Out and about

Getting help if you fall

Further information

Next:Dementia prevention.

Links and downloads

Next:
Dementia prevention.