Medication management key to reducing dementia falls
With some medications linked to an almost 60 per cent increase in falls risk for people with dementia, medication management and regular review is critical for supporting independence.
Bolton Clarke Senior Clinical Nurse Adviser - Dementia Fleur O’Keefe says about 40 per cent of people living with dementia in the community enter residential aged care after a first hospitalised fall.
“We know that medications and falls are deeply connected for people living with dementia,” Fleur said.
“Common medications like psychotropics, anticholinergics, antihypertensives and diuretics raise the risk of falls because they interfere with systems essential for safe mobility – they can impair cognition, balance, blood pressure and co-ordination.
“Cognitive impairment in dementia reduces a person’s ability to recognise and respond to hazards, and this becomes especially dangerous when medications impair alertness or balance.
“When behavioural symptoms like agitation or wandering – which already lead to unsafe mobility – are managed with psychotropic medications, the risk increases further.”
Research shows antipsychotics are associated with a 59 per cent increased risk and benzodiazepines with a 47 per cent risk.
Education and strong partnerships between prescribers, pharmacists, nurses and carers are key to improving those outcomes and optimising medication management to reduce falls.
“There are many ways to optimise medication management in the home, which plays an equally important role in preventing falls and other adverse outcomes,” Fleur said.
“Strategies such as reducing medications through deprescribing or lowering dosing frequency by using long-acting formulations, can help simplify schedules and reduce confusion. Dose administration aids like blister packs or pill organisers support accuracy, while orientation tools such as calendar clocks can also greatly assist independence with medication.
“Education can focus on safe administration practices, recognising side effects, and understanding the purpose of each medication—empowering both the person with dementia and their carer to manage medications more confidently.”
She said in-home nurses backed by dementia care expertise could play a key role.
“Home care nurses can also work collaboratively with the person, their carer, and the prescriber to implement and adjust these strategies, ensuring they are practical, personalised, and effective in the home environment."
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