Frequent Falls

mommafour

Have any of you had experience with your LO having frequent falls that have worsened suddenly? I'm sure a number of things can cause this problem but I am wondering if DH's falls could be a result of the impairment caused by Alzheimer's. DH has lost balance and fallen just a handful of times over the past couple of years, mostly caused by tripping over something that he failed to notice. His Alzheimer's decline has progressed much quicker within the past few months and I suspect his now-frequent falls are related to the faster decline. Since early this year, he leans forward and shuffles his feet when he walks. He has now fallen 5 times within the past 2 weeks. He say's he wasn't dizzy each time and I didn't see any indication of dizziness before or after he fell. The first fall was caused by failing to notice a big step up going into our neighbor's home. Two other times he couldn't maneuver stepping off a curb with bright yellow paint even though I pointed it out to him and stood next to him to help balance. He also fell flat on his face walking down a slight hill in our backyard. The 5th time was different - he actually rolled out of bed during the night and cut his head on a bedside table (he wasn't trying to get out of bed), resulting in a trip to the ER for a CT scan. Fortunately he hasn't had serious injuries but I'm worried it's just a matter of time. The ER Dr. advised him to use a walker but he chuckled and refused. When he falls, it can take a very long time to get him back on his feet and stable due to weakness and increasing frailty. Our very nice neighbor gave me his phone number to call for his assistance if DH falls again. My daughter who has work-related experience is coming to our home Saturday to help me DH-proof our house to alleviate the fall risk.

I emailed both his Primary Care provider and the separate Older Adult Clinic that treats him for Alzheimer's at the VA to report the 5 falls within 2 weeks. So far, I have only received a response from the Older Adult Clinic. They scheduled a video appointment for this afternoon with the Clinical Pharmacist who supervises the medication prescribed by the Older Adult Clinic. I am sooooo very worried that it will be blamed on the Seroquel (quetiapine) medication. He has been on 150 mg/day since February and it was recently increased in early July to 200 mg/day. The falls have only increased within the past 2 weeks. I actually fear him being taken off this medication and returning to the horror of his prior behavior, since it has helped him greatly. I'm also asking his Dr. to test him for a UTI and maybe testing to rule out TIA's. But I honestly think this is simply due to his worsened cognitive impairment and the shuffling activity when he walks.

Have any of your LO's experienced falls due to medication such as Seroquel, or any falls that just result from the cognitive impairment itself? Is this just what can be expected as part of this awful disease? 😥

Ed1937

I'm sorry you are experiencing this. My wife fell several times. Her balance was not good before dementia. This was caused by Meniere's disease, but exasperated by dementia. I don't think it is possible to keep them from ever falling unless they are bedridden. Wish I had better news for you.

Joydean

My dh has been falling lately too. He’s end stage 6 and stepping into 7. He shuffles/slides his feet and he just started leaning forward. Not on the same meds you mentioned. But I have contacted his doctors at the VA to see what they say.

best of luck to you and your dh. I hope you get good results from his doctor.

ButterflyWings

M4-You can tell the Dr. not to change the Seroquel. You are with your LO 24/7 right? You know him best. I share your feeling about that med and have often said I could not keep my DH here at home without it. Seriously.

To answer your question, taking 300mg daily for some time now causes no falling, dizziness, or balance issues for DH. And he is not a large person so even for his size that is 'no' as to causing falls.

Could your DH be having vision and depth perception changes? Also balance if he is leaning. And possibly check for a silent UTI if this is a sudden change as it sounds... when my DH has had falls in the past, it was UTI-related, or much later a couple of fainting spells which have resolved in recent months (knock on wood).

mommafour

Thanks for the responses.

Ed - I think you're right, there is no way to keep this from happening.

Joydean - DH is probably mid-stage 6. This could be due to the shuffling and balance issues. I did get a response from the VA and an appt. with a Dr. in the Older Adult Clinic. His usual person is out on an extended personal leave so we are being passed around somewhat. I hope you find help at the VA for your DH's falls too.

ButterflyWings - The Clinical Pharmacist did end up letting us (me) make the decision about the Seroquel. I had the option to reduce the dosage and see if that helps, but I told her I fear the results. She doesn't think the falling is due to his medication, so we are keeping it at 200mg/day. You may be right about the vision and depth perception due to the nature of some of these falls.

Denise1847

Would a walker help him?

Drapper

Is it possible he could get some home physical therapy to help with this issue. Could be balance or weakening of muscles.

strength could help with walking ability.

mommafour

Denise1847, yes I think he needs a walker. The ER doctor suggested it but he laughed and rolled his eyes. We actually have the type of walker the doctor suggested - I had to use one while recovering from a serious leg injury and saved it “just in case”. I plan to work on getting him used to the idea.

Drapper, I agree. He sleeps most of the day and I think that has contributed to muscle loss. He probably does need some PT.

upstateAnn

PT has really helped my DH. His doctor wrote out a prescription as soon as he fell a second time. I go with him and was struck by how shaky he was on his feet.

zauberflote

Hi @mommafour I'm really glad the clinical pharmacist thought the seroquel wasn't the cause here.

I'll second the PT suggestions, although if the budget allows, an in-home Personal Trainer can work wonders. Mom's budget in AL did allow, and the trainer was a geriatric specialist with several certifications I'd never imagined!. Mom was already on a walker and got used to it reasonably well, and the trainer improved her to the point where she could do little obstacle courses without it. Mom loved this woman, and "performed well" for her.

M1

Falls and swallowing difficulties are part of the motor loss of advancing Alzheimer's, so you are correct that it is related to the overall disease progression and is to be expected--this is why broken hips and aspiration pneumonia are frequently the ultimate, proximate cause of death.. I doubt that physical therapy will make much difference. But also doubt that the Seroquel is contributing. I'm sorry....

upstateAnn

I should add my husband also has a twice a week session with a trainer who works with other AZ folks, it has done hi. a world of good. I plan to keep it going as long as possible. I do not waste the hour either. I am stretching and doing weight work in another part of the gym.