Memory care residents is the fastest-growing population in the long-term care assisted living (AL) industry, with four in 10 AL residents suffering from dementia.
Most are only one unmonitored exit or disorienting fall away from serious danger and irreversible harm. Thus, keeping this population safe, from both themselves and the world around them, is one of the greatest challenges for medical professionals who serve them.
For memory caregivers, resident safety is a delicate balancing act. As Lindsay Schwartz, an Associate Vice President at the National Center for Assisted Living recently told The New York Times, facilities are ever mindful of the need to provide memory care residents with the kind of personal freedom assisted living is known for. According to Schwartz, assisted living facilities are also ensuring the doors are locked and tripping hazards are removed.
Below is a look at the major safety risks dementia residents in assisted living face, and some of the things that put them in harm’s way.
According to the Alzheimer’s Association, nearly two out of every three dementia residents will wander, though it’s difficult to predict what triggers the behavior. Opportunity is indubitably a culprit. And a wandering resident with dementia can often inexplicably find one on their way past locked doors.
Statistics vary by state, but according to a recent news article in The New York Times, the assisted living industry’s rapid growth, staffing issues and the recent influx of dementia residents has led to safety gaps. There are many stories of assisted living residents, with and without dementia, who have wandered unnoticed, later dying from everything from exposure to alligator attacks. Memory care resident elopement is one of the most pressing concerns for memory caregivers as outcomes are seldom positive.
For seniors who are already frail, falls can be among the most physically devastating occurrences. With the growth of assisted living memory care populations often outpacing support systems, there are increased opportunities for these kinds of mishaps. According to the Center for Disease Control (CDC), about one in five assisted living residents will suffer a fall within a year of entering a facility.
Even the most able-bodied senior living resident is susceptible to a fall. Memory care residents have the added handicap of being easily disoriented and confused.
Emerging research shows that powerful medications like antipsychotics are a contributing factor in falls. Other medications like overactive bladder treatments, such as anticholinergics, have been linked to side effects like blurred vision that can contribute to instability. Benzodiazepine and some insomnia medications have also been associated with higher rates of falls.
Unsurprisingly, physical surroundings are another major contributing factor to fall risk amongst memory care residents. Busy patterns in wallpaper or subtle transitions in the colors of wall paint can quickly put a dementia resident off balance. Designers can employ a variety of methods to dissuade dementia residents from falling, tripping or wandering into dangerous areas, including using high-contrast colors which will help a dementia resident distinguish where spaces begin and end. Painting a door the same color as adjoining walls, for instance, provides a visual “cue” in the eyes of a designer.
Poor or ill-conceived lighting schemes can also create opportunities for falls and tripping. Researchers have discovered certain kinds of blue lighting can significantly reduce levels of agitation and stress in dementia residents.
Violence and aggression
A recent Kaiser Health News report explored the myriad risks of violence and aggression among dementia residents. Such behaviors endanger not only those residents’ own lives but the lives of fellow residents and memory care staff.
In a study reported in the Journal of Applied Gerontology, analyzing 6,848 senior residents, researchers found that nearly eight percent had engaged in physical aggression or abuse toward other residents or staff in the month before the survey. Higher percentages had engaged in verbal abuse or aggression.
Researchers concluded that “dementia and severe mental illness were significant risk factors for all three types of resident aggression and abuse,” (Castle, Chowdhury and Gimm). They went on to state that resident aggression and abuse in assisted living facilities is prevalent and warrants greater attention from policymakers, researchers, and long-term care providers, adding that “future research is needed to support training and prevention efforts to mitigate this risk,” (Castle, Chowdhury and Gimm).
Polypharmacy is a medication management issue that poses several dangers. Seniors in most assisted living settings are free to get their own prescription and over-the-counter medications from multiple sources, leaving them vulnerable to a host of problems like over-medication and drug interactions. Such issues can create liability issues for providers themselves.
Breakthrough innovation has led to powerful preventative measures to the risks among the memory care populations in assisted living and elsewhere, many of which are rooted in military and emergency preparedness and response applications. These solutions include everything from sensors and sophisticated-tracking systems, like global positioning and real-time location services, to powerful data analytics software that can accurately pinpoint security weaknesses and predict these kinds of incidents.
Coming next: A look at the innovations around memory care safety, and a peek into what’s in the pipeline.
Any adverse medication interaction or medication error can be debilitating, but especially so for residents suffering from dementia. With more than 30 years of pharmaceutical experience, ValueMed pharmacists are part of the solution. We are experts in the varying medication needs along the trajectory of the disease and help ensure medication safety and efficacy. Contact us at ValueMed@PharMerica.com or 866-628-2583 to learn more.