Caring Checklist: What to Be Sure to Tell a Doctor After Someone With Dementia Falls
After your loved one with dementia falls, it's critical to first determine whether you need to call 911 or get same-day nonemergency medical treatment. Even if there seem to be no signs of injury, you should mention a fall at the next regular checkup.
Note: It's probably best if you plan on doing the talking instead of the person with dementia. There's a lot to cover and time is often at a premium during a medical visit. You'll be a more accurate reporter of symptoms, medications, and other conditions than the person with dementia. (You can invite your loved one to add additional details.)
(Find out why doctors sometimes prefer to talk to caregivers instead of patients.)
Whenever you discuss an accidental fall with medical personnel, whether at the ER or in the doctor's office, you'll get better help if you're sure to cover the following points:
Information about the fall to share
Explain how the fall happened, and where.
Did your loved one trip on a carpet? Stumble on stairs? Lose balance? Suddenly just collapse?
Note whether there were any obvious symptoms before the fall.
For example, light-headedness?
A loss of balance?
Chest pain?
Shortness of breath?
Vertigo?
Overall weakness, or weakness on one side?
Was there a loss of consciousness before or after the fall?
Describe anything else the faller said about the fall.
Does he or she remember blacking out?
Feeling nauseated?
Being surprised?
Think about whether there's been a pattern of falls.
Was this an isolated incident or part of a series of falls?
If the person has fallen before, how were the circumstances the same, or different, this time?
Convey how the person has been feeling and acting since the fall.
Any change in mobility?
Any change in range of motion?
Any confusion?
Any sleepiness?
Any change in confidence about walking?
Any complaints of pain?
Other relevant background information the doctor needs
Stage of dementia
What is the person with dementia usually like?
Explain mental status:
Mildly/moderately/very forgetful
Mildly/moderately/very disoriented (knowing where he or she is and what's going on)
Explain functional status:
Can/can't usually manage walking, transferring (getting out of bed/chair)
Moves around with nothing/cane/walker/wheelchair
How far the person can walk: just a few feet, around the house, less than a block, a few blocks or more
Whether the person can manage dressing, getting to the bathroom, feeding self
Other physical conditions
Is there normally any evidence of bladder or bowel incontinence?
What other medical conditions (besides dementia) is the person being treated for? Especially relevant conditions may be:
Hypertension
Congestive heart failure
Coronary artery disease
Cancer
Diabetes
Parkinson's disease
Previous stroke
Arthritis
Any neurological disease
Medications
Bring a current list of all medications, including prescription drugs, over-the-counter products, and herbs or supplements.
Ideally, bring the medications themselves in a bag. (The problem with lists, alone, is that they tend to be quickly outdated.)
Does the person use alcohol or other drugs? How often?
Living situation
Make sure doctors understand where the person lives:
With you?
In a nursing home?
In assisted living?
With a fulltime caregiver, or independently with caregivers dropping in?
Contact information
The treating physicians need to know who the person's primary medical doctor is, along with that doctor's address and phone number.
