FAQ: How Do I Keep My Loved One From Falling on His Way to the Bathroom at Night?

There's no way to guarantee that your loved one won't fall on the way to the bathroom at night, but there are steps you can take to reduce the chance of a fall:

• Try to reduce the need to go at night.

  • Ask the doctor to evaluate your loved one for causes of increased urination at night. For example, in older men, an enlarged prostate is a common cause of needing to go at night. Treatment of an underlying medical condition may result in fewer nighttime trips to the bathroom.

  • Consider keeping fluid intake to a minimum after dinner. Avoiding caffeine and alcohol can also help.

  • Ask the doctor to help you identify medications that increase urination (such as diuretics for high blood pressure). If your loved one needs to take these drugs, ask about scheduling the dosing earlier in the day.

• Avoid medications that impair balance and/or cloud thinking.

  • These include virtually all sleeping pills and tranquilizers, including over-the-counter (OTC) drugs such as diphenhydramine (brand name Benadryl), which is often included in the night-time versions of common OTC painkillers.

  • Ask the doctor to help you identify other medications that increase fall risk. You should especially ask about medications for blood pressure, depression, itching, pain, or overactive bladder. You should also ask about antipsychotics, which are often prescribed to people with dementia.

  • Once the doctor has helped you identify medications that increase fall risk, you can discuss whether each medication is absolutely necessary or whether a lower dose might be effective.

• Try to reduce the distance traveled at night.

  • For men, consider placing a urinal at the bedside. For women, consider a bedside commode. (Bear in mind that someone with dementia may forget to use these, however.)

• If your loved one still has to get up at night to urinate, try to make the journey as safe as possible.

  • Keep the path to the bathroom lit at night.

  • Remove clutter from the path from bed to bathroom.

  • Provide assistance and supervision, if possible.

Remember that although there are many ways to reduce the chance of falling, it's not usually possible to guarantee that a person won't fall at all. When it comes to falls and dementia, families often end up facing difficult trade-offs between safety and independence. Still, asking the doctor to help you with the steps above should help lessen the chance of a bad fall.