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Least-restrictive falls prevention in dementia — SCE Geriatric Medicine MCQ

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ModerateFallsLeast-restrictive falls prevention in dementiaSCE Geriatric Medicine

An 89-year-old man with AF, dementia and recurrent falls is admitted after a fall. He has no injury but his daughter asks for bed rails to be kept up and for him to be prevented from walking. He repeatedly tries to reach the toilet and becomes agitated when stopped. What is the most appropriate management?

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Correct answer: E — A least-restrictive multifactorial falls-prevention plan

Falls prevention must balance safety, autonomy, continence and deconditioning risk. Least-restrictive strategies such as supervised toileting, sensor mats, appropriate footwear, mobility aid review and environment modification are preferable to restraint. Bed rails can increase injury if the patient climbs over them. The pearl is that preventing movement can worsen falls risk through delirium, agitation and deconditioning.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/neurological-conditions/dementia