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Caregivers wear many hats, each carrying their own challenges and rewards. For those caregivers supporting older adults living with cognitive decline the challenges may be greater, especially when it comes to fall safety and prevention.
Older adults living with cognitive decline are at an increased risk for falls.1,2 Using falls prevention strategies can help promote safety for both you and the person you’re supporting.
5 practical strategies for caregivers to promote safety and prevent falls
1. Focus on what you can control
When it comes to supporting someone living with cognitive decline or dementia, there are many things you can’t control, like disease progression or what the person remembers on a day-to-day basis. When it comes to fall safety strategies, though, among the things you can control:
- Maintaining adequate lighting in their home
- Removing clutter from walkways
- Taking them for routine vision checks
- Ensuring they have supportive footwear
Another thing you can control is how you communicate with the person you’re supporting. It can be tempting to engage in “reality checking” with the person. This involves explaining things repeatedly to get the older care recipient to understand what’s happening in the here and now. But when it comes to fall safety, it doesn’t matter if the person is “in the present” with you. What matters is our tone of voice, the language we use, and the empathy we bring to the situation.
2. Create a routine
Falls are more likely to occur at certain times of the day, like early morning or overnight. A person's blood pressure may drop if they get up too quickly from bed in the morning, also known as postural hypotension.3 Lack of proper lighting4 and continence issues5 can increase fall risk overnight.
Establishing a routine and ensuring that proper tools are available, especially during times when the risk of falls is heightened, are key to prevention. If a person experiences postural hypotension, encourage them to get up slowly using visual aids like a sign reminding them to go slow, or utilizing recliners that help someone stand slowly. You may have to adjust this strategy based on the care recipient's cognitive state. You may even consider a bedside commode if getting to the bathroom urgently is part of their overnight needs. Ensuring proper lighting, like smart lights that turn on when someone gets up and/or nightlights, can make it easier for the person to see where they are going and reduce their risk of falls.6
Receiving routine medical care7 including vision exams and requesting regular medication reviews, should also be a part of your fall safety routine.3
3. Incorporate movement
Engaging in movement can help build strength, balance, coordination, and flexibility, which are all vital components of falls prevention. Adults with mild cognitive impairment may be eligible to participate in falls prevention programs through your local senior center, area agencies on aging, YMCA, health care facilities or State Falls Prevention Coalitions. For those living with a more significant cognitive decline, encourage the person in your care to participate in activities that they prefer. If there’s a risk of wandering, usinga stationary bike or treadmill may be best.
4. Tap into technology
Technology can offer a vital lifeline for long-distance caregivers and those who aren’t with their care partner 24 hours a day. From medical alerts to smart home technology and remote monitoring, technology can offer peace of mind and increase safety.
Medical alert systems and medical alert watches have come a long way over the years and can ensure access to help if your care partner falls. NCOA has extensive reviews on the best medical alert systems with falls detection and the best medical alert watches.
Medication management may be tricky for those living with cognitive decline. Tools like Alexa, Google Home, or Apple HomePod can provide medication reminders, or you may choose an automatic pill dispenser, both of which may reduce accidental medication misuse that could lead to falls due to drug interactions or side effects.
When it comes to smart home technology, there are many options to choose from such as cameras, doorbells, smart lights, appliances, and speakers to name a few.8 The AgeTech Collaborative from AARP offers insights on the perception of technology and its value for older adults.
5. Lead by example
As caregivers we can often neglect ourselves which could lead to an increased risk of health conditions9 and falls.10 By engaging in the listed strategies for ourselves, we can lead by example for those in our care. This can help normalize fall safety strategies while supporting independence, health, and well-being for both you and the person in your care.
Through practical strategies, caregivers can foster fall safety with those they care for, supporting safer and healthier lives.
Sources
1. Okoye, SM, et al. Predictors of falls in older adults with and without dementia. ALzheimer's and Dementia. Jan. 12,2023. Found on the internet at https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12916
2. Fisher Center for Alzheimer's Research Foundation. Falls in older adults may presage dementia onset. Oct. 31, 2024. Found on the internet at https://www.alzinfo.org/articles/caregiving/falls-in-older-adults-may-presage-dementia-onset/
3. National Institute on Aging. Falls and Fractures in Older Adults: Causes and Prevention. Jan. 20, 2026. Found on the internet at https://www.nia.nih.gov/health/falls-and-falls-prevention/falls-and-fractures-older-adults-causes-and-prevention
4. Appeadu, MK, and Bordoni, B. Falls and fall prevention in older adults. StatPearls—NCBI Bookshelf. June 4, 2023. Found on the internet at https://www.ncbi.nlm.nih.gov/books/NBK560761/
5. NHS Inform. Causes of Falls. March 18, 2026. Found on the internet at https://www.nhsinform.scot/healthy-living/preventing-falls/causes-of-falls/
6. National Institute on Aging. Preventing Falls at Home: Room by Room. Jan. 26, 2026. Found on the internet at https://www.nia.nih.gov/health/falls-and-falls-prevention/preventing-falls-home-room-room
7. Mayo Clinic. Fall prevention: Simple tips to prevent falls. June 14, 2024. Found on the internet at https://www.mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/fall-prevention/art-20047358
8. Edward C. Baig. How a Smart Home Can Help You Age in Place. AARP. Nov. 1, 2024. Found on the internet at https://www.aarp.org/personal-technology/smart-home-age-in-place/
9. Caregiver Action Network. The Caregiving Landscape: Data & Insights on the Caregiver Experience in the U.S.. Feb. 27, 2026. Found on the internet at https://www.caregiveraction.org/caregiver-statistics/
10. American Psychological Association. Mental and physical health effects of family caregiving. 2015. Found on the internet at https://www.apa.org/pi/about/publications/caregivers/faq/health-effects
This project was supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $5,000,000 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.
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