Safety Considerations in Older Adults with Cognitive Impairment Including Dementia

Dementia, or progressive brain failure, is common among older adults and the prevalence rises rapidly with advancing age. Although there are currently no curative treatments for dementia, health professionals serve a critical role in helping people living with dementia and their caregivers successfully manage the disease, including timely identification and mitigation of safety risks. This chapter briefly reviews the key features of dementia and how it is diagnosed and treated. Next, the chapter provides an overview of safety considerations in older adults in all stages of dementia. Risk areas discussed include transportation, financial management, nutrition, healthcare management, wandering, falls, worsening behavioral and psychological disturbances, caregiver stress and burnout, elder abuse and neglect, and complications of end-stage dementia. The chapter concludes with a discussion on interventions to mitigate safety risks for older adults with dementia, including managing ethical conflicts that can arise in this context. This chapter will equip health professionals with the knowledge and tools to reduce safety risks, and thus help maximize independent activity, dignity, and quality of life, for people living with dementia.