Why do people with dementia start avoiding stairs

People with dementia often start avoiding stairs due to a combination of physical and cognitive challenges that make navigating them increasingly difficult and unsafe. One of the primary reasons is the decline in physical abilities, such as balance and coordination, which are common in dementia. Conditions like Lewy body dementia, for instance, can lead to balance problems and difficulties with movement, making it hard to climb stairs safely[5].

Cognitive changes also play a significant role. Dementia affects thinking and judgment, making it harder for individuals to assess risks or remember how to perform tasks safely. This can lead to confusion and fear when faced with stairs, as they may struggle to judge distances or understand spatial relationships[5]. Additionally, visual impairments can occur, further complicating the ability to navigate stairs safely[5].

Another factor is the fear of falling. People with dementia may experience frequent falls, which can be particularly dangerous on stairs. The risk of injury from a fall can be very high, leading to a loss of confidence and a desire to avoid stairs altogether[3]. Furthermore, the emotional and psychological impact of living with dementia can lead to anxiety and stress, which may exacerbate the avoidance of stairs due to perceived risks or past experiences[3].

In many cases, individuals with dementia may find it easier and safer to stay on one level of their home, avoiding the need to use stairs. This can be supported by adapting the home environment to reduce hazards and improve safety, such as installing handrails or ensuring good lighting[1]. However, if the person’s needs become too challenging to manage at home, moving to a care facility might be considered to ensure their safety and well-being[3].