Transcript falls_in_elderly

Falls in Elderly
Presented by
Dr. Soad H. Abd El Hamid El Tantawy
Lecturer of Gerontological Nursing
Faculty of Nursing
Mansoura University
 Introduction
 Definition
of falls
 Incidence of falls
 Risk factors of falls
 Consequences of falls
 Management
 Prevention
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Falls in older adult are not brief interruption in
activity as they are younger persons but
potentially life- threatening events and may be
simply the first signs of single problem.
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Moreover it lead to hospitalization and
increase cost and burden on society and even
lead to death .
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Falls is an event which result
in a person coming to rest on
the ground or another lower
level with or without loss of
consciousness or injury.
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Falls are the sixth leading cause of death in older
adults.
About 25% of person aged 70 years .It increase to
35% for people aged 75 years and older .
Between one –half and two third of
institutionalized elderly people experience fall
every years .
Falls occur approximately 25 to 33% of
community dwelling older adult
50 to 67% of nursing home resident experience
falls.
A-Intrinsic risk factors:
 Age Related changes
 Diseases (medical problems).
 Female sex .
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Visual function
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Neurological function
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Musculoskeletal function
Sensory
 Neurological
 Musculoskeletal system
 Cardiovascular disease
 Gastrointestinal system
 Metabolic
 Psychological
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 Drugs:
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Such as cardiac medication, CNS depressant, laxative,
antihypertensive, Narcotic, Chemotherapy drugs,
narcotic and oral hypoglycemic .
 Environmental
 Improper assistive devices
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Physical consequences:
 Skin tear and internal bleeding, subdural
hematoma.
 Falls result in physical injures, disability and
death
 Sever injures that require hospitalization.
 Hypothermia, dehydration, bronchial pneumonia
and pressure damage to the skin .
 Hip fracture one of the most serious injures
resulting annually more than 233,000 hip
fracture .
 Immobilization
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Fear of falling can itself be debilitating. It can lead to
restricted activity, decreased exercise, eventually to
increased dependency, depression, anxiety, loss of
confidence, social withdrawal and
institutionalization. Older adults who fall may or may
not experience psychological trauma post fall (falls
phobia syndrome) one significant consequences of
falling may be fear of falling aging .
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Economic consequences
Assessment :
1-History of falls ''SPLATT"
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Symptoms ' dizziness or vertigo, palpitation, chest pain ''
Previous fall '' during past year ''
Location .
Activity at time of falls .
Time of fall.
Trauma or injury with fall
2-Physical examination
◦ Sensory examination ' visual acuity , fields , cataracts,
glaucoma , hearing loss
◦ Cardiovascular examinations 'arrhythmias , heart
failure .
◦ Neurological examination 'mental status, mood and
behavior.
◦ Musculoskeletal; examinations muscle weakness severe
arthritis,
limited range of motion
◦ Mobility evaluation .
◦ Balance
◦ Gait transfer (wheel chair patient )
3- Environmental assessment: Lighting, walking
surface, furniture, clothing, and equipment
4-Mental and Affective testing: As indicated
formal cognitive and affective function should be
evaluated .
5- Laboratory /diagnostics testing: Any
laboratory or diagnostics tests should be tailored
to be the suspected underlying cause of the falls
for example anemia, electrolyte imbalance,
dehydration, arrhythmia, screening for
osteoporosis using bone mineral density
techniques , complete blood count , X-ray , ECG .
1-Intervention for predisposing factors:
 Educate patient how to use assistive devices
 Educate patient about arising slowly (count 30 ,
changing position
 Maintain adequate hydration and provide small
frequent meals rest periods after meal , give
antihypertensive medications after meals
 Educate patient about signs and symptoms of
hypoglycemia and need to carry concentrated
sugar ,
 Regular eye examination
2-Enviromental modification:
 Provide adequate lighting in rooms and
hallways with switches located at room
entrance
 Use nights keep flashlights, keep flashlight in
beside table in case o9f power failure
 Arrange furniture so that pathway are not
obstructed
 Provide stable furniture along pathway for
balance and support
 Provide nonskid rugs and carpets runners on
slippery floors , use non –skids floor wax ,
wipe up spills immediately
Use elevated toilet seat or
install toilet safety frame
 Apply nonskid mat on tub
floors
 Provide handrails on both
sides of bathroom
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3-Rehabilitation:
 Adequate rehabilitation physically, socially,
and psychologically of injured person is very
important post fall.
Thank you