801e Fall Prevention in Older Adults

Question 1

intrinsic risk factors for falls

Answer 1

advanced age, previous falls, muscle weakness, gait & balance problems, poor vision, postural hypertension, chronic conditions, & fear of falling

Question 2

intrinsic chronic conditions risk factors for falls

Answer 2

arthritis, diabetes, stroke, Parkinson’s, incontinence, & dementia

Question 3

extrinsic risk factors for falls

Answer 3

lack of stair handrails, poor stair design, lack of bathroom grab bars, dim lighting or glare, obstacles & tripping hazards, slippery or uneven surfaces, psychoactive medications, improper use of assistive devices

Question 4

medical conditions that influence falls

Answer 4

poor general health, DM, arthritis, osteoporosis, stroke, incontinence, musculoskeletal disease, & muscle weakness

Question 5

behavioral causes for falls

Answer 5

exercise, footwear, alcohol use, nutrition, & hydration

Question 6

what footwear is recommended to prevent falls?

Answer 6

velcro shoes, shoes without laces, non-skid socks

Question 7

why do people fall?

Answer 7

clutter, poor lighting, obstacles in paths (sliding pats, cords, furniture), lack of handrails

Question 8

psychological fear of falling warning signs

Answer 8

need to touch or hold onto things or people, walks very slowly, takes small steps, limited movement, & expresses fear of falling

Question 9

psychological fear of falling downward cycle

Answer 9

increased fear of falling, moves slower, avoids movement, becomes de-conditioned, dec strength & endurance, & inc risk of falling

Question 10

fall assessment

Answer 10

fall history, medical diagnosis, support network, physical activity, cognition/memory, fear of falling & environment

Question 11

meds that cause fall risk

Answer 11

diphenhydramine, sedative hypnotics, diuretics, sleep agents, digoxin, benzodiazepines, SSRIs, antidepressants, TCA, antihypertensives

Question 12

fall assessment tools

Answer 12

orthostatic hypotension screening, timed up & go, BERG balance scale, beer’s criteria, eye card, monofilament test, cognitive function test

Question 13

positive orthostatic hypotension screening

Answer 13

drop in SBP of >20 mmHg or DBP of >10 mmHg within 3 min of standing or inc in HR >20 bpm supine to standing

Question 14

timed up and go assessment

Answer 14

• <10 freely mobile
• <20 mostly independent
• 20-29 variable mobility
• > 20 impaired mobility

Question 15

BERG balance scale

Answer 15

A 14-item objective measure designed to assess static balance and fall risk in adult populations

Question 16

interventions for fall prevention

Answer 16

• assessment & management of chronic conditions, vision, & hearing
• osteoporosis screening & prevention
• CMR
• referral to PT or OT

Question 17

assistive devices for fall prevention

Answer 17

reacher, portable seat lift, perching stool, raised toilet seat, shower bench, grab bars

Question 18

canes

Answer 18

improve balance & provide support

Question 19

walkers

Answer 19

improve balance, relieve or reduce weight bearing, & provide 4 way stability

Question 20

interventions

Answer 20

• encourage exercise & nutrition such as tai chi
• fall programs that include more than 1 intervention
• fall risk assessment & interventions for LYC residents w/at least 1 fall
• LTC residents offered hip protectors

Question 21

STEADI

Answer 21

stopping elderly accidentally, deaths, & injury