fall and balance training Flashcards
frequency of falls. How many falls occur in overall population. How many falls occur in the elderly.
Falls comprise of 2/3 accidental deaths
75% falls occur in elderly
13% population (65 yrs and older)
. Major cause of death for people over 65 years
- Stair falls account for more than 10% of fatal falls
- Falls cause 90% of hip fractures, cost of 10 billion dollars
- Fall occur in settings – home, hospital, and long-term care facility, 85% occur at home
- About 10,000 adults die each year as a result of falls
- Women have a higher rate of falls than men
Why do falls happen in the first place??
An individual who has had two or more unexplained falls within a 6 month period
Of those persons hospitalized as a result of falling, only ½ will be alive 1 year later
Mortality not a direct result of the fall but rather a consequence of comorbidity (heart failure, pneumonia)
The well elderly can become frail within 24 hours
Accident/ environment
Gait/ balance disorder
Dizziness/ vertigo
Confusion
Postural hypotension
Vision problem
where do most fractures occur??
The most common fractures associated with falls are those of the forearm and hip.
250,000 hip fracture every year
Many never regain premorbid level of ambulation and ADL functioning
What can falls lead to? Think like limited social interaction llmited ADL’s what else??
Loss of independence • Limited ADLs • Loss of confidence • Limited social interaction • Fear of additional falls
Reasons for falls??
Prior fall Assistive device Vision deficit Arthritis Depression MEDICATION
Extrinsic and Intrinsic reasons for falls.
Multi-factorial: intrinsic, extrinsic and situational circumstances
Intrinsic factors: age-related physiologic changes, disease states, medications
Extrinsic factors: hazardous environment conditions, faulty devices, footwear.
Additional factors: length of stay, time of day and staff characteristics influence the occurrence of falls.
visual reasons for falling think like acuity, depth perception, and contrast medium.
what about somatosensory??
what about neuromuscular?
vestibular
Visual (acuity, contrast sensitivity, depth perception)
Somatosensory (touch, proprioception, vibration sense, muscle spindle activity)
CNS (slow processing of information)
Vestibular (decrease vestibular hair cells, nerve fibers
Neuromuscular (decrease flexibility, endurance, sequencing, strength, postural alignment – impaired,
what is the vestibular ocular reflex
what is the vestibular spinal reflex??
what are the symptom of vesitibular disorders??
Regulates the head and neck position
Vestibular ocular reflex (VOR) : stabilizing images on the retina during head movements
Vestibular spinal reflex: reflex control of the neck and lower extremity postural muscles so that the position of the head and trunk can be maintained accurately and correlated with eye movements.
Symptoms of the vestibular system: dizziness, blurry vision, feeling of falling
Loss of peripheral hair cells and nerve fibers (increase with age)
number reason for falls in the nursing home pretty self explanatory
Muscle weakness and walking or gait problems
are the most common causes of falls among
nursing home residents. These problems account
for about 24% of the falls in nursing homes.”
What is polypharamcy described as taking how many drugs at one time??
Polypharmacy‐ taking more than 4 drugs
Drug metabolism and distribution decrease with age, liver and kidneys are less efficient,
Drugs may stay in their system longer
No one knows the interactions of multiple drugs in the body, most studies are of one or few drug combinations
What types of drugs cause postural hypotension (parkisons)
What type of drugs cause fatigue and weakness (think NSAIDS)
What type of drugs cause dizziness (think cancer or heart)
Antidepressants, antipsychotic, antihypertensive drugs, Parkinson’s drugs (levodopa) : CAUSE POSTURAL HYPOTENSION
Beta blocker, antidepressants, pain and inflammation related drugs, most cancer drugs : Cause Fatigue and weakness
Cardiovascular drugs, peripheral neuropathy drugs, cancer drugs: Cause dizziness
best type of carpet to have in your house??
Carpet has acoustic values, uncut low pile carpet (best choice)
When do most falls occur like what time??
Time of Fall
Most falls occur during the night (11-7pm)
Less staff available
Selected day time hours (6am- 10am) (4pm- 8pm)
STAFF CHARACTERISTICS
NUMBER OF NURSES, AIDES AVAILABLE ON ONE SHIFT
Some factors that can make you fall in public think like the noise, enviorment, wether
Pace: moving at a speed not in tune with the person’s capabilities
Mobility behaviors: not being able to accept a walking stick or selectively not taking it on the some outings
Environmental influences: weather, noise, crowds, windy, rainy
Eyesight behaviors: misjudge or fail to notice details in the environments
Overexertion:
Health factors affecting physical abilities: past/ present physical condition
what does SPLATT stand for?? Things you should assess for when an individual falls.
Symptoms Previous falls Location Activity Time Trauma
