Falls

Question 1

What are the neuromuscular RFs for falls?

Answer 1

Neuromuscular RFs for Falls

• Balance
  
  • Increased reflex time
  • Proprioception problems
  • Vestibular apparatus problems
  • Stroke
  • Other neuro diseases
• Muscle weakness
• Joint stiffness
• Centre of Gravity position

Question 2

What special senses may contribute to RFs for falls?

Answer 2

Special Sense RFs for Falls

• Decreased vision
• Decreased hearing

Question 3

What specific illnesses are a RF for falls?

Answer 3

Specific Illness RFs for Falls

• Diabetes
• Blood pressure
• Heart and Lung Disease
• Stroke
• Parkinson’s Disease

Question 4

What medications put pts at risk for falls?

Answer 4

Medications RFs for Falls

• Antidepressants
• Sleeping pills
• Hypoglycemics
• Antihypertensives
• Anticonvulsants
• Antiarrhythmics

Question 5

Name some environmental hazards for falls.

Answer 5

Environmental RFs for falls

• Loose rugs
• Telephone or light cords
• Poor lighting
• Stairs
• Loose fitting shoes
• Carrying heavy bags

Question 6

What is the screening protocol for falls?

Answer 6

Screening for Falls

• Ask all patients >70 about falls, balance, difficulties walking in previous year
• Observe patient getting in & out of chair & walking

Treatment

• 0-1 falls: recommend strength and balance exercises
• >1 fall: mulitfactorial assessment

Multifactorial Screening for Falls

• >70 years old
• >1 fall over 6 months
• A fall that resulted in a fracture or serious injury (unconscious)

Question 7

What are thes strategies for fall prevention?

Answer 7

Strategies for Fall Prevention

• Ask specifically about falls at least once/year
• Observing gait & testing balance annually
• Discuss walking aids
• Assess bone mineral density
• Multifactorial Assessment: do this if two falls within 6 months
  
  • Team approach ex. Living Wellness/CARS program
  • Targeted interventions ex. strength & balance exercises

Question 8

What specific strategies would you implement in a fall prevention program for a patient?

Answer 8

Prevention of Falls

• Exercises for balance, muscle strength & flexibility
• Remove environmental hazards
  
  • “osteo-proof” the home ex. ensure adequate lighting
• Well-fitted shoes
• Walking aids
• Monitor medical illnesses and medications
• Discontinue psychotropic meds
• Multifactorial assessment: required if two falls occur within 6 months
• Educate patient and family members
• Teach waht to do if they fall and can’t get up: personal emergency response team
• Inform them of the consequences of falls