Falls Flashcards
What is the first year post-fracture mortality rate in post-menopausal women?
12-40%
People 75 and older who fall are ______ times more likely to be admitted to a long-term care facility for a year of longer?
4-5x
What is the leading cause of unintentional injury hospitalization and death among older Mainers?
Falls
On average, a Maine resident over the age of 65 is hospitalized every _____ minutes from a fall related injury
Seven
What is the most common type of fall in the hospital setting?
Anticipated physiological
What is the most common type of fall in the community?
50-67% accidental falls in the home
25-45% accidental falls are environmental
Death, injury, restricted mobility, difficulty with ADL and IADL’s, fear of falling, increase risk of LTC placement, new caregiver responsibilities, risk of early death, social isolation, financial burden are all consquences of what?
Falling
What do we know about preventing falls?
- Reasons for falling and risk factors
- Accumulation model
- Effective Interventions
What is the most potent intrinsic factor for falls?
Previous falls
What are some extrinsic factors? Aka, what in the environment can lead to falls?
Shoes, layout, restraints, furniture, surfaces, handrails, lighting, contrast
In terms of medications, the strongest risk factor is polypharmacy. What does this mean?
> 3 medications
What are some individual drug classes to consider for fall risks?
- Serotonin-reuptake inhibitors
- Tricyclic antidepressants
- Anti-hypertensives
- Class IA anti-arrhythmics
- Neuroleptics
- Benzodiazapines
- Laxatives/Diuretics
- NSAIDs
- Sedatives/Hypnotics
What are some periods in one’s life where we might be at a higher risk for a fall?
- Acute illness/Exacerbation of chronic illness
- Institutionalization
- Home and Community-based Care recipients
- Transitions of care (1 month post hosptial discharge and new living environments)
I don’t know how to make this a question, just know its important to fix visual impairment…
HI GUYS!
What vitamin should we be supplementing in the elderly?
Vitamin D
*all patients with proven or suspected definiciency
How can improve target balance and strength in the “at risk for falls” population?
All adults should be offered exercise options to meet their needs.
Balance Training Program Recommendations–what would these recommendations looks like for someone who is low to moderate risk?
Non-targeted, group exercise programs that include strength balance, flexibility, and aerobic endurance component
Balance Training Program Recommendations–what would these recommendations looks like for someone who is at high risk?
Targeted interventions, trained professionals, long duration/lower intensity, responsive to changing status, and complicated patient
What are some examples of when we should screen for falls?
Every adult 65 years and older
Every healthcare encounter
Every healthcare provider
Assessments are effective only if an intervention is applied.
What are our 3 “must ask” screening questions?
- Have you had 2 or more falls in the past year?
- Have you been injured in a recent fall?
- Do you have difficulty with walking or balance?
What are some recommended physical screening tests?
- Orthostatic BP check
- Timed Up and Go Test
- 30 second chair stands test
- Quiet standing balance
- Feet together stance, semi-tandem stance, tandem stance, single leg stance
What is the Time Get up and Go test?
- Patient rises from a standard arm chair
- Walks 3m (10 feet) to a line on floor
- Returns to chair and sits down
For the Timed Get Up and Go Test, what length of time is associated with elevated fall risk?
12 seconds or more to complete the test
For the Balance in Quiet Standing Test, what length of time suggests high risk for injurious fall.
30 seconds suggest low fall risk
What is the most powerful predictor for assessing fall risk?
Gait Speed
What makes communication about falls so difficult?
- Sensory/cognitive impairment
- Office visit time
- Reactive health care model
- Complex medical conditions
- Cultural beliefs re: stoicism, ageism
When obtaining a history on a fall, what are some important questions to ask?
- Define the fall
- How many falls in the last 3, 6, 12 months
- Near falls?
- Circumstances of falls or near falls
- Associated symptoms?
What are the names of cognitive assessments that we can use to assess dementia–and in turn fall risk?
Montreal Cognitive Assessment (MoCA)
Mini-Cog
