Falls and Immobility

Question 1

what are some causes of a fall in an elderly person?

Answer 1

MSK:
- arthritis of weight bearing joints
- sarcopenia
- deformities of feet

Drugs:
- anti-hypertensives
- sedatives
- alcohol and lots other

Neurological:
- stroke, old or new
- parkinsonism
- dementia
- delirium, ataxia (seizure, TIA)
- other

Sensory:
- visual impairment
- inattention
- (hearing)

Cardiovascular:
- postural hypotension
- arrhythmia
- heart failure
- aortic stenosis

Being generally unwell
Incontinence

Question 2

how do drugs cause falls?

Answer 2

they can decrease:
- blood pressure
- heart rate
- awareness

they can increase:
- urine output
- sedation
- hallucinations
- qTC
- dizziness

Question 3

what are the main types of drugs that can cause falls?

Answer 3

• antihypertensive
• beta-blocker
• sedatives
• anticholinergics
• opioids
• alcohol

Question 4

The falls clinical involves a fullt MDT. What member of the team is involved with what tasks?

Answer 4

• Nurse: eye test, ECG, lying and standing BP, incontinence questionaire, MMSE.
• Physio: full assessment of gait and balance
• Doctor: full history and exam, consider bone health and osteoporosis screening (45 minutes +)
• MDT discussion: treatment plan made.