Falls and incontinence Flashcards
Risk of hip fracture in residential care vs community?
10x higher risk in RH then community
Strongest risk factors for falls?
Advanced age History of falls Limited with ADLs Impaired mobility/gait/sit to stand Reduced vision, sensation, weakness and reaction time Impaired cognition Stroke Parkinsons disease Psychoactive medication use Use of greater than 4 medications
Management of falls?
MDT interventions
Stop psychoactive medications
Vitamin D
Excercise
12 month mortality following hip fracture?
30%
Placement rate after hip fracture?
20%
Types of urinary incontinence?
Urge Stress Mixed urge and stress - most common Overlow with retention Functional - due to reduced mobility etc.
Management of incontinence?
Pelvic muscle excercises - always first line for stress incontinence
Bladder retraining
Timing of oral fluids
Treat constipation
Weight loss in obese
scheduled toileting
Continence aids
Drugs
- oxybutynin in urge incontinence in cognitively intact patients
- topical estrogens in those with stress incontinence
Surgical treatment
- sling as last line for stress incontinence
What are the drugs that most increase falls?
From greatest to least: Antidepressants Anti psychotics Benzodiazepines Sedatives/hypnotics
What has the best evidence for falls prevention?
Strength and balance training
What are worse for falls SSRIs or TCAs?
SSRIs
What is the best assessment of mobility?
Gait speed
What is the normal for the get up and go test?
10 seconds
- get up from sitting to stand, walk 3m turn around and return to sitting
What is the most common type of incontinence in the elderly?
Urge
What is the correct use walking aid in left hip OA?
Hold in right hand and advance when advancing left leg
