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Therapeutics III > Falls - Block 4 > Flashcards

Falls - Block 4 Flashcards

1
Q

Describe the progressions to falls?

A

Fraility -> falls -> debility

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2
Q

Wha are the potential complications for falls?

A
  1. SOft tissue injury
  2. Fractures
  3. Subdural hematoma
  4. Hospitalization
  5. Limited mobility
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3
Q

What are intrinsic RF for falls?

A
  1. Medical and neurological conditions, sensory impairment
  2. Age related changes in NM function, reflexes, and gait
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4
Q

What is the difference between older men and women walks?

A

Men: wide-based, short stepped gaits
Women: narrow-based, waddling gait

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5
Q

What are extrinsic RF for falling?

A
  1. Medications
  2. Improper footwear or use of assistive devices
  3. Environmental hazards
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6
Q

What are meds that contribute to fall risk?

A
  • Antihypertensives/ alpha-blockers -> bradycardia/hypotension
  • Antidepressants -> postural hypotension
  • Cholinesterase inhibitors -> bradycardia
  • Diuretics -> hypovolemia
  • Sedatives -> sedation
  • Antipsychotics -> sedation, muscle rigidity, postural hypotension
  • Hypoglycemics -> acute hypoglycemia
  • Alcohol -> acute intoxication
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7
Q

What are examples of improper footwear?

A

Older adults have lower arches and increased circumference of foot unit

Narrow or small shoes: Pain
Loose shoes: lower gait speed, shorter stride length, irregular gait pattern

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8
Q

What are the goals for assistive devices?

A

Improve independent mobility, reduce disability, delay functional decline, and decrease the burden of care

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9
Q

What are the types of assistive devices?

A
  1. Canes (standard, offset, quadripod)
  2. Crutches (axillary, forearm, platform)
  3. Walkers (standard, front-wheeled, four-wheeled)
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10
Q

What are the difficulties of using assistive devices?

A
  1. Lifting and advancing the device -> destabilization
  2. Need to allocate attention to control device -> disrupts balance
  3. Interference with limb movements
  4. Repetitive stress on upper extremity joints -> tendinopathy, OA, carpal tunnenl
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11
Q

How do we determine what walking device we use?

A
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12
Q

What are the environmental hazards of using assistive devices?

A
  1. Slippery surfaces
  2. Inadequate lighting
  3. Loose, deep pile, or worn carpets
  4. Staircases without railings
  5. Unsupportive or badly arranged furniture
  6. Poorly designed tubs, toilets, and fixtures in the bathroom
  7. Clutter
  8. Pets underfoot
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13
Q

WHat are the behavioral RF?

A
  1. Performing behaviors that could increase fall risk
  2. Not performing behaviors that could reduce fall risk
  3. Selecting unsafe clothing, footwear, or inappropriate or outdated eyewear prescriptions
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14
Q

What are the core elements for fall prevention?

A
  1. Screen
  2. Assess
  3. Intervene
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15
Q

How do we help others prevent falls?

A
  1. Adaptation or modification of home environment
  2. Withdrawal or minimization of psychoactive medications
  3. Withdrawal or minimization of other medications
  4. Management of postural hypotension, urinary frequency/urgency, vitamin D deficiency
  5. Management of foot problems/footwear, visual impairment
  6. Exercise, particularly balance, strength, and gait training
  7. Increase caution or awareness and reduce other high-risk behaviors
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16
Q

How do we modify the home to prevent falls?

A
  1. Removing hazards
  2. Adding special features or assistive devices
  3. Moving furnishings
  4. Changing places where activities occur
  5. Renovating rooms to accomodate disabilities
17
Q

What are tools used to assess falls at home?

A

**Checklist: **
* Check for Safety: A Home Fall Prevention Checklist for Older Adults
* Westmead Home Safety Assessment (WeHSA)

Functional fall risk assessment:
* Conducted by health care or social service professionals
* Falls Home Assessment
* Comprehensive Assessment and Solution Process for Aging Residents

18
Q

What are the characterizations of fraility and debility?

A

High risk of severe illness, falls, malnutrition, and death
* Low physical activity
* Muscle weakness
* Slowed performance
* Fatigue or poor endurance
* Unintentional weight loss

19
Q

What are the common medical ADR?

A

Musculoskeletal -> arthritis, osteoporosis
Neurological -> stroke, PD
Cardiovascular -> HF, PVD
Pulmonary -> COPD
Others -> pain, motivation, mood, fear

20
Q

What are the assessment tools for fraility?

A

Questionnaires:
Frail Elderly Functional Questionnaire
Groningen Frailty Indicator
Tilburg Frailty Indicator

Assessments:
Edmonton Frail Scale
Comprehensive geriatric assessment

21
Q

How do you manage fraility and debility?

A
  1. Exercise (physical and mental)
  2. Treatment of underlying health issues
  3. Healthy diet

Therapeutics III (40 decks)

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