Falls - LO Flashcards
Fall definition
An event that results in a person coming to rest inadvertently on the ground or another lower level
Incidence of falls each year for people >65
1 out of 4 older people fall each year (but less than ½ tell their doctor)
% hip fx caused by falls
> 95%
Definition of balance
- A complex process involving the reception/integration of sensory inputs and the planning and execution of movement to achieve a goal requiring upright posture
- Simply: the ability to keep one’s center of gravity over one’s base of support in any given sensory environment
Identify factors placing a person at risk for falling
• Lower body/trunk weakness • Difficulty with gait/balance - Limitations in postural control and range of motion - Dizziness • Vision problems • Foot pain/poor footwear • Home hazards • Vitamin D deficiency • Postural BP changes • Low mental status score • Low depression score • 3+ falls in the past 12 months • Multiple medications • Disease precursor: poor vision/hearing, infection, CHF, RIA, CKD, CLD, peripheral neuritis, Parkinson’s, electrolyte disturbance, delirium, dementia) • Dizziness/vertigo • Meds: sedatives, anti-seizure/depression, antihypertensives, diuretics • Alcohol
Identify environmental contributors increasing the risk to fall
- Dim lights
- Throw rugs
- Slippery floors
- Uneven/non-level surfaces: pavement, sidewalk, driveway
psychological consequences of a fall
- Loss of function → loss of independence
- Loss of confidence → fear of falling again
- Dependency
- Institutionalization
- Social isolation
- Depression
- Anxiety
- Confusion
consequences of immobility
- Decreased PO intake
- DVT, PE
- Pressure sores
- Constipation/fecal impaction
- Urinary incontinence/UTIs
- Pneumonia
- Atelectasis
- Orthostatic hypotension
- Deconditioning
- Contractures
- Osteoporosis
Provide the Joint Commission definition for a sentinel event.
Any unanticipated event in a HC setting resulting in death or serious physical or psychological injury to a patient, not related to the natural course of the patient’s illness
Define the elements of the acronym SPLATT in assessing a fall
- Symptoms before the fall
- Previous falls
- Location of the fall
- Activity at the time of the fall
- Time of day when the fall occurred
- Trauma acquired from the fall
Timed Up and Go (TUG) screening test
- purpose
- method
- evaluate gait and balance
- record time it takes for person to → rise from chair without using arms, walk 10 feet, turn, return to chair, sit down
Timed Up and Go (TUG) screening test
- helps determine what 4 things
- Risk of falling
- Balance deficits
- Gait speed/stride length
- Functional capacity for household/community mobility
Timed Up and Go (TUG) screening test
- Results
- Most adults can complete in ≤10 seconds
- Frail adults can complete in 11-20 seconds
- > 14 seconds=high fall risk
- > 20 seconds=need for comprehensive evaluation (Refer to PT)
environmental alterations that may be recommended to reduce the risk for falls
- Remove throw rugs
- Secure carpet edges, repair flooring
- Remove clutter
- Address lighting/night-lights
- Install handrails/grab bars/raised toilet seats
- Eliminate low chairs
- Avoid waxed floors
- Use rubber mats in tub/shower
- Repair cracked sidewalks
- Keep phone within reach
- Lever door handles
- Pets!
strategies used in a rehabilitation setting to minimize the risk for a future fall in an elderly patient
- Encourage training in balance, gait, transfers, strengthening
- Encourage exercise: walking, tai-chi, swimming/water aerobics, stretching, light weights
- Occupational therapy: reacher, sock/shoe tools
- Assistive devices: cane, walker, wheelchair, power chair
- Home safety inspection: home health, council on aging→shower chair, roll in shower, elevated toilet seat
- Alarm device to call for help when needed
