قراءة
عرض

Fall in elderly

Adel Gassab Mohammed
MD, CABMS, MSc of Medicine Specialist Endocrinologist, Thi-Qar Specialized Diabetes, Endocrine and Metabolism Center, Lecturer Diabetes, Endocrine and Metabolism Division, Department of Medicine, College of Medicine, University of Thi-Qar,

• Outline:

• Introductions of falls in elderly.
• Cause and risk factors of falls.
• Consequences of falls in elderly.
• Assessment of fall in elderly.
• Preventing falls in older people.
• Summary.

• Definition of Falls

• A fall is defined as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level.

• Introduction

• Falls and fall-related injuries are a common& serious problem for older people.
• Fall potentially life- threatening events and may be simply the first signs of single problem.
• It lead to hospitalization and increase cost and burden on society and even lead to death .


Fall in Elderly




Fall in Elderly




Fall in Elderly




Fall in Elderly

• Intrinsic risk factors:

• Age Related changes (Visual function Neurological function, Musculoskeletal function)
• Diseases Female sex
• Extrinsic risk factors:
• Drugs Environmental Improper assistive
• devices
Fall in Elderly




Fall in Elderly

• (I HATE FALLING)

• I: Inflammation of joints (or joint deformity)
• H: Hypotension (orthostatic blood pressure changes)
• A: Auditory and visual abnormalities
• T: Tremor (Parkinson's disease or other causes of tremor)
• E: Equilibrium (balance) problem
• F: Foot problems
• A: Arrhythmia, heart block or valvular disease
• L: Leg-length discrepancy
• L: Lack of conditioning (generalized weakness)
• I: Illness
• N: Nutrition (poor; weight loss)
• G: Gait disturbance
Fall in Elderly



Fall in Elderly



Fall in Elderly



Fall in Elderly



Fall in Elderly



Fall in Elderly



Fall in Elderly



Fall in Elderly



Fall in Elderly



Fall in Elderly



Fall in Elderly



Fall in Elderly




Fall in Elderly

• Consequence of falls

• Physical:
• Skin tear internal bleeding
• subdural hematoma Hip fracture Immobilization /
• disability
• Hospitalization
• Psychological:
• Fear of falling increased dependency Depression
• Anxiety
• loss of confidence social withdrawal


Fall in Elderly

• ASSESSMENT OF FALL

• How to approach elderly with fall

• History

• Examination

• Investigations

• History

• A thorough history is essential to determine:

• Fall ( mechanism of fall, Location, Activity, Injury related to the fall, witness/help)
• Associated symptoms concurrent with a fall (change in level of or loss of consciousness, chest pain, palpitations, dizziness, vertigo or lightheadedness, Symptoms related to a change in position ,headache, weakness/tingling/numbness or acute change in mental status)

• previous falls and whether the falls were the same or different in character.

• medical history
• Medications
• Functional history
• Social history

• Physical Examination

• General looking Hydration status postural changes
• Vital signs( orthostatic hypotension) Visual & Hearing abnormalities

• Cardiovascular: murmur ,presence of arrhythmias & carotid bruits

• Neurologic and mental evaluation: looking for focal deficits, assessment of lower extremity peripheral nerves,
• proprioception, vibration sense, and tests for cortical, cerebellar, and extrapyramidal functions is important.

• Musculoskeletal: lower-extremity weakness, presence of contractures, limitations or pain in range of motion
• Gait and balance: abnormalities, lower extremity strength, and joint function.
• Environmental assessment: Lighting, walking surface, furniture, clothing, and equipment

• Testing and imaging

• Complete blood count, Electrolyte, Blood urea nitrogen , Creatinine , Glucose , Thyroid function, Vitamin B12 levels
• X-ray
• ECG, ECHO, EEG
• Brain imaging(CT/MRI)
• DEXA(dual-energy x-ray absorptiometry)

• The American Geriatrics Society and British Geriatrics Society recommend that all adults older than 65 years be screened annually for a history of falls or balance impairment.


Fall in Elderly




Fall in Elderly




Fall in Elderly

• Evaluate gait, strength, and balance

• Recommended test:
• Timed Up and Go
• Optional tests:
• 30-Second Chair Stand 4-Stage Balance tests


Fall in Elderly




Fall in Elderly




Fall in Elderly

• https://youtu.be/Ng-UOHjTejY

• https://youtu.be/3HvMLLIGY6c
• https://youtu.be/BA7Y_oLElGY

• PREVENTION OF FALL

Fall in Elderly



Fall in Elderly




Fall in Elderly



• Participate in regular physical activity. Exercise makes you stronger, increases flexibility and improves balance and coordination. ...
• Remove hazards in your home. ...
• Review your medications regularly. ...
• Have your vision and hearing checked once a year. ...
• Talk to your family members and enlist their help.
Five Safe Steps to Prevent Falls Among Elderly
Fall in Elderly

• Multifactorial falls risk assessment

• identification of falls history
• assessment of visual impairment
• assessment of cognitive impairment and neurological examination
• cardiovascular examination and medication review.
• assessment of gait, balance and mobility, and muscle weakness
• assessment of osteoporosis risk
• assessment of the older person's perceived functional ability and fear relating to falling
• assessment of urinary incontinence
• assessment of home hazards

• Multifactorial interventions

• An intervention with multiple components that aims to address the risk factors for falling that are identified in a person's multifactorial assessment.

• MULTIFACTORIAL INTERVENTIONS

• Multifactorial interventions should include: Exercise, particularly balance, strength, and gait training
• Vitamin D supplementation with or without calcium
• Management of medications Home environment modification
• Management of postural hypotension, vision problems, foot problems, and footwear.

• Improve home supports.

• Provide opportunities for socialization and encouragement.
• Involve the family.
• Provide follow-up.

• Rehabilitation

• Adequate rehabilitation physically, socially, and psychologically of injured person is very important post fall.
Fall in Elderly

• SUMMARY

Fall in Elderly




Fall in Elderly

• Healthcare professional should routinely ask about falls

• Identify if being at risk of falling Multifactorial risk assessment Multifactorial risk intervention

Fall in Elderly



Fall in Elderly



Fall in Elderly

• Elderly aged 65 or above



رفعت المحاضرة من قبل: Mubark Wilkins
المشاهدات: لقد قام 0 عضواً و 31 زائراً بقراءة هذه المحاضرة






تسجيل دخول

أو
عبر الحساب الاعتيادي
الرجاء كتابة البريد الالكتروني بشكل صحيح
الرجاء كتابة كلمة المرور
لست عضواً في موقع محاضراتي؟
اضغط هنا للتسجيل