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Falls in the Elderly: Who Why What Happens Next

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Motor Vehicle. 10.2% DEATH BY INJURY SEVERITY SCORES. Age Group. 1 8. 9 -15. 16 -24 24 ... CVA that results in hemiparesis, sensory and/or motor function deficits ... – PowerPoint PPT presentation

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Title: Falls in the Elderly: Who Why What Happens Next


1
Falls in the ElderlyWho? Why? What Happens
Next?
  • Rhonda Bugbee, RN, CEN
  • Trauma Consultant

2
Help! Ive Fallen and I Cant Get Up!
3
Emergency Visits
  • Falls are the leading cause of external injuries
  • Most common in children less than 5 years old and
    adults 65 and older
  • Trauma is the 5th cause of death in those gt65
    years
  • Falls are responsible for 70 of accidental
    deaths in people over 75 years old
  • 1/4 of the elderly people who fracture their hips
    die within 6 months of the injury

4
Leading Causes of Death
5
Death by Injury Severity Scores
6
Hip Fractures
  • In 1996 more than 250,000 older Americans had
    fractured hips
  • 90 are associated with falls
  • Excess of 10 billion
  • Leading fall-related injury that results in
    hospitalization which are often prolonged and
    costly.

7
Traumatic Brain Injury
  • Also a common injury following a fall
  • Many elderly on blood thinners
  • Symptoms may be subtle and not apparent at the
    time of injury.

8
Risk Factors for Falls
  • Increased age
  • Living alone
  • Previous falls
  • Use of a cane or walker
  • Acute illness
  • Reduced vision
  • Glare intolerance
  • Altered depth perception
  • Decreased night vision
  • Decline in peripheral vision

9
Risk Factors for Falls
  • CVA that results in hemiparesis, sensory and/or
    motor function deficits
  • Decreased range of motion and flexibility in
    lower legs and spine
  • Weakness
  • Decreased step length (short shuffling steps)
  • Alzheimers or dementia
  • Arthritis
  • Parkinsons disease
  • Foot problems
  • Toenail length, callouses, bunions, deformities

10
Risk Factors for Falls
  • Difficulty rising from a chair
  • Neurologic changes
  • Slowed reaction times
  • Diminished sensory awareness for light touch,
    vibration, and temperature
  • Decline in proprioception
  • Decreased hearing
  • Impaired speech discrimination
  • Excessive cerumen accumulation
  • Loss of high frequency tones
  • Risky behaviors

11
Risk Factors for Falls
  • Medications
  • Some antidepressants
  • Sedatives
  • Some antihypertensive and cardiac medications
  • Hypoglycemic drugs
  • Alcohol

12
Preventing Falls
  • Exercise
  • Physical Therapy assessment
  • Review all medications by the health care
    provider
  • Vision exam
  • Podiatrist exam

13
Preventing Falls in the Home
  • Remove throw rugs
  • Secure carpet edges
  • Reduce clutter
  • Remove cords and wires on the floor
  • Avoid floor wax
  • Push in the drawers

14
Preventing Falls in the Home
  • Check lighting for adequate illumination at night
    and on the stairs
  • Install handrails on both sides of the stairwell
  • Eliminate chairs that are too low to sit in and
    get out of easily
  • Keep often used items in cabinets that can be
    reached easily without using a step stool.
  • Wear well-fitting shoes and slippers with
    non-skid bottoms.

15
Preventing Falls in the Bathroom
  • Install grab bars in the shower and by the toilet
  • Use rubber mats in the bathtub and shower
  • Install a raised toilet seat
  • Keep drawers closed

16
Preventing Falls Outside the Home
  • Repair cracked sidewalks
  • Install handrails on stairs and steps
  • Trim shrubbery along the pathway to the home
  • Install adequate lighting by doorways and along
    walkways leading to doors.

17
Preventing FallsFrom the Medical Standpoint
  • Test for balance Get Up and Go Test
  • Refer to PT for gait assessment
  • Postural hypotension
  • Taking 3 or 4 prescription medications
  • Treat osteoporosis

18
What Happens After the Hip Fracture?
  • One in four people that have a hip fracture that
    lived independently before the fracture had to
    live in a nursing home for a year afterward,
    according to the CDC
  • Some never recover their balance and strength
  • This can lead to depression and dementia and a
    downhill spiral.
  • Unfortunately 1/4 of the elderly people who
    fracture their hips die within 6 months of the
    injury

19
So What TO Do?
  • Do safety checks of the home inside and out
  • Test for gait and balance
  • Encourage exercise and movement
  • Check the medications
  • Dress right
  • Get your feet checked and cared for
  • If you drink, do so moderately
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