Description
Falls and fractures in older adults are common and can lead to significant morbidity, highlighting the importance of fall prevention strategies such as strength training, balance exercises, and home safety modifications. Immediate care involves quick assessment for fractures, pain management, and stabilization, along with appropriate transport to healthcare facilities for further evaluation and treatment.
Résumé
- The global senior citizen population is increasing, with China and India having the largest numbers. In India, about 14% of the population are senior citizens. Falls are a significant concern in elderly care, affecting their day-to-day lives. Raising awareness about falls, their prevention, and post-fall care is crucial.
- Falls occur more frequently with age, affecting 30-40% of those 65 and older living in the country. Approximately half of these falls result in injury, with 10% being serious. The CDC reported a 41% increase in age-adjusted death rates from falls between 2012 and 2021. Falls cause a decline in self-care abilities, limit physical and social activities, and can lead to bone injuries like fractures. Fear of falling can further limit activities and independence.
- A fall is defined as unintentionally coming to rest on the ground or a lower level, not due to overwhelming events like stroke or accidents. Causes are categorized as intrinsic (within the person) and extrinsic (environmental). Age-related physiological changes, such as decreased muscle strength and slowed reflexes, contribute to intrinsic falls.
- Environmental factors like uneven surfaces, poor lighting, and inadequate furniture also lead to falls. Polypharmacy and drug interactions are significant medical factors. Inadequate care support further increases the risk of falls in elderly people needing assistance with daily living.
- Fractures, particularly hip fractures, are common injuries from falls in the elderly. Neck and intertrochanteric fractures are the most frequently observed hip fractures, often treated surgically. Post-operative complications, including psychiatric issues, wound infections, cardiac events, and pulmonary complications, are significant concerns.
- Post-discharge care and rehabilitation are crucial events in an elderly person's life after a fall. Factors like the type of medical intervention, patient cooperation, and presence of dementia affect the care plan outcome. Secondary systemic infections, rehospitalization, severe osteoporosis, and co-morbid conditions can also impede rehabilitation.
- Preventing falls involves periodical screening of elderly persons for falls in the last year, difficulty walking, or recurrent falls. Self-assessment tools can also help, with scores above four indicating the need for a fall risk assessment. Multifactorial fall risk assessments include history review, medication review, and physical and environmental assessments.
- Simple tests, such as the Timed Up and Go test and the 30-second chair stand test, aid in fall assessment. Risk is categorized as low, moderate, and high, guiding interventions. General interventions involve home environment modifications, medication review, and managing foot problems. Exercise, vision correction, and addressing cardiac issues are also important.
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