A variety of factors can cause falls in older individuals, therefore it is important to determine what the risk factors are in order to provide patient-centered care.
At this point, coordination is at a point where falls are often major risks, and considering many cases of the disease occur in the elderly, this can become a fatal risk. Close relatives are soon to become unrecognizable and the long term memory of the individual begins to fade as the disease worsens. It is often that at this point of the disease, the patient is put into a care center, as they may become a burden to the family members around them. Emotions swing and become entirely unpredictable and often resistance to care will occur as the patients lose awareness of their condition and become confused with their surroundings.
The widespread falls among the geriatric population reduce their quality of life and take away their functional independence. Lee et al (2013) state that falls leads to the rise in mortality rates and morbidity complications such as fractures and disabilities,1 out of 3 elderly persons in a community setting falls in a year. About 87% of all fractures in the elderly are due to falls. Several of the risk factors that are associated with falls are visual impairments, cognitive impairments, and health-related problems: arthritis, orthostatic, back pains, lack of balance-weakening muscles, previous falls, polypharmacy or psychoactive drugs (Lee et al, 2013).
Literature Review: The Effectiveness of the use of Sensory Therapy for Elderly Adults Diagnosed with Dementia.
When a person suffers from dementia then they are at an increased risk of falls. People with Alzheimer’s and other types of dementia tend to be at a high risk of falling. They are more than three times more likely to fracture their hip when they fall, which leads to surgery and immobility. The rate of death following a hip fracture for those with Alzheimer's is also increased. Thus, fall prevention for people with dementia is critical. There are many causes for a person with dementia to fall over and jeopardise their health, the first is Physical Weakness, Gait Changes and Poor Balance, Lack of Physical Exercise, Memory Impairment, Poor Judgment and Visual Misperception, Alzheimer’s can affect the visual-spatial abilities, a person can misinterpret what he sees and misjudge steps, uneven terrain, shiny areas on the floor or changes in floor color. Be sure to have his vision checked regularly.
Several patients suffered from dementia and some had accompanying diagnoses, such as hip fracture from falling or upper and lower extremity weakness. Dementia is a decline in memory and greatly affects how activities
Anyone can be at risk for a fall due to their environment, though some are at a greater risk than others. Someone with confusion or cognitive impairment for example, is at greater risk for experiencing a fall both within the community and the home setting. Patients with dementia are three times more likely to fall than
The clinical features Mrs Lee now 83 is displaying changes to health and cognition noted in the last three to four months, with two transient ischaemic attacks but no significant medical issues. Although currently taking three medications for high blood pressure. Changes in word finding, getting words mixed up and confusing identifying words. Insisting everything is fine showing a lack of insight into her changes or difficulties. Short term memory Mrs Lees has difficulty retaining recent memories, however long term memory appears reasonable. Although Mrs Lees home is reasonably well maintained, she is emaciated and personal hygiene is poor. There is also evidence of emotionally Liable being frequently teary with no reason. History includes
Problem statement: According to Quality Improvement Organization Health Services Advisory Group, Alabama’s state average for falls without injury is 41.9% with the National average being slightly higher at 45%, falls with injury in Alabama is 3.2% with the National average being 3.4%. Research done by the Alzheimer’s Association (2016) has revealed that “People with dementia are at risk of falls because of their neurological impairments.” Another study completed by Esstmann discusses “The etiology of orthostatic hypotension should be investigated for older adults with known orthostatic
The patient is an 85-year-old female who is brought to the ED by her family because of increasing confusion and supposedly she had a degree of altered mental status of two hours previous to presentation. In the ED she is completely worked up. CT shows advanced atrophy with microvascular changes and several lacunar infarcts nothing acute. Specific gravity in the urine reveals her to be markedly dehydrated. She culture completely, started on IV antibiotics, IV fluids and B12. On the day after admission she still presents as persistently confused. She is evaluated by PT. The patient who was formerly ambulating with a walker and allegedly driving a car is unable to be ambulated. Before the history indicates that she has a slow downward
Upon review of this case study, it became paramount to differentiate between the diagnosis of the fall. The plan of care was dependant on the evaluation from the history and physical exam. The history of present illness needed to extract enough information to determine the cause of the fall as this would guide the treatment. The timing of the fall, the loss of consciousness would give clues to differentiate between a fall that was related to intrinsic or extrinsic. Secondarily, identifying and learning more related to community resources was critical. I was unaware of services available to help patients with dementia in the sorrowing tri-city area. Thirdly, I was able to recognize how essential it is to integrate the family in the plan and to offer support to them. The daughter, in this case, was the sole caretaker and resources were made available to her.
Falling risks are increased in seniors with dementia, musculoskeletal disorders, neurologic conditions, vision and hearing loss, and those on multiple medications. Given this list, is it any wonder that more than 50
The patient is a 72-year-old black female who presented to the ED with complaints of low blood sugar. Her son found the patient at home in bed unresponsive. The son states he checked the patient's blood sugar it was 47. The patient is on NovoLog 3 times a day and Lantus one time a day. The patient had similar symptoms in the past. The patient has a medical history of dementia. She also is known to be hypertensive, insulin-dependent diabetes and has no surgical history. It is to be noted on presentation her BP was 128/95 with a pulse of 52, respirations of 15, hypothermic with a temp of 93 and oxygenating 94% on room air. She also showed significant bradycardia. EKG at 48 beats per minute, T waves were inverted in leads 4, 5 and 6 but
Risk factors for falls are categorized by intrinsic or extrinsic (Tzeng, & Yin, 2009). According to Tzeng and Yin (2008), intrinsic factors, referring to the patient themselves, are related to their health status and possibly associated with age-related changes: previous falls, reduced vision, unsteady gait, musculoskeletal system deficits, mental status deficits, acute illness, and chronic illness. Extrinsic factors are involved in the patient’s environment, including medications, lack of support equipment, furniture, bathroom designs, small patient rooms, poor lighting, and improper use of and inadequate assistive devices. Tzeng & Yin (2008; 2009) focused on the extrinsic risk factors for the basis of their studies.
In the case of Anne Morrell there are several normal physiologically changes that impact her quality of life. Anne is experiencing normal aging related changes to her musculoskeletal system. Changes in musculoskeletal tissue occur through the loss of muscle mass and strength which replace lean body mass which fat and fibrous tissue. These changes in tissue cause a decrease in contractile muscle force with increased weakness and fatigue (Boltz, Capezuti, Fulmer, & Zwicker, 2012). As discussed in her case study she reports back pain when standing or walking for longer than 15 minutes, needs assistance with steps, ambulates with a cane since she fell last year which affects her mobility and ability to perform her activities of daily living. This loss in Anne’s muscle function greatly increases her chance of falls and she also has an increased risk for disability.