Decreasing Falls in Geriatric Patients

568 words | 2 page(s)

Falls are a growing health problem globally in the elderly (Day et al., 2011; Li et al., 2014). It has been estimated that 30% of aged individuals 65 years and older fall annually (Ambrose et al., 2013). Some of the injuries resulting from falls include lacerations, trauma to the head and hip fractures (Stevens et al., 2006a) resulting in reduced mobility. About 89% of admissions to hospital are fractures due to a fall-related injury (Peel et al., 2002). The Centers for Disease Control and Prevention have determined that falls are the leading cause of injury-related deaths in the elderly (Centers for Disease Control and Prevention, 2016). Furthermore, there is increasing evidence that falls are a major cause of mortality, morbidity and disability in the aging population (Hartholt et al., 2011; Ambrose et al., 2013; Gale et al., 2016). Falls are also linked to overall lower quality of life, increased hospitalisations, emergency department visits and admissions to long-term care facilities (Chou et al., 2012). It has been estimated that the annual medical cost of falls in the U.S. is $34 billion (Centers for Disease Control and Prevention,  2016, Stevens et al.  2006b).

There have been some reasons proposed for why the elderly fall and they include lack of exercise which results in reduced balance, muscle tone, bone mass and flexibility. Impaired vision, medications such as sedatives, anti-psychotics, anti-depressants, multiple medication treatment regimes, diseases such as Alzheimer’s, Parkinson’s and arthritis (weaken limbs and balance) and hip replacement also increase risks for falls. While environmental hazards such as faint lighting, loose carpets and lack of safety equipment around the house cause about one-third of falls in the aged (Sollitto, 2016).

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While some risk factors are out of one’s control, there are several changes that can be implemented in the home to minimise and prevent falls. This includes improving the lighting in the home, removing items that can cause the elderly to trip, ensuring the carpets are secured to the floor by non-slip strips, installing handrails on stairs and corridors and placing grab bars and anti-slip mats in the showers and bath tubs (Sollitto, 2016; NIH/Senior Health, 2016).

Numerous Fall Prevention Programs have been explored over the last decade to prevent falls among those susceptible and at risk in the community. Several systematic reviews have indicated that exercise programs are effective in minimising falls and fall-related injuries in the elderly (Sherrington et al.  2008; Sherrington et al.  2011; Gillespie et al.  2012; El-Khoury et al.  2013). However most of the programs are costly requiring specialised trained personnel and facilities and therefore are less accessible to the general population (Davis et al., 2010; Frick et al., 2010; Heinrich et al., 2010; Bateni et al., 2012). One potential fall prevention option are home-based exercise programs especially for the homebound elderly (Campbell et al., 1999; van Haastregt et al., 2000; Elkan et al., 2001; Asmidawati et al., 2014). A recent review confirmed that home-based exercise programs had been proven to reduce falls in the elderly (Gillespie et al., 2012). And in agreement with a prospective cohort study (Sherrington et al., 2010) an effective home-based exercise program should include both balance and progressive strength training (Gardner et al., 2002; Sherrington et al., 2010; Panel on Prevention of Falls in Older Persons American Geriatrics Society and British Geriatrics Society, 2011).

With the devastating impact of falls in the elderly, there has been a greater focus in the last decade to develop strategies to minimise falls as well as fall prevention programs. Exercise-based programs for the elderly in particular have proven to be effective in reducing falls.

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