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Ebook Essentials of clinical geriatrics (7/E): Part 2

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Ebook Essentials of clinical geriatrics (7/E): Part 2

229CHAPTER 9FallsFalls arc a major cause of morbidity in (he geriatric population. Close to one-third of those age 65 years and older living at home s

Ebook Essentials of clinical geriatrics (7/E): Part 2suffer a fall each year. Among nursing homes residents, as many as half suffer a fall each year; 10% to 25% cause serious injuries. Accidents arc the

filth leading cause of death in persons older than age 65, and falls account for two-thirds of these accidental deaths, of deaths from falls in rhe Un Ebook Essentials of clinical geriatrics (7/E): Part 2

ited States, more than 70% occur in the population older than age 65. Fear of falling can adversely affect older persons’ functional status and overal

Ebook Essentials of clinical geriatrics (7/E): Part 2

l quality of life. Repeated falls and consequent injuries can be important factors in rhe decision to institutionalize an older person.Table 9-1 lists

229CHAPTER 9FallsFalls arc a major cause of morbidity in (he geriatric population. Close to one-third of those age 65 years and older living at home s

Ebook Essentials of clinical geriatrics (7/E): Part 2al complications. Many of these injuries will result in hospitalization, with the attendant risks ol immobilization and iatrogenic illnesses (sec Chap

ter 10). Fractures OÍ the hip and lower extremities often lead to prolonged disability because of impaired mobility. A less common, but important, inj Ebook Essentials of clinical geriatrics (7/E): Part 2

ury is subdural hematoma. Neurological symptoms and signs that develop days to weeks alter a fall should prompt consideration of this treatable proble

Ebook Essentials of clinical geriatrics (7/E): Part 2

m.Even when the fall docs not result in serious injury, substantial disability may result from fear of falling, loss of self-confidence, and restricte

229CHAPTER 9FallsFalls arc a major cause of morbidity in (he geriatric population. Close to one-third of those age 65 years and older living at home s

Ebook Essentials of clinical geriatrics (7/E): Part 2her with the use of falling as an indicator of underlying risk for disability make an understanding of rhe causes of falls and a practical approach to

rhe evaluation and management of gait instability and fall risk important components of geriatric care. Similar to many other conditions in rhe geria Ebook Essentials of clinical geriatrics (7/E): Part 2

tric population, factors that can contribute to or cause falls are multiple, and very often more than one of these factors play an important role in a

Ebook Essentials of clinical geriatrics (7/E): Part 2

n individual fall (Fig. 9-1).PARTAGING AND INSTABILITY_____________________________________________________________Several age-related factors contrib

229CHAPTER 9FallsFalls arc a major cause of morbidity in (he geriatric population. Close to one-third of those age 65 years and older living at home s

Ebook Essentials of clinical geriatrics (7/E): Part 2 ra I h aza rds.Aging changes in postural control and gait probably play a major role in many falls among older persons. Increasing age is associated

with diminished proprioceptive input, slower righting reflexes, diminished strength of muscles important in maintaining posture, and increased postura Ebook Essentials of clinical geriatrics (7/E): Part 2

l sway. All these changes can contribute to fallins—especially the ability to avoid a fall after encounterins an environmental230 Differential Diagnos

Ebook Essentials of clinical geriatrics (7/E): Part 2

is and ManagementPART ITABLE 9-1. Complications of Falls in Elderly PatientsInjuriesPainful soft tissue injuriesFracturesHipFemurHumerusWristRibsSubdu

229CHAPTER 9FallsFalls arc a major cause of morbidity in (he geriatric population. Close to one-third of those age 65 years and older living at home s

Ebook Essentials of clinical geriatrics (7/E): Part 2 of physical injuryImpaired mobility from ieai, loss of self confidence, and leslficlion of ambulationIncreased risk of institutionalizationIncreased

risk of deathhazard or an unexpected trip. Changes in gait also occur with increasing age. Although these changes may not be sufficient to be labeled Ebook Essentials of clinical geriatrics (7/E): Part 2

truly pathologic., they can increase susceptibility ro falls. In general, elderly people do nor pick their feet up as high, thus increasing the tenden

Ebook Essentials of clinical geriatrics (7/E): Part 2

cy to trip. Elderly men tend to develop wide-based, short-stepped gaits; elderly women often walk with a narrow-based, waddling gait, lhese gait chang

229CHAPTER 9FallsFalls arc a major cause of morbidity in (he geriatric population. Close to one-third of those age 65 years and older living at home s

Ebook Essentials of clinical geriatrics (7/E): Part 2ment.Intrinsic factorsExtrinsic factorsMedical and neuropsychiatric conditions \MedicationsImpaired vision and hearing

229CHAPTER 9FallsFalls arc a major cause of morbidity in (he geriatric population. Close to one-third of those age 65 years and older living at home s

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