Fall-Risk Evaluation and Management: Challenges in Adopting Geriatric Care Practices

Tinetti, Mary E.; Gordon, Catherine A.; Sogolow, Ellen; Lapin, Pauline; Bradley, Elizabeth H.

doi:10.1093/geront/46.6.717

Cited by 198 publications

(178 citation statements)

References 31 publications

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“…Yapılan çalışmalar yaşlıların davranışsal risklerinin, düşmelere neden olduğunu bildirmektedir. (39,40) Çalışmamızda kullanılan ve yaşlıların günlük aktiviteleri sırasında düşmelerden kendilerini korumak için sergiledikleri davranışları ölçmeyi amaçlayan YDDÖ'nden alınan toplam puan ortalaması 2.99±0.56 olarak bulunmuştur. Ölçekten alınabilecek en düşük puanın bir, en yüksek puanın ise dört olduğu düşünüldüğünde, yaşlıların kendilerini düşmelerden koruma davranışlarının orta seviyede olduğu söylenebilir.…”

Section: Discussionunclassified

Mobility and Fall Behavioral in Elderly: A Study of Nursing Home

Okuyan¹,

Bilgili²

2018

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ÖZAmaç: Huzurevinde kalan yaşlılarda mobilite ve düşme davranışlarının belirlenmesidir.Yöntem: Kesitsel tipteki bu çalışmaya 124 yaşlı birey alınmıştır. Araş-tırma verileri, tanıtıcı bilgi formu, Rivermead Mobilite İndeksi ve Yaşı-lar İçin Düşme Davranışları Ölçeği kullanılarak toplanmıştır. Bulgular: Yaş ortalaması 77±8.2 olan yaşlı bireylerin %49.2'si son bir yıl içinde en az bir kez düşmüştür ve %65.3'ü düşme korkusu yaşa-maktadır. Düşme korkusu olan, kadın olan, 81 yaş ve üzerinde olan, bedensel ve ruhsal sağlığını kötü olarak algılayan, düzenli egzersiz yapmayan yaşlı bireylerin Rivermead Mobilite İndeksi puan ortalaması daha düşük (p<0.05) olup, bu yaşlıların mobilite sorunu daha fazladır. Yaşlıların günlük aktiviteleri sırasında düşmelerden kendilerini korumak için sergiledikleri davranışları tanılamak amacıyla kullanılan Yaş-lılar İçin Düşme Davranışları Ölçeği puan ortalamaları; kadınlarda, 81 yaş ve üzeri olanlarda, okuryazar olmayanlarda, kronik hastalığı olan ve bedensel sağlık algısı kötü olanlarda, düşme korkusu yaşayanlar-da, düzenli spor yapmayan yaşlı bireylerde daha yüksek bulunmuştur (p<0.05).Sonuç: Huzurevinde yaşayan yaşlı bireylerde düşme sıklığı yüksek olup, yaşlıların büyük çoğunluğu da düşme korkusu yaşamaktadır. Düşmelerin önlenmesi için yaşlı bireylerin düzenli şekilde egzersiz yapmalarının desteklenmesi ve düşme korkusunu önlemek/azalmak için düşmeye neden olabilecek davranışlar konusunda yaşlı bireylerde farkındalık oluşturulması önem taşımaktadır. ABSTRACT Aim:To determine the mobility and fall behaviors of elderly residents in a nursing home. Methods:This cross-sectional study comprised 124 nursing home residents. The research data were collected by using a personal information form, the Rivermead Mobility Index (RMI), and the Falls Behavioural Scale (FaB) for the Older Person. Results:The average ages were 77±8.2. It was found that 49.6% of the residents had fallen at least once within the past year and 65.3% of them had a fear of falling. The RMI score was found lower in women aged 81 and over who had a fear of falling, poor subjective physical and mental health, and little regular exercise (p<0.05). The scores of the FaB were signi cantly higher in women aged 81 and over who were illiterate and had chronic diseases, poor subjective physical health, fear of falling, and little regular exercise (p<0.05). Conclusion:The prevalence of falls among elderly residents in a nursing home was high, and most of them were afraid of falling. In order to prevent falls, the residents should have a regular exercise program. In addition, it is important to take necessary fall precautions and to decrease the fear of falls in the elderly residents.

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Section: Discussionunclassified

Mobility and Fall Behavioral in Elderly: A Study of Nursing Home

Okuyan¹,

Bilgili²

2018

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“…Falls cause serious injuries in about 10-20% with fall injuries rates rising sharply in higher age groups. These injuries are associated with significant morbidity, reduced function and mobility, and loss of independence [25,32,36,38]. Falls are also the leading cause in 14% of emergency and in 4% of all hospital admissions in the UK [6].…”

Section: Introductionmentioning

confidence: 99%

“…For the US health care costs due to falls was estimated to be about $5.7 billion in 2002 and is predicted to reach $43.7 billion in 2020 [16,32,33,38].…”

Section: Introductionmentioning

confidence: 99%

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Falls recall—limitations of the most used inclusion criteria

Freiberger

Vreede

2011

Eur Rev Aging Phys Act

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“…20 Falls are 300% more likely to require hospitalization than any other type of injuries (motor vehicle accidents, poisoning, drowning, etc.). 21 Nursing home admissions after an ED visit and hospitalizations constitute an average of about 54% (versus 29% for "all causes"). 22 CDC estimated that the direct cost of falls leaped from $19B in 2000 to $34B in 2013.…”

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confidence: 99%

Improving the Care of Fall Injured Elders in U.S. Emergency Departments

Schwartz¹,

Dalsey²,

Hardigan³

2017

Emerg Med Open J

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Objective: Geriatric fall-related injuries have become a fatal public health crisis in America which has affected the population at an ever growing rate. America's Emergency Departments (EDs) are the heart of the problem and the solution towards preventing geriatric falls. The purpose of the study reported here is to address the concerns associated with the quality of care that American EDs provide to their fall-injured geriatric patients. Methods: To address these concerns (see supplementary data) a survey was conducted in April/May of 2015 among 800 ED physicians of American College of Emergency Physicians (ACEP). Approximately, 83% of the physicians (N=660) responded to the survey which was designed and analyzed by the authors. Data was appropriately analyzed using the chi-square test of goodness of fit. Result: Most of the physicians participating the survey perceived that none of these diagnostic observations like balance, gait, vision, hearing, physical therapy needs, clinical depression, fear of falling, etc., are routinely provided to fall-injured elders in their ED. Sixty-three percent of the physicians perceive that these fall injured patients routinely leave the ED without a documented appointment with a medical provider for follow-up diagnosis or evaluation. Sixty-two percent of the physicians associated with the survey believe that fall injured patients return to the same ED almost 26-59% of the time. Sixty-six percent of the respondents would recommend that they and their colleagues take an 8-hour online course in geriatric fall prevention. Fifty-seven percent of our respondents were likely to refer high fall risk ED geriatric patients to a nearby Center of Excellence in Geriatric Fall Prevention and Treatment (CGFPT). Conclusion: American ED physicians agreed on two initiatives: Firstly, 66% of the surveyed physicians agreed that they and their colleagues need to be more informed about geriatric fall prevention (via an online course). Secondly, 57% would recommend the creation of nearby CGFPT to which they can refer high fall-risk patients. Adoption of these two strategies would possibly help improve the healthcare of full injured geriatric ED patients in future.

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Fall-Risk Evaluation and Management: Challenges in Adopting Geriatric Care Practices

Cited by 198 publications

References 31 publications

Mobility and Fall Behavioral in Elderly: A Study of Nursing Home

Mobility and Fall Behavioral in Elderly: A Study of Nursing Home

Falls recall—limitations of the most used inclusion criteria

Improving the Care of Fall Injured Elders in U.S. Emergency Departments

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