What are common causes of a fall?
Mechanical
Cardiovascular
Neurological
What are some risk factors associated with a fall?
- weak muscles, poor balance, foot problems (poor nails, bunions + poor footwear)
- dizziness, light headedness, fainting or other LOC
- vision loss
- delirium/dementia affecting problem solving abilities
- some medications, alcohol
- bladder / bowel problems
- occupations at heights
- socioeconomic factors including poverty, overcrowded housing, sole parenthood, young maternal age
- underlying medical conditions, such as neurological, cardiac or other disabling conditions
- unsafe environments.
How can you prevent a fall?
-Screening within living environments for risks for falls
-Clinical interventions to modify risk factors
-Muscle strengthening and balance retraining, dynamic balance and
strength training
-Use of hip protectors for those at risk of a hip fracture due to a fall.
Describe the epidemiology of falls.
-second leading cause of accidental or unintentional injury deaths worldwide
-an estimated 646 000 individuals die annually from falls globally
-adults older than 65 years of age suffer the greatest number of fatal falls
-fall-related injuries may be:
- fatal
- non-fatal.
What is pain influenced by?
-biological factors
-psychological factors
-social factors
Acute pain = useful
Chronic pain = ongoing for >6 months.
Describe the assessment of a fracture.
-Check skin – look
-Feel
-Move: The joint above and below the fracture
-Neurovascular status.
How do you manage a fracture?
-Reduction
-Immobilisation
-Rehabiliation
Describe the pathology of fracture healing.
mmediately after a fracture:
-Haematoma
In the first few weeks:
-Granulation tissue
-Immature cartilagenous matrix – produced by?
-Immature new bone – produced by?
Over months – endochondral ossification occurs – which is what..? And remodelling.
What is lay care?
What is lay care, as opposed to formal care?
-Setting
-Training
-Rewards
Carers look after, helps or supports someone who wouldn’t be able to manage everyday life without their
help
-Don’t have to be living with the person
-The help doesn’t have to be physical
Lay Care is extensive
Carers Allowance may help.
What is osteoporosis?
-A progressive systemic skeletal disease
- characterized by low bone mass and microarchitectural deterioration of bone tissue
- with a consequent increase in bone fragility and susceptibility to fracture
What are some risk factors for osteoporosis?
-advancing age
-post-menopausal state (for women)
-having a family history of osteoporosis
-smoking, excessive alcohol consumption
-exposure to corticosteroids
-low dietary calcium intake
-hyperthyroidism, coeliac disease, hyperparathyroidism, hypogonadism, Cushing’s syndrome.
Multiple myeloma is an important mimic.
How do you diagnose and treat osteoporosis?
-Fracture risk calculator = FRAX
-Measuring bone mineral density..
- dual-energy X-ray absorptiometry = ‘DEXA’
- See Dr Hamilton’s video
Treating osteoporosis
- lifestyle and medication.
What makes up the 5 As model?
Ask, assess, advise, agree, assist.
What is a fragility fracture?
A low impact fracture.
