Unit 2 - Fall Risk

Question 1

What is the definition of a fall?

Answer 1

• An unexpected even in which the participant comes to rest on the ground, floor, or lower level

Question 2

What percentage of older adults fall each year?

Answer 2

20-30%

Question 3

What percentage of injury related to admissions of older adults are because of a fall?

Answer 3

80%

Question 4

What are intrinsic risk factors associated with falls? (7)

Answer 4

• Parkinson’s
• chronic conditions
• poor vision
• gait and balance problems
• incontinence
• fear of falling
• advanced age

Question 5

What are extrinsic factors associated with falls? (3)

Answer 5

• psychoactive drugs
• lack of grab bars
• uneven surfaces

Question 6

What assessment tool assesses the intrinsic and extrinsic factors and their causes?

Answer 6

Comprehensive Geriatric assessment/ Multidisciplinary assessment

Question 7

What assessment tool helps assess underlying causes of falls?

Answer 7

• fall risk assessment tools

Question 8

What assessments recognize mobility issues impacting mobility?

Answer 8

• performance based tests; Berg Balance test
  see functional performance tests in Boscart Box 13.2, p 199

Question 9

How else can we assess/recognize intrinsic and extrinsic factors pertaining to fall risk? (3)

Answer 9

• recognize risk by assessing potential adverse medication effect that impact mobility
• recognize risk by applying a mobility and fall risk assessment tools
• recognize environmental risk

Question 10

How do we treat symptoms of Parkinson’s? (4)

Answer 10

Dopamine replacement
- mimicking
- slowing dopamine breakdown
- drugs

Question 11

Which drugs are used for Parkinson’s therapy?

Answer 11

carbidopa and levodopa

Question 12

What are some risks for taking carbidopa and levodopa? (3)

Answer 12

• break down quickly, high risk for adverse effects, dyskinesia
• see safety alert: timing before meals, routine
• other medications - have serious side effects

Question 13

How can we treat pain experienced from osteoarthritis non-pharmacologically? (2)

Answer 13

• moist heat to relieve pain, spasms, and stiffness
• use of orthotic devices like braces and splints to support joints

Question 14

How can we treat pain experienced from osteoarthritis pharmacologically? (2)

Answer 14

• acetaminophen is the first line
• NSAIDS pose a risk for older adults

Question 15

How are falls a symptom of an underlying problem? (2)

Answer 15

• indicate underlying neurological problem, sensory, cognitive, medication-related, osteoporotic, MS
• may indicate an impending physical illness

Question 16

Falls are related to an interaction between extrinsic factors and intrinsic factors. What exactly are extrinsic and intrinsic factors?

Answer 16

extrinsic
- environment

Intrinsic
- related to person
- sensory, gait, or cognition

Question 17

What other factors contribute to fall rate? (2)

Answer 17

• iatrogenic factors in health care settings
• medication

Question 18

How does in-patient settings contribute to fall risk? (5)

Answer 18

• inadequate assessment and communication with patient
• poor footwear
• environmental safety
• UTI’s associated with falls
• Insomnia

Question 19

Why is fear of falling an intrinsic factor?

Answer 19

• a person’s anxiety towards usual or normal walking or mobilizing, with the perception that a fall will occur

Question 20

What are some evidence based risk factors associated with falls? (5)

Answer 20

1. Gait patterns put the older adult at risk because older adults have stiffer and less coordinated gaits
2. Women with functional impairment and take medications are at higher risk
3. Chronic conditions and feelings of vertigo associated with higher risk
4. relationship between UTI and falls in LTC
5. Insomnia in LTC associated with increased risk

Question 21

Where can one experience extrinsic factors that increase the risk of falls? (3)

Answer 21

• in the home
• in the institution (hospital and PCH)
• in the neighbourhood