13. FALLS

A fall is defined as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level. Fall-related injuries may be fatal or non-fatal¹ though most are non-fatal₃

The falls are very related with the loss of mobility in the elderly.

Also influences the changes in the musculoskeletal system.

The main physical and psychological consequence of the falls is the post fall syndrome.

The post-fall syndrome leads to isolation

According to a study, the falls are a frequent occurrence among the elderly (13-25% over 65 years, 31-35% over 85 years). The falls are more common in institutionalized elderly (up to 50%), and especially in the women until 75 years. With 75 years, the frequency is the same for both sexes₁.

As OMS₃

·         Falls are the second leading cause of accidental or unintentional injury deaths worldwide.

·         Each year an estimated 424 000 individuals die from falls globally of which over 80% are in low- and middle-income countries.

·         Adults older than 65 suffer the greatest number of fatal falls.

I think that is more common in women because osteoporosis has higher incidence in women and begin with menopause.

The institutionalized elderly have more falls because they don’t know the psysical environment, and their admission is produced by physical problems that entail taking drug.

The elderly has more fear to the falls, so they feel insecurity. This situation has that they are cautious. Consequently they walk slowly, and avoid stairs and bath. As I have named before, the elderly are isolated due to fear

The most important is that the elderly know their limitations and they act accordingly.

I see important to the prevention of falls, because most are preventable, leave here the link to this video₂: http://www.youtube.com/watch?feature=player_embedded&v=w9qHZdCj8IE#

Also, I would like to say that in the prevention of falls has a very important role nurses because we can give advice and help to prevent falls.

The comorbidity of falls prevention leads to environmental factors or the environment, and those specific to the elderly. So I think it's very important to carry out a primary prevention, secondary and terciary.

It is good that the elderly have a little fear, before of daring to do things and to fall.

There are places where there is more danger of falling, the most dangerous place in the house is the bathroom. And in the street, the stairs, the field... etc

Based on scares the elderly see their chances

Finally, The fall risk assessment should be performed in the framework of GERIATRIC ASSESSMENT GLOBAL, focusing specifically on the assessment of gait and balance. By the following scales: TINETI and TIME-UP AND GO.

And other scale for valuate to fall risk is the DOWNTON scale.

Bibliography:

1. Marnet. Las caidas en los ancianos. Kioskea Salud. [Revisado el: 10 de mayo del 2013]. Disponible en: http://salud.kioskea.net/faq/3434-las-caidas-en-los-ancianos
2. OMS. Falls. World health organization. [Revisado el: 1 de mayo de 2013]. Disponible en: http://www.who.int/mediacentre/factsheets/fs344/en/index.html