Assess risk factors for further falls among seniors
practice partner
Assess risk factors for further falls among seniors
The American Geriatric Society and British Geriatric Society recommend that primary health-care providers ask all older adults at least once a year about falls , the frequency of falling and any difficulties in gait and balance . According to the recommendation , any older person who presents with an acute fall ( fall with an injury ), has difficulty with gait or balance , or reports two or more falls in the previous 12 months warrants a comprehensive risk assessment . For those without a reported fall or with a single fall in the previous 12 months , a comprehensive assessment is not required , unless the older adult has difficulties with gait or balance .
Multifactorial risk assessment of falls among seniors
2 + falls in past 12 months or acute fall
Medical exam and multifactorial risk assessment
Multifactorial intervention for identified risk ( s )
Difficulties with gait or balance
Components of a comprehensive assessment A comprehensive clinical assessment can determine the risk of falls , identify the risk factors and assist in identifying the most appropriate tailored interventions . The 2011 AGS / BGS guidelines recommend that the following components be included in a comprehensive clinical assessment :
1 . Medical history , physical examination , cognitive and functional assessment ;
2 . History of falls ; taking multiple medications ( particularly psychotropic medications ); problems with gait , balance and mobility ; impaired vision ; other neurological impairments ; reduced muscle strength ; problems with heart rate and rhythm ; postural hypotension ; foot problems and incorrect footwear ; environmental hazards .
The assessment may be carried out by a single clinician or , alternatively , several clinicians , such as physicians , nurse practitioners , physical therapists , occupational therapists or pharmacists , with each health-care professional completing the components most relevant to their expertise .
Source : © All rights reserved . Seniors ’ Falls in Canada – Second Report . Public Health Agency of Canada , 2014 . Adapted and translated with permission from the Minister of Health , 2017 . frequency and nature of any falls could not be determined upon review of the health record . A CT brain scan was performed as the patient ’ s health continued to decline with decreased mobility , decreased oral intake and worsening expressive and receptive aphasia . The
CT brain scan revealed a right subdural hematoma ; this was surgically evacuated , but he did not have significant improvement in his neurological status . He received supportive medical care before being transferred to a palliative care unit where he died of pneumonia . MD
Issue 1 , 2017 Dialogue 41