GERIATRIC ASSESSMENT AND SENIOR FALL PREVENTION TIPS

      

       GERIATRICS is a branch of medicine dealing with the physiological changes of ageing and the diagnosis and treatment of diseases affecting the aged which helps in raising standarad living lengthens life expectancy and increase the proportion of aged persons in the society.                                                                       

   The Geriatric Assessment

   Medical Screening and Assessment

              

  Medical screening and assessment by doctors and 

  Physical therapists for prevention of falls in older persons:

  Each person should be asked whether he/she has fall in the 

  past year if so, about the frequency and circumstances 

  of falls. Did they faced any experience of difficulties with 

  walking / balance.Anyone who has had a fall should be 

  evaluated for gait and balance.Anyone who has problems 

  in standarad gait and balance tests should be 

  given comprehensive assessment.

                                                         

   Focused History

 a)History of falls:Causes of the fall,frequency,symptoms at time of fall,injuries,  other consequences.

 b) Medication review

 c)History of relevant risk factors : Acute/chronic health problems 

  

   Physical Examination

a) Detailed assessment of gait, balance, and mobility levels and

    Lower extremity joint function. 

b) Neurological function: cognitive evaluation, lower extremity 

    Peripheral nerves, Proprioception, reflexes, co ordination.

c) Muscle strength (lower extremities)

d) Cardiovascular status: Heart Rate,

                                           Postural pulse

                                           Blood pressure

                                           Rhythm

                                          

e)Respiratory status

f) Assessment of visual acuity & Hearing

g) Examination of the feet and footwear

h) Nutritional Assessment   

 Functional Assessment 

 a) Assessment of activities of daily living (ADL) skills including use 

     of adaptive equipment 

 b) Assessment of the individual’s perceived functional ability and fear related to falling 

 Environmental Assessment This assessment includes home safety                        

         

 SENIOR FALL CAUSES & PREVENTION TIPS                                  

Falls are the leading cause of injury death in Older Adults and       

20-30% who fall suffer from moderate to severe injuries such as  

Lacerations, hip fractures, or head traumas.

Because of these injuries it makes them difficult to move  

  around and live independently and some are becoming 

bedridden and leads to risk of early death.

Fall Fear- Many people who fall & not injured developing a fear 

of falling & due to this they are reducing body mobility 

which leads to loss of physical strength and they are 

   increasing their actual risk of falling.

Falls are more in women than men because early osteoporosis 

in women,decrease bone density causes falls and resultant injuries.

 Repeated Falls:who fall earlier will fall again within six months

 to one year.

                    

MAJOR RISK FACTORS F FALLS AND PREVENTION TIPS

OSTEOPOROSIS means decrease in the bone density where the bones become weak and less resistant to stress and more prone to the fractures. Commonly seen in the menopause women. 

Prevention TIPS: Encourage calcium rich foods like milk, fish, selected vegetables such as broccoli, soyabeans and almonds. Meet your dietician for proper planning of your diet.Take doctors advice and give them calcium supplements if needed. Sufficient vitamin D is needed for the absorption of this calcium in to the bloodstream. We can get vitamin D naturally through sunlight but some older adults needed supplement. Weight bearing exercises are good to follow regularly. Please take your doctor advice before taking the supplements/ exercises.        

                  

VISION PROBLEMS Age related vision diseases leads to impaired vision which makes them to move difficulty in their homes or any shopping malls, can increase the Risk of falling.

Prevention Tips: Regular checkups by ophthalmologist. Use balance  aiding objects like Grab bars and handrails. Add contrasting colour on first and last steps to identify change of level. If they wear then clean them to improve visibility.

MEDICATIONS like Antidepressants , sedatives or any Antipsychotic drugs can contribute to the falls by reducing mental alertness, worsening the balance and the gait and causing drops in systolic blood pressure while standing. 

Prevention Tips: First make a note on side effects of medicines you are taking and talk to your doctor about the dosage of medicine. Use walking aids while using medicines that affect balance. Limit intake of alcohol as it may interact with medications.

                  

 ENVIRONMENTAL HAZARDS in the home also one of 

      the cause for falls 

  Prevention Tips:  Asses your house to identify any fall hazards by room by room. Then do home modification if needed which includes ramps,handrails,lifts, stair glides, roll in showers, grab bars, easy to reach kitchen work and storage areas , daily used things should be placed at lower case shelves so that they can easily reachable. Bathroom or bedroom should be reachable easily without climibing stairs. Place a lamp close to the bed where its easy to reach the things they want to use. Give some assistive equipment if needed like power wheel chair, power seat lift chairs. Give them any emergency alarms which are coming in the way of watch or pendent they can easily wear it, if they need anything they will press the button which automatically dials on. 

 LACK OF PHYSICAL ACTIVITY which results in the decreased balance,flexibility and the strength, poor muscle tone. 

 Prevention Tips: Encourage them to do exercises for atleast alternate days for 15 to 20 minutes.Let them go for a  group walking and swimming where they enjoy. Tell them to wear supportive shoes with low heels/ rubber soles.

  

Physiotherapist will train them to do daily activites in a safe 

manner such as reaching and bending activites and how to raise 

from bed to chair and from chair to stand  or else transfer to an 

wheel chair.

Physiotherapist will plan your exercise programme according to 

your health issues or medical problems in order to improve 

 balance, flexibility and muscle strengthening.

Strengthening exercises

Balance training

Co ordination exercises

Flexibility exercises

Weight bearing exercises

Breathing exercises to improve lung function

Endurance exercises

Stability ball exercises for hips

Joint Mobility exercises like Pendular exercises to shoulder

Squeeze ball exercises for wrist

Neck isometric exercises

Back strengthening exercises

Treadmill training

Aerobics

Yoga

   Start exercises at a low intensity and slowly work your way up to harder.Always consult a doctor before starting an exercise program.