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Falling: a disaster for the elderly.

Falling: A Disaster for the Elderly

Falls are a major medical problem for the aged. They often lead to fractures, dependency, and death. The causes are many, including cardiac failure, neurologic disease, osteoporosis, and a multitude of other factors.

Hospital admissions indicate that at least 185,000 elderly people suffer fractures after a fall. The mortality rate is also high.

After such an accident, many are fearful of venturing out of their homes with the consequent deterioration of quality of life. Some do not inform family or physician because of fear that they would be committed to a nursing home.

The most common site of accidents for the elderly is the house in which they live, followed by hospitals and nursing homes.

Physiologic causes for accidents among the elderly entail frailties of aging, impairment of vision, hearing, and faltering gait. Elderly persons sway more than younger people and may not be able to right themselves quickly because of muscular or osteoarthritis problems. The response of the heart rate to standing, exercise, and hypoxia (sudden reduction of oxygen supply) is usually lessened.

Pathologic causes could also be present. A fall may be an indication of impending deterioration not evident to the attending physician.

Medications have been known to induce postural hypotension (drop in blood pressure upon rising). Many elderly people are taking tranquilizers, antipsychotic agents, and antidepressants, which may affect their movements. Even aspirin can cause vertigo in susceptible individuals and should be used cautiously.

Patients with poorly controlled diabetes may suffer from dysfunctions and dehydration that prevents their feeling the ground when they walk. Osteoporosis degenerates hip structure to the point where the hip cracks and falling follows.

Management of elderly persons who fall should use preventive measures that attempt to deal with the many hazards that confront the debilitation that attends frailty and overmedication.

A Check List of Hazards

Home hazards:

- Floors that are slippery from polish, spills, or urine.

- Rugs that are loose or have holes.

- Chairs with castors.

- Poor lighting and high steps.

- Provide handy light switches with good illumination, and install night lights.

- Erect handrails for toilets, baths, and stairways.

- Floors in bathrooms should be nonslip.

- Eliminate extension cords wherever possible. Install numerous electrical outlets.

Conditions associated with falls:

- Heart failure

- Hypotension

- Seizures

- Vertigo

- Depression

- Parkinson's disease

- Arthritis - Anemia

- Diabetes

- Drugs

- Dehydration - Alcoholism

- Malnutrition
COPYRIGHT 1989 Vegetus Publications
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1989 Gale, Cengage Learning. All rights reserved.

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Publication:Nutrition Health Review
Date:Jun 22, 1989
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