Falls

Question 1

What age does NICE hold “at risk” of falls

Answer 1

65 years or above

Question 2

What are the three kinds of risks within falls

Answer 2

Intrinsic (MSK, dementia, vision), extrinsic (clutter), behavioural (bending over/tasks outside balance capabilities

Question 3

What is the over-rching strategy for falls prevention?

Answer 3

Target older people/at risk groups, assess for treatable factors, and act with interventions which reduce risk

Question 4

Which groups are at greater risk of falls

Answer 4

Aged 65+, one injurious fall in the last year, >1 injurious fall in the last year, falls plus gait/balance impairment, clinical evidence of osteoporosis, presents with acute fall

Question 5

How are those at risk assessed

Answer 5

Evakuate gait and balance (physio specialise)

Also history, medications, visual acuity, neurological impairment, heart rate and rhythm, postural hypotension

Question 6

What is the get up and go test

Answer 6

Test to see if a patient can get up out of a chair, walk across room, get back and sit down (using hand to push up?)

Question 7

What happens if you see an abnormality when assessing balance (get up and go, etc)

Answer 7

If abnormality, obtain relevant history, physical exam, cognitive and functional assessment, determine multifactorial fall risk

Question 8

What do the physiotherapists assess

Answer 8

Gait, balance, mobility as well as muscle strength

Question 9

What do occupational therapists focus on?

Answer 9

Functional balance and mobility (feet and footwear, environment hazards)

Question 10

Which way os optimal for therapy tp be given

Answer 10

At the patients home (especially OT)

Question 11

How does intervention against falls take place?

Answer 11

Review medications, manage heart rate and thythm abnormalities, manage postural hypotension

Manage osteoporosis risk/vitamin deficiency, make tertiary referrals as required (opthalmology, cardiology chiropody)

Exercise programme, home hazard modification, education and info