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46 Cards in this Set
- Front
- Back
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FALLS (FACTS AND FIGURES) |
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• Falls are a risk factor for motor vehicle collisions |
• Decreased reaction time • Decline in coordination • Changes to cognition • Flexibility is reduced |
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SOURCES OF DATA ON FALLS |
• Canadian Community Health Survey (Statistics Canada) • Hospital Morbidity Database (HMDB; CIHI) • Vital statistics (Statistics Canada) • Smaller research studies • CLSA |
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• Estimated cases and rates (per 1,000) of injuries resulting from a fall, age 65+, Canada, 2003, 2005, 2009/2010 (95% CIs shown) - What is the trend? |
• These rates of number of fall-related injuries are increasing
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• Estimated rates (per 1,000) of injuries resulting from a fall by sex, age 65+, Canada, 2003, 2005, 2009/10 (95% CIs shown) |
• Females have more falls in comparison to males |
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• Estimated rates (per 1,000) of injuries resulting from a fall by age group, age 65+, Canada, 2009/10 (95% CIs shown) |
• The older you get the more likely you are going to get injured when falling • Increasing age is a risk factor for falls |
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• Estimated rates of injuries from all causes vs. injuries due to a fall by age group, age 12+, Canada, 2003, 2005, 2009/10 (95% CIs shown) |
• Fall related injuries make up over half of the reasons why older adults have injuries. |
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• Body part affected by fall-related injury, age 65+, Canada, 2009/10 |
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• Type of fall-related injury, age 65+, Canada 2009/10 |
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• Type of treatment sought for fall-related injury, age 65+, Canada, 2009/10 |
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• Number and rates of fall-related hospitalizations, age 65+, Canada, by fiscal year (crude and age standardized) |
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• Fall-related hospitalization rates, by sex and age group, age 65+, Canada, fiscal year 2010/11 |
• As we suspect, the hospitalization rate among females tends to be higher than males
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• Average length of stay (LOS) of fall-related hospitalizations (FRH) and all-causes hospitalizations, age 65+, Canada, by fiscal year |
• Higher for fall related hospitalizations than other causes. Averages around 20 days. |
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• Number of deaths and age-standardized mortality rate due to falls, age 65+, Canada, 2003-2008 (95% CIs shown) |
• Slight increase from 2003 to 2008 for the number of deaths and age-standardized mortality rate due to falls. |
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RISK FACTORS FOR FALLS AMONG SENIORS (4) |
• Biological (intrinsic) • Behavioural • Environmental • Socioeconomic |
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INTRINSIC RISK FACTORS (3) |
• Balance deficits |
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BEHAVIOURAL RISK FACTORS (4) |
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ENVIRONMENTAL RISK FACTORS (3) |
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SOCIO-ECONOMIC (3) |
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BEST PRACTICES IN FALL PREVENTION |
• The Registered Nurses Association of Ontario publishes their professional guideline, RNAO: Prevention of falls and injuries in the older adult |
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• Install night lights in the hallways |
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• Mobility among older adults is… |
• The ability to move oneself within environments, or life-spaces (an environment that you deem important), that expand from one’s residence to the neighbourhood and to regions beyond (Webber, Porter, |
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FALLS (FACTS AND FIGURES)
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• Second leading cause, after motor vehicle collisions (leading cause), of injury-related hospitalizations for all ages, accounting for 29% of injury admissions • 62% of injury-related hospitalizations for seniors are the result of falls • Almost half of seniors who fall experience a minor injury, and 5% to 25% sustain a serious injury such as a fracture or a sprain • Falls cause more than 90% of all hip fractures in seniors and 20% die within a year of the fracture. • 1 in 4 Canadians over the age of 65 in the household population reported experiencing at least one fall (Statistics Canada, 2010) • By 2036 the estimated number of older persons in the community who will fall will increase to almost 2 million |
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• Falls are a risk factor for motor vehicle collisions |
• Decreased reaction time • Decline in coordination • Changes to cognition • Flexibility is reduced |
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SOURCES OF DATA ON FALLS |
• Canadian Community Health Survey (Statistics Canada) • Hospital Morbidity Database (HMDB; CIHI) • Vital statistics (Statistics Canada) • Smaller research studies • CLSA |
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• Estimated cases and rates (per 1,000) of injuries resulting from a fall, age 65+, Canada, 2003, 2005, 2009/2010 (95% CIs shown) - What is the trend? |
• These rates of number of fall-related injuries are increasing
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• Estimated rates (per 1,000) of injuries resulting from a fall by sex, age 65+, Canada, 2003, 2005, 2009/10 (95% CIs shown) |
• Females have more falls in comparison to males
o Getting out more (social events) o There are a lot more females and they live longer o Statistics for osteoporosis is higher in women than in men • Osteoporosis may be a risk factor for fracture when having had a fall |
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• Estimated rates (per 1,000) of injuries resulting from a fall by age group, age 65+, Canada, 2009/10 (95% CIs shown) |
• The older you get the more likely you are going to get injured when falling • Increasing age is a risk factor for falls |
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• Estimated rates of injuries from all causes vs. injuries due to a fall by age group, age 12+, Canada, 2003, 2005, 2009/10 (95% CIs shown) |
• Fall related injuries make up over half of the reasons why older adults have injuries. |
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• Body part affected by fall-related injury, age 65+, Canada, 2009/10 |
• Majority: shoulder/upper arm followed by the knee/lower leg • It is difficult to heal from a hip fracture (but there are large implications) |
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• Type of fall-related injury, age 65+, Canada 2009/10 |
• Majority: broken or fractured bone followed by sprain or strain |
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• Type of treatment sought for fall-related injury, age 65+, Canada, 2009/10 |
• Most people went to the emergency room followed by the doctor’s office. |
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• Number and rates of fall-related hospitalizations, age 65+, Canada, by fiscal year (crude and age standardized) |
• Pretty stable over time: number and rates of fall-related hospitalizations of those over the age of 65 |
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• Fall-related hospitalization rates, by sex and age group, age 65+, Canada, fiscal year 2010/11 |
• As we suspect, the hospitalization rate among females tends to be higher than males
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• Average length of stay (LOS) of fall-related hospitalizations (FRH) and all-causes hospitalizations, age 65+, Canada, by fiscal year |
• Higher for fall related hospitalizations than other causes. Averages around 20 days.
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• Number of deaths and age-standardized mortality rate due to falls, age 65+, Canada, 2003-2008 (95% CIs shown) |
• Slight increase from 2003 to 2008 for the number of deaths and age-standardized mortality rate due to falls.
• Champion: someone who will be looked at as a leader who will promote the prevention-based initiative. Someone who will “champion the cause”. Could be an older adult, a geriatrian, health care professional, etc. • Vicky Scott – an expert in knowledge translation in lieu of a researcher • The efficacy of each type/characteristics of hip protector varies. Therefore they need to be tested and modified to the older adult in question. |
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RISK FACTORS FOR FALLS AMONG SENIORS (4) |
• Biological (intrinsic) • Behavioural • Environmental • Socioeconomic |
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INTRINSIC RISK FACTORS (3) |
• Balance deficits
– Leads to instability and falls – Result from changes to the vestibular or somatosensory system • Changes to hearing can cause changes to the these systems and experiences with deficit • Sensory changes – Vision changes (reduced acuity or contrast sensitivity) make hazard perception difficult. • Acute illness – Acute infections may result in weakness, fatigue or dizziness and lead to a fall |
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BEHAVIOURAL RISK FACTORS (4) |
• History of fall – Previous fall may reduce mobility, resulting in loss of strength, balance and reflexes • Risk-taking behaviour – Climbing, reaching, or bending 32 while performing activities of daily living • Falling from ladders • Polypharmacy and alcohol consumption – Sleep and anxiety medications may cause balance deficits • Vitamin D supplementation – Shown to reduce the occurrence of falls as well as injuries resulting from a fall. |
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ENVIRONMENTAL RISK FACTORS (3) |
• Stairs – High or narrow steps, slippery surfaces, unmarked edges, discontinuous or poorly fitted handrails, inadequate or excessive lighting. • Stairs without railings • Around the home – Loose or uneven rugs, cords, slippery surfaces, lack of grab bars – “Drop-rugs” that are loose and independent • Public Environment – Cracked or uneven sidewalks (Components of the built environment → age friendly environments and communities) – Poor building maintenance |
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SOCIO-ECONOMIC (3) |
• Low-income – Higher risk of fall is below Low income cut-off (LICO) • Social networks – Having a spouse, social participation and strong social networks are protective • Care setting |
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BEST PRACTICES IN FALL PREVENTION |
• The Registered Nurses Association of Ontario publishes their professional guideline, RNAO: Prevention of falls and injuries in the older adult
• Evidence supports multidisciplinary, multifactorial, health and environmental approaches to fall prevention • Exercise programs • Clinical management of chronic and acute illness • Medication review and modification • Assistive devices and other protective equipment • Nutrition and supplementation • Environmental assessment and home modification • Education |
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Suggestions for proofing your home against having a fall |
• Install night lights in the hallways
• Secure mats onto the floor • Install grab bars in the kitchen • Handrails for the stairs • Slippers may not be the best → slippery • Sit on the side of the bed for a few minutes before you get up • Don’t place everyday items too high or too low from your reach |
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• Mobility among older adults is… |
• The ability to move oneself within environments, or life-spaces (an environment that you deem important), that expand from one’s residence to the neighbourhood and to regions beyond (Webber, Porter, and Menec, 2010)
• Not just walking or driving o Hospital setting and long-term care setting also are life spaces to some extent as well. • Essential to completing ADLs • The best guarantee of maintaining independence and the ability to cope with life transitions (WHO, 2008) |
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• Reduced mobility is associated with… |
• Physical deconditioning
• Reduced levels of social participation • Increasing the risk of falling • Loss of independence • Institutionalization • Mortality |
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MOBILITY DETERMINANTS (6) |
• Gender, culture, and biography
o Women demonstrating greater limitations and greater risk of mobility disability compared to men o Culture affects social relationships, educational and occupational opportunities, and physical activity habits • Cognition o Mental status, memory, speed of processing, and executive functioning • Psychosocial determinants o Self-efficacy, coping behaviors, depression, fear, and relationships with others that affect interest and/or motivation to be mobile • Physical o Previous fall, physical limitations, physical health • Environmental o Accessibility of home and community environments o Availability of transportation o Presence (or absence) of fall hazards • Financial o Ex: Low income |
