Main cause of F A L L S :
ARE YOU AT RISK OF A FALL?
“Falls in toilets and bathrooms account for around one quarter of all falls,” Professor Paul Varghese from the Falls Injury Prevention Collaborative said. “We’ve looked at the data to identify the underlying factors for falls in these areas and found that most falls occur when a patient is reaching for an object or changing their position. The data also showed that men were more likely to fall than women.”
Almost three-quarters of people report slips, trips and loss of balance as the cause of their fall – ie. balance-related factors.
Falls are also the leading cause of injury-related death and hospitalization
· Aged over 65 years
· Over three times more likely to be admitted to a nursing home after a fall, and over ten times more likely after a fall that caused an injury or disability
· Falls can result in permanent disability, restriction of activity, loss of confidence and fear of falling – reducing your quality of life and independence
. Falls prevention
· Poor balance
· Slow reaction time
· Muscle weakness
· Poor eyesight
· Reduced sensation in hands and feet
· Limitations in activities of daily living (eg feeding and dressing oneself)
· Medical conditions (eg stroke and Parkinson’s disease)
· Medication use (eg drugs that affect the brain, and multiple medications)
• Balance - Vision plays a significant role in balance. Approximately twenty percent of the nerve fibers from the eyes interact with the vestibular system. There are a variety of visual dysfunctions that can cause, or associate with dizziness and balance problems. Sometimes these are purely visual problems, and sometimes they are caused from other disorders such as stroke, head injury, vestibular dysfunction, deconditioning, and decompensation.
• Hip Fracture and recovery:
This booklet has been put together to help shine a light on the important steps to follow when you leave hospital to best support your hip fracture recovery. It includes basic hip fracture information, treatment options and a guide to osteoporosis planning to support bone health when you leave hospital. Go online to watch NeuRA’s short talks series on hip fracture and falls prevention at NeuRA Talks. Just scroll down a bit.
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Hip Fractures: What are they and how can they be prevented?
Supplier: HealthSaver By: Ian Lancaster 05 April, 2010
Hip fractures are most commonly sustained during a fall. Falls and hip fractures have serious implications on an elderly persons' life as the consequences can be very severe. There is a high degree of morbidity and mortality, pain and hardship.
The majority of people suffering hip fracture never regain their previous mobility and permanently lose their independence. The costs to the health services and social care systems are extremely high. Preventing hip fractures is, therefore, of the utmost importance.
Hip fractures are a major public health problem. In the U.S. alone the cost of hip fracture is approximately $7 billion annually, and hip fracture is the second most common cause of admission to nursing homes, accounting for some 60,000 admissions each year.
Osteoporosis in the elderly contributes to most of these fractures. Many elderly patients who break a hip face a broad array of problems that transcend the treatment of the injury itself. In many cases, an elderly person's independent existence is impacted by a fall that causes a hip fracture, an event that can forever lessen the patient's level of function.
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Fraility -
- They are usually very thin and look like they have lost vitality.
- They look tired.
- They walk as if just doing so might make them fall down.
- It's one of those conditions that physicians and non-physicians alike kind of know when they see it. It has always been around, but it's only in the past 30 years or so that frailty has gotten a formal definition.
- Frail people typically have at least three of five symptoms, including unintended weight loss of roughly five kilograms or more within the past year, tiredness, loss of muscle mass as well as weakness, walking slowly and physical inactivity.
Antidepressants, opioids can more than double risk of falls
by: Dallas Bastian in News, June 3, 2019
"Older Australians starting antidepressants or opioids face more than double the risk of a fall or hip fracture, a new paper says. For the study, published today in Australian Prescriber, the research team compared 8828 veterans with hip fractures with 35,310 people of the same age and gender, examining their medicine use in the previous six months.
The risk of hip fracture was higher for all five groups of drugs tested (antidepressants, opioids, antiepileptic drugs, benzodiazepines and antipsychotics).
The highest risk, more than double, was when selective serotonin reuptake inhibitors or opioids were started. The team said this risk remained high with ongoing use.
Co-lead author Professor Libby Roughead from the University of South Australia said combining any of the five medications increases the risk even further – up to five times when antidepressants and anxiety medicines are started together."
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Multiple Medications:
Professor Jennifer Martin from the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists (ASCEPT) (experts in the use and toxicity of medicines) says, "Many of our recommendations today will help patients avoid unnecessary tests and procedures and lead to discussions on reducing waste and overuse of medicines.
"One of our recommendations is to reduce the use of multiple medicines, common in older patients. Hyperpolypharmacy is where people may be on as many as 15 to 20 medicines at a time. Research has confirmed a significant association between polypharmacy and adverse outcomes among older people and an association with decreased physical and social functioning; increased risk of falls, delirium, hospital admissions and death. With an ageing population, use of many medicines at the same time is something we need to be having conversations about to avoid potentially harmful implications."
Older Australians may not be aware that they are on a ‘prescribing cascade’, where they take one medicine and have an adverse reaction, so are put on another medicine. One common example is when a patient is prescribed a nonsteroidal drug for pain, and is then prescribed a proton pump inhibitor (PPI) to reduce the risk of stomach side effects caused by the first prescribed medicine.
- Since 1 February 2018, medicines that contain low-dose codeine will no longer be available without prescription in pharmacies.
- The medicines affected include codeine-containing combination analgesics, available under brand names such as Panadeine, Nurofen Plus and Mersyndol, and pharmacy generic pain relief products, and codeine-containing cough, cold and flu products, available under brand ranges such as Codral, Demazin and pharmacy generic cough, cold and flu medicines.
The new recommendations on appropriate use and prescribing of medicine include:
- recognising and stopping the prescribing cascade, to avoid adverse drug reactions in older people
- reducing the use of multiple medicines
- to not prescribe medicines without conducting a drug review, to avoid adverse outcomes for people on 5 to 20 medications, and
- to stop medicines when no further benefit will be achieved, particularly for older patients with a limited life expectancy where the treatments are unlikely to prevent disease.
"With the focus on medicines and older Australians in these lists, we urge people to consider if they are on the right medicine, or whether they could be taking too many medicines and if you are due for a review. It’s always timely to check with your doctor or pharmacist to see if any medicines are unnecessary and if they could cause harm if taken together."
http://www.nps.org.au/
with grateful and sincere thanks for alerting, particularly older Australians, to the possibility that it may be that 'extra' medication that is causing this latest reaction.
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Results of Falls
Activity:
In the majority of cases activity while injured was recorded as:
· resting,
· sleeping,
· eating or other personal activity (27%),
· other type of work (10%)
· or other leisure activity (6%).
· On examination of the injury description the type of activity being engaged in were normal day to day activities around the home such as cleaning, cooking, gardening etc.
Nature and body location
The most common injury suffered as a result of a fall was:
· a fracture to either the hip, forearm or wrist
Other injuries recorded were:
· sprain or strain (18%),
· open wound (15%)
· and superficial injury (11%)
· Other major sites of injury were
· Head (10%)
· Knee (6%)
· Face (6%)
· and shoulder (5%)
WHAT TO DO:
· Exercising in programs that include balance and strength training
· Improving vision (eg removing cataracts and restricting use of multifocal glasses)
· Modifying the home for high-risk persons
· Improving podiatry treatment, and foot and ankle exercises
· Have your medications reviewed by your local pharmacist
A Doctors referral is needed if want Medicare cover.
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Coffee and Risk of Falls in Older Adults:
Habitual coffee consumption has been associated with lower risk of type 2 diabetes, cardiovascular disease, and sarcopenia, which are strong risk factors of falls. In addition, caffeine intake stimulates attention and vigilance, and reduces reaction time. Therefore, a protective effect of coffee on the risk of falling can be hypothesized.
CONCLUSIONS:
Habitual coffee consumption was associated with lower risk of falling in older adults in Spain and the United Kingdom.
21 April 2019
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Have a look also at "What to do if you fall at home"...
1. That Urgency to get to the toilet to pee - Walking
2. Trying to position yourself over the toilet bowl - Balancing
3. Removing clothing - Co-ordination
4. Never walk into the bathroom in socks
5. Never Ever use a lay-in type bath, the risk of falling while getting in and out of the bath is very high. Combined with the risk of getting "stuck" in the bath ie. not able to rise out of the bath, make this an unacceptably high risk.
If you bathe without a carer, be cautious of using a chair in the shower if you experience any giddiness, or similar, from the steamy environment.
6. The difficulty of 'Finding' a suitable toilet. Search your nearest location Welcome to the National Public Toilet Map. As part of the National Continence Program, the Toilet Map provides information on over 16,000 publicly available toilets across Australia, including accessibility, opening hours and facilities, such as showers & baby change.
What to DO to make it easier:
1. Wear a “light” pad. It is Alright to pee in the pad :-)
2. Have railings each side of the toilet - on the wall
3. An over toilet seat
4. Have an elasticized waist band – or Velcro opening
- no zip
- no ties at the waist
- Women wear a loose skirt or
- elasticized waist for shorts/slacks
5. Make sure there is adequate lighting, especially at night
6. Install grab rails in the bathroom. Using grab rails/bars as towel rails is also recommended. If you grab a towel rail when falling, there is a high risk of it coming off the wall, or of your wrist breaking because towel rails can be too close to the wall and will not allow your wrist to pivot as you fall.
5. For Men:
SIT down on the toilet seat for BOTH peeing and bowel movements. Anyway, it's a heck of a lot easier than trying to balance upright, unzip/pull down, and grab onto that wall railing!
- aim Down into the bowl
E A S Y !
Hint: for those who have Alzheimer's or Vision problems, a clue is to put "Blue" into the bowl. Just makes it that much easier to aim... otherwise Everything in the bathroom is WHITE, the walls, the floor tiles, the toilet bowl, the hand basin... Where to pee???
A Specialist falls prevention team - The Falls and Balance Clinic at Robina Health Precinct – a 6-7 week program. Gives medical assessments, undergo comprehensive medication reviews conducted by a pharmacist in conjunction with a geriatrician, a senior physiotherapist with expertise in aged care rehabilitation and vestibular physiotherapy and with a clinical nurse consultant or nurse practitioner.
Central Intake Unit 1300 668 936 No Charge
CAP Payment up to $609.70 index annually - Incontinence assistance
https://health.gov.au/health-topics/bladder-and-bowel
Helpline Ph 1800 330 066 Mon-Fri 8.00am to 8.00pm includes NDIS
Who can apply for the scheme? A person is eligible for CAPS if they are five years of age or older and have one of the following:
- a permanent and severe loss of bladder and/or bowel function caused by an eligible neurological condition
- a permanent and severe loss of bladder and/or bowel function caused by another condition, provided the person has a Centrelink Pensioner Concession Card (whether as a primary cardholder or cardholder's dependent)
OzCare nurse can come to your home - show continence samples - available to Seniors over 65 years of age. Call 1800 692 273
www.continence.org.au
07 January 2021
Bladder and Bowel for Older Australians
And that ALL IMPORTANT HELP for Carers http://www.bladderbowel.gov.au/assets/doc/ContinenceCarers.html
§ Positioning and Lifting Patients in bed
And don't forget that when your loved one returns home from hospital, that YOU are the one who will be doing most of the 24/7 care. Do ask the visiting Nurse or Allied Health Worker to teach you how to lift them up and make them comfortable in their bed. You need to be particularly aware of bedsores if they cannot move in bed themselves.
Have a look here so that you know how you can help them feel comfortable when you are re-positioning and lifting them in their bed.
POSITIONING AND LIFTING PATIENTS-Title2
https://www.youtube.com/watch?v=H68Sa04s_1s
Since 1 February 2018, medicines that contain low-dose codeine are no longer available without prescription in pharmacies.
- The medicines affected include codeine-containing combination analgesics, available under brand names such as Panadeine, Nurofen Plus and Mersyndol, and pharmacy generic pain relief products, and codeine-containing cough, cold and flu products, available under brand ranges such as Codral, Demazin and pharmacy generic cough, cold and flu medicines.
The new recommendations on appropriate use and prescribing of medicine include:
- recognising and stopping the prescribing cascade, to avoid adverse drug reactions in older people
- reducing the use of multiple medicines
- to not prescribe medicines without conducting a drug review, to avoid adverse outcomes for people on 5 to 20 medications, and
- to stop medicines when no further benefit will be achieved, particularly for older patients with a limited life expectancy where the treatments are unlikely to prevent disease.