INSTABILITY AND FALLS.

Falls are the most common safety problems in older adults.

As people age they lose the normal protective responses or reflex against falls as the extension of hands and arms.

Fall prevention is everyone’s responsibility. Outreach sessions about fall prevention designed to meet the needs of elderly adults, their families, and anyone who has contact with elderly adults could be offered at senior centers, libraries, businesses, and community colleges.

When an elder falls may appear physical consequences (hip fracture), psychological (post-fall syndrome) and social (isolation and dependence for AVD)

ALARM INDICATOR

• Eye disorders: decreased of visual acuity, accommodation capacity, near vision, night vision and Peripherals vision, decreased tolerance to bright Light.
• Auditory disorders: disorder in the discrimination of language, increasing the threshold of pure tone, tendency to excessive accumulation of earwax
• Nervous system disorders: slowing of reaction time, decreased of sensory recognition.

PREVENTION.

Primary prevention:

Falls are preventable phenomenon in the elderly. Primary prevention includes measures to:

• Living habits: maintaining functional capacity, exercise programs, no toxic habits
• Environmental security measures
• Early detection and correction of intrinsic and extrinsic factors

Among the measures to note, the nurse stands out:

• Will avoid slippery uneven or vet floors
• Good lighting in all rooms where they circulate the elderly
• Smoothly and orderly environment
• Immobilizer:
• Bed side rails, bed down to the maximum
• Place hands handles in bathrooms and handrails on stairways and hallways
• Use of support measures: walkers, canes, crutches for greater base of support.
• Promote a safe environment:
• Help the elderly to recognize the dangers adapt the environment
• Leave to reach everything the patient can use

Secondary prevention:

• Discard loss of consciousness
• Discard syncopal disease
• Assessment of the state of the elderly and possible injury.
• Inform to the doctor or emergency services if necessary
• No mobilize or incorporate the old man if you suspect may have a fracture
• If there is no referral to hospital: observation

Tertiary prevention

• Teach the elderly to rise. Avoid remaining in the soil after the fall
• Rehabilitate the stability
• Exercise program
• Retraining gait. Orthotics Help
• Supportive psychotherapy

NURSING INTERVENTIONS

• Evaluate the person for the risk for falls
• Modify the environment to reduce risks
• Recognize the presence of pain
• Gently handle the limb, supporting it with pillows
• Administer prescribed analgesia
• Help frequent position changes that relieve the pressure and discomfort
• Instruct the elderly and help in changing position and transfer activities
• Teaching isometric exercises
• Start ambulation with frequent short walks
• Instruction on the safe use of auxiliary devices and monitor progress

1.     Gloria Hoffmann Wold. Basic Geriatric Nursing. 5^th ed. Milwaukee, Wisconsin:Elsevier; 2012