The purpose of this essay is to analyse and evaluate the risk and causative factors relating to falls associated with the elderly in their home environment. The question presents a case study of Mavis Bazmati and outlines various aspects of her health and home situation. As a community nurse Mavis’ home will be assessed for potential hazards and provide strategies to prevent further falls. There are different community resources that are available to help Mavis and other members of the multi-disciplinary health team to assist with her activities of daily living.
Falls in the elderly is a health risk priority (Crisp & Taylor. Pg. 235). People aged 65 and over are at most risk as falls can often result in morbidity, mortality and injury (Shumway-Cook et al, 2009). The Australian Institute of Health and Wellbeing show statistical data relating to hospitalisation due to elderly people falling in the home. It is categorised by age and sex in Australia from 1998. The total number of women falling in the home leading to hospitalisation was 14,974 compared to the males who accounted to just 4799 (http://www.aihw.gov.au). The most prevalent injuries from elderly people falling are fracture of the femur and pelvis and may lead to death (http://www.aihw.gov.au). Sustained injuries from a fall may not heal properly for an aged person as their bones and muscle tissue are weaker than an average young adult. Therefore, the healing process is prolonged and likely to be more problematic in the future after healing.
In the case study of Mavis Bazmati it stated that she was admitted to hospital with lower back pain and had had a fall three weeks prior. The case study gives limited information about Mavis but some possibilities relating to her back pain could be Osteoporosis, a slipped vertebral disc and/or muscular damage.
There are many different reasons for the incidence of falling. The types of falls that an aged person could include: slips and trips, which relate to slipping on a wet surface or tripping over a rug, a drop attack where the person is conscious and falls from a loss of muscular tone or drop in blood pressure (Ebersole, Hess & Luggan, pg. 383), syncope, where the person loses consciousness from lack of oxygen to the brain but regains consciousness after seconds or several minutes. Vertigo, where dizziness and disorientation affects the person’s balance and leads to falling.
However there are also intrinsic and extrinsic factors which contribute to the causative factors of falling. The intrinsic factors can be psychogenic, physiologic with extrinsic factor relating to environment (Ebersole, Hess & Luggan, pg. 381). Since falling is a problem when it occurs, it may be a symptom of another problem. Psychogenic factors relate to psychological disorder, including dementia, depression and fear and anxiety (Heath and Schofield, pg. 262). Dementia could lead to a person falling because of the alterations in gait, lack of sufficient vitamins and an unawareness of the possible hazards in their environment (Ebersole, Hess & Luggan pg.381). Depression could cause the person to lose their motivation for life and not care about their own safety. Fear and anxiety could possibly lead to a fall as the person may get a fright or become distracted with scattered perceptions.
Physiological factors are health problems the person is experiencing. Falls from physiological disorders include neurosensory and visual deficits such as vertigo, syncope, seizures, glaucoma and cataracts (Ebersole, Hess and Luggan, pg.381). Disorders such as cardiovascular disorder, hypotension, cerebral vascular insufficiency, osteoporosis and cancer are other physiological factors. Antidepressants, analgesics and sedatives are medications that may be potentially dangerous as they may cause loss of balance, light headedness or drowsiness. Diagnosing physiological factors is extremely important for nurses and other health care members to care appropriately...
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