SPECIFIC GERIATRIC SYNDROME: INSTABILITY AND FALLS

Falls are the most common safety problems in older adults. It’s a consequence of any event which tumbles down the person against their will. Syndromes geriatric, it’s one of the most important because of its high incidence and the impact on quality of life of the elderly.

Alarm Indicators:

-        Ocular impairment

-        Hearing impairment

-        Nervous system disorders

-        Existence of disability

-        Emotional disorders

Impact:

-        Physical: highlight the fractures à can be a major cause of disability later. It can also cause painful soft tissue injuries, subdural hematomas and burns, rhabdomyolysis.

-        Psychosocial: restriction of patient activity, lack of confidence and anxiety producing a new fall. Can trigger aggression, behaviour disorders, social isolation and loss of self-esteem.

Prevention:

-        Primary:

o       Life style: maintaining functional capacity, exercise programs, no toxic habits.

o       Environmental safety measures: in the home and community environment

o       Early detection and correction of intrinsic and extrinsic factors predisposing

Risk of falls à SCALE DOWNTON:

               Sections:

                              ▪ Previous falls

                              ▪ Drugs

                              ▪ Sensory deficit

                              ▪ State of mind

                              ▪ Ambulation

-        Secondary:

o       Check passenger injury. Discard loss of consciousness

o       Highlight syncopal diseases

o       Rating the state’s elderly and possible injury

o       Tell the doctor or emergency services if necessary

o       No mobilization or incorporate the old man if you suspect may have a fracture.

-        Tertiary:

o       Teaching the old man to get up. Avoid remaining in the soil after the fall: dehydration, hypothermia, pneumonia, rhabdomyolysis.

o       Rehabilitate stability. First sitting, the while standing.

o       Retraining the fly. Help orthopaedic devices.

o       Supportive psychotherapy

Nursing care:

1. Recognize the presence of pain
2. Gently handle the limb, supporting it with pillows
3. Administer prescribed analgesia
4. Help frequent position changes that relieve the pressure and discomfort
5. Instruct the elderly and help in changing position and transfer activities
6. Teaching isometric exercises
7. Start ambulation with frequent short walks
8. Instruction on the safe use of auxiliary devices and monitor progress
9. Install handrails in bed if the patient is confused and disoriented
10. Assess the patient’s skin and note if there are areas of redness
11. Keep the clothes dry and wrinkle bed
12. Keep the patient clean and dry
13. Provide special mattresses, pillows, foam protectors seconds need
14. Provision of adequate liquids
15. Identify if the patient is at risk

.

Personal reflection:

The nurse must be alert to any alarm indicator.

For this purpose, the prevention of the patient is valued by scales.

Tell the patient household measures (avoid slippery floors, secure environment, railings, immobilizers ...)

Teaching the patient and mark targets.

BIBLIOGRAPHY:

Estrategia para la prevencion de caidas en el anciano. Prevencion primaria. Area de salud de Badajoz. Revisado en: http://www.areasaludbadajoz.com/datos/atencion_primaria/Estrategias%20prevencion%20anciano.pdf