INSTABILITY AND FALL

With the age, the body deteriorates and the primordial functions. The gait instability and falls are common in elderly people, while falls are among the leading causes of morbidity or mortality in this population. The falls are usually an indicator of frailty, and may be predictive of death, and indirect causes (usually through fractures). Nearly a third of people 65 years of age or older living in the home suffer a fall each year, and about one in 40 get in to a hospital.

The Fall Syndrome, due to various intrinsic and extrinsic factors of the patient. Among the intrinsic factors can include: age, acute and chronic diseases, and the use of some drugs. Extrinsic factors encompass architectural barriers and conditions that produce destabilization as the type of shoes or the floor. These factors together with the weakness of the lower limbs and lack of balance, is a risk for the elderly to fall and become disabled thus leading it to be dependent for some time or permanently of another person.

Nursing work is of great importance in various fields:

In primary prevention,  nurse intervention will primarily detect and correct predisposing factors that lead to falls, we will remove carpets at home, obstacles, maintain functional capacity, we exercise programs, avoid toxic habits.

In secondary prevention, initiate measures before a fall. The nurse can apply the Integral Geriatric Assessment. First is discarded loss of consciousness, syncope diseases, ask when and where it fell, what was at the time, how he got up, ask if there have been previous falls, identify gait disturbance, mental confusion…

 

In tertiary prevention, the objective is to reduce the consequences of the fall both physically and psychologically. The nurse should teach the elderly, to restore stability, first sitting and then standing up to reeducate the orthotics and supportive psychotherapy.

I believe that currently, the falls are a major health problem for the elderly and this cause very high costs, as I have seen in my clinic stays. Therefore, prevention is very important, and therefore should improve or adapt practices fall prevention in our country.

Bibliography.

• Millan, J. Inmovilidad, inestabilidad y caídas. En: Geriatria y gerontología. 2010

• Hile ES, Studenski SA. Instability of Geriatrics. In: Duthie EH, Katz PR, Malone ML, eds. Practice of Geriatrics. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007