INESTABILITY AND FALLS

The gait instability and falls are common in aging, while that falls are among the leading causes of morbidness or morbilidaden this population. The falls are usually are a 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 over living at home suffer a fall each year, and about one in 40 will have to be hospitalizated in a hospital. Only about half of geriatric patients tric hospitalized for a fall will live a year later. Half of nursing home residents suffer a fall each year, and 25% have serious consequences. Accidents are the fifth leading cause of death in people over 65 years of age, whereas falls represent two-thirds of these deaths. aging accidentals with lose normal protective responses or reflex against falls, as the extension of hands and arms.

After reading the above lines I think it is clear the importance and frequency arising from instability and falls for our older patients more.

Main fall risk triggers are:

More than 75 years

Stability and gant alteration

Falls previous

Number of drugs taken: 4 or more

Frail elderly

Living outside the family

Muscle weakness

Deficit gait and balance

Cognitive impairment (mental confusion))

Polymedication

Decreased vision

Chronic pathologies (osteoporosis), acute (hypoglycemia, orthostatic hypotension)

History of falls

The fall risk assessment should be performed in the framework of the Global Geriatric Assessment, focusing specifically on the assessment of gait and balance (Tinetti and Timed Up and Go) Also a good scale named Downtown is used to valuate fall risk triggers.

Is in our hands as nurses and primary responsibility for the care of the elderly to make health education. I was lucky to have a fabulous associate professor at my first Practicalities at the Health Center from who I learned a great prenvencion in all fields of health leads to better patient health status in the future.

These are the recommendations that we give patients or caregivers who are who handle them. I remember how the nurse gave some of these advices to patients who came to the consulting of their small rural Health Center:

- Avoid slippery floors, uneven or wet

- Good lighting in all rooms where they circulate the elderly

- Smoothly and orderly environment (avoid loose wires, carpets, keep the same layout ...)

- Immobilizer: as safety restraints in the elderly (abdominal belt, vest holding and fixing sheets). Such mechanisms will be used always in very concrete and with the consensus of the whole team, to avoid the misuse and / or abuse of the same.

- Bed side rails and lower the bed as much as possible

- Place hands handles in bathrooms and handrails on stairs and hallway

- Use of support measures: walkers, canes, crutches for greater base of support.

- Promote a safe environment:

Helping the elderly to recognize the dangers

Adapt the environment (home modifications)

Let the hand all that the patient can use

RERENCES:

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:chap 17.

http://www.facmed.unam.mx/deptos/salud/censenanza/spivsa/antol%202%20anciano/kane.pdf