Patient Falls Among Aged People Discussion Paper

Patient Falls Among Aged People Discussion Paper

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Ms. R, an 86-year-old, thin, osteoporotic woman, got up onto a stepstool to reach something on the top shelf of her cabinet. She lost her balance and fell onto her left side. She found that she could not sit up without pain. Her daughter later found her and called an ambulance to take her to the emergency department. She was found to have the left femoral fracture. Surgery was scheduled for open reduction internal fixation (ORIF). Blood clot prevention injections and pain medications were prescribed. Later, the patient was monitored for post-operative anemia and infection. After discharge, Ms. R was transferred to a skilled nursing facility for rehabilitation. She was just discharged to her daughter’s home with home health and assistive equipment. Patient Falls Among Aged People Discussion Paper

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Today’s visit:

• Chief Complaint: “I am still recovering from my fall last month and now am staying at my daughter’s but want to go home.”

• Concerns: Recent fall with osteopenic condition, new living situation, rehabilitation, possible hypotension.

Are there any national guidelines you want to refer to for the post-operative and rehabilitation care of this patient? Discuss the long-term treatment plan for this patient. Patient Falls Among Aged People Discussion Paper

Discussion Three

Patient falls become a problem as people age and undergo the typical decline in physiological processes that go along with it. Many older adults who fall are at increased risk of avoidable disease and death. Actually, falls account for most of the injuries sustained by this population (Guirguis-Blake et al., 2018). According to AHRQ (2018), there are between 3.3 and 11.5 patient falls for every 1,000 hospital days in US healthcare settings. Mrs. R is 86 years old and squarely falls in this geriatric population demographic.

After being discharged from the skilled care facility where she was rehabilitated after ORIF surgery on her broken femur, Mrs. R will now require close monitoring and mobility assistance at home. She will specifically be in need of a caretaker and this is because at 86 years old she probably also has some degree of neurodegeneration making her a bit disoriented and prone to further falls (Guirguis-Blake et al., 2018). Being a falls risk patient and elderly, she has to be looked after having in mind the national guidelines on falls among the elderly.

National Guidelines and Long-Term Treatment Plan

If an older adult lives in the community and is at a higher risk of falling, the U.S. Preventive Services Task Force and the American Academy of Family Physicians advise physical therapy or exercise as well as vitamin D supplements to prevent falls (Moncada & Mire, 2017)Patient Falls Among Aged People Discussion Paper. The American Geriatrics Society/British Geriatrics Society guidelines can be used more easily thanks to an algorithm developed by the Centers for Disease Control and Prevention. The technique suggests assessment and interdisciplinary involvement for previous falls victims. Multifactorial solutions include physical activity, gait instruction, provision of a safe home environment, medication management, vitamin supplementation in the diet, and proper footwear. The long-term treatment plan for this patient involves assistance with mobility, help with medications, assessment for neurodegeneration, and help with activities of daily living.

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References

Agency for Healthcare Research and Quality [AHRQ] (2018). Preventing falls in hospitals. https://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/index.html

Guirguis-Blake, J., Michael, Y., Perdue, L., Coppola, E., & Beil, T. (2018). Interventions to prevent falls in older adults. JAMA, 319(16), 1705. https://doi.org/10.1001/jama.2017.21962

Moncada, L.V.V., & Mire, L.G. (2017). Preventing falls in older persons. American Family Physician, 96(4), 240-247. https://www.aafp.org/pubs/afp/issues/2017/0815/p240.html#:~:text=The%20U.S.%20Preventive%20Services%20Task,at%20increased%20risk%20of%20falls  Patient Falls Among Aged People Discussion Paper