NURSING ACTION OR INTERVENTION DESIGNED TO IMPROVE FALL RISK CARE IN THE GERIATRICS POPULATION Author Author Affiliation Introduction Geriatric Care Geriatrics is basically sub-specialty of internal family medicine while Geriatric care refers to the professional nursing of elderly people.Geriatrics is different from Gerontology that is aging process but sometimes it is referred to as “Medical Gerontology”…
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Common chronic problems like hindered vision, hearing failure and impaired memory arise in old age which leadsto different problems and severe distress. Elderly people are generally subjected to polypharmacy (using multiple medications) due to multiple problems of old age. A study shows that there are about as many elderly who take nonprescription drugs as take prescription drugs. This however, may cause adverse drug effects (categorized as serious, life-threating and fatal)if the drugs interact with each other within the body.Another complexity is the refusal of elderly people to cooperate due to the fear of consequences of treatmentand they reject taking any medical care. However, many of these problems are treatable, if proper nursing measures are taken. Overview: Falls in Elderly Falls among elderly are not related to normal aging; rather, they are regarded as a geriatric syndrome because of discrete multifactorial and interacting, predisposing (intrinsic and extrinsic risks), and precipitating (vertigo, syncope) causes. We have taken two studies into consideration based on the randomized trials of the elderly people living in: Homes (Day et al., 2002) Residential care facilities (Jensen, Lundin-Olsson, Nyberg & Gustafson, 2002) There has been a lot of research in the past decade on randomized controlled trials based on fall prevention. Day et al. (2002) report that exercise, minimization in medication, professional support services and home modifications have proved to be effective interventions as supported by RCT.Trails of multiple interventions have also shown to be effective in fall prevention. While in another study Jensen, Lundin-Olsson, Nyberg & Gustafson (2002) has designed a hypothesis intervention program based on specific multiple risk factors for falls in elderly residents of residential care facilities and conducted RCT for fall prevention. Designs Study-I Day et al., (2002) designed the evidence based study which targeted fall risk factors: strength, balance disorder, impaired vision, and home hazards (included because of its extensive presence although no strong evidence was available). The study used a full factorial design, designating eight groups on the basis of three interventions. Seven groups availed at least one intervention and the remaining one group didn’t till the end of the study.“Adaptive Biased Coin” technique was used to select the participants. A flow chart of the scheme is provided in appendix-I. Placement – CityofWhitehorse, Melbourne, Australia Participant Age– 70 years and above (residing at own homes) Data Assessment– The researchers compared and divided individuals into different groups according to the available data on the basis of higher percentage: Sample size–On the basis of 25%annualfall-reductionconsidered to be an achievable target the studies required 914 participants and 1143 participants for a non-intervention assessment and main effect comparison(annual fall-rateof 35 per 100 individuals) allowing a 20% dropout. Study-II Jenson’s (2002) study was designed onelderly people (having cognitive dysfunction)residing in residentialcare facilities. The study reports that out of 25 residents, nine met the criterion and were split into groups A and B (based on age, number and type of facility setting and record of previous falls). To maintain the discreetness the medical staff
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