older people’s health issues
Falls in Older Adults
Causes of Falls
Most falls occur when several factors interact. Factors include Physical conditions that impair mobility or balance Use of certain medications Hazards in the environment Potentially hazardous situations For example, people with Parkinson Disease (PD) and impaired vision (physical conditions that impair mobility or balance) may trip on an extension cord (an environmental hazard) while rushing to answer the telephone (a potentially hazardous situation). A person's physical condition is affected by changes due to aging itself, physical fitness, disorders present, and medications used. The physical condition probably has a greater effect on the risk of falling than do environmental hazards and hazardous situations. Not only does a poor or impaired physical condition increase the risk of falls, but it also affects how people respond to hazards and hazardous situations. Physical conditionsthat increase the risk of falling include impairments in the following: Balance or walking Vision Sensation, particularly in the feet Muscle strength Cognition Blood pressure or heartbeat For example, loss of muscle strength may prevent older adults from maintaining or recovering balance when they step on an uneven surface or are bumped. With aging, people become less able to judge where objects are in relation to each other and may need brighter light to see well. Cognitive impairment may prevent older adults from remembering to take safety measures when walking—for example, to hold onto the railing when going up and down stairs. Low blood pressure or a slow heartbeat can cause dizziness fainting, or loss of consciousness. The reason is that heart problems can reduce the amount of blood reaching the brain. Use of certain medicationscan also increase the risk of falling. These medications include those that affect attention (such as opioid analgesics, antianxiety medications, and some antidepressants) or lower blood pressure (such as antihypertensives, diuretics, and some heart medications). Hazards in the environmentare involved in many falls. Falls may occur when people do not notice a hazard or do not respond quickly enough after a hazard is noticed. Environmental hazards that increase the risk of falling include Inadequate lighting Throw rugs Slippery floors Electrical or extension cords or objects that are in the way of walking Uneven sidewalks and broken curbs Unfamiliar surroundings Most falls occur indoors. Some happen while people are standing still. But most occur while people are moving—getting in or out of bed or a chair, getting on or off a toilet seat, walking, or going up or down stairs. While moving, people may stumble or trip, or balance may be lost. Any movement can be hazardous. But if people are rushing or if their attention is divided, movement becomes even more hazardous. For example, rushing to the bathroom (especially at night when not fully awake or when lighting may be poor) or to answer the telephone or walking while talking on a cordless phone can make walking more hazardous. 