Fall prevention
In any year, half of the people who are 80 years and above fall. Approximately, 27% of hospital costs are due to these falls. All this is attributed to the fact that older people are at risk of loss of independence, injury, rest home admission or even death. Over the past decade, a variety of fall prevention trials have been successful. This success is associated with the use of a variety of interventions, and the successful trials have been published. As a result, there have been numerous international interests as well as investment in the fall prevention programs. Nonetheless, for any effect that is noticeable, like falls, the community needs to have the effectiveness of these programs proved and their acceptability and affordability (within the limited public health budgets) determined.
Fall prevention requires an approach that is all inclusive. This requires significant amount of work for all those who make a provision of healthcare setting environment safe, with the overall objective of recognizing, evaluating and preventing falls.
The causes of fall can be classified based on physiological as well as environmental factors. According to Janice Morse, falls can be accidental, anticipated or unanticipated. Accidental falls occur when the fall is unintentional. For example, an individual may slip, trip or fall due to equipment failure or environmental factors like spilled water or slippery floor. On the other hand, anticipated physiological falls occur when an individual is at a risk of falling - like in epileptic cases. Unanticipated physiologic falls occur when the physical cause of the fall is not reflected. For example, hip fracture, fainting or a seizure; previous falls are strongest risk predictors. The risk is worsened if the falls were injurious hence high risk patients require a multifactor assessment that is complex.
Knowledge gap
There has been extremely little consideration that has been given to falls in the young, middle and old adults as they go their everyday activities. Therefore, there is knowledge gap regarding circumstances under which adults fall, and the difference between these falls and those occurring in older adults. The interpretation is that instrumental knowledge in fall prevention especially in these groups and also in the improvement of environment, health and other necessary conditions influencing falls that may occur in future is lacking. As a result, there is need to have the participation of policy makers, program implementers as well as key stakeholders in supporting identification of interventions that are informed by evidence on fall prevention. Again, the commonly used assessment tools for fall risk have validity and reliability issues that vary, and it has been a challenge to interpret data due to poor data standardization and analysis making it difficult to determine trends. Community or public health initiatives for reducing fall are, however, necessary in order to translate positive evidence that could be used towards development of more effective strategies for fall prevention.
Strategies
Two approaches are necessary in fall prevention: individual patient’s services that require specialist management and community programs which target older populations in the community and those at the risk of falling. Individual patient services will be based on a patient assessment and assessment that are comprehensive as well as resource and staff intensive. Treatment will be provided by multi-disciplinary teams. Public health or community programs will need to be staff intensive and also less expensive so as to reach people who are at risk of falling. There will also be a focus on Muscle endurance, power and strength improvement in my strategy especially in muscle groups which contribute to alignment of postural and stability such as knee, ankle, trunk and hip. In no doubt, a fitness routine that is effective will be aimed at maintaining a high independence and life quality level.
References
National Institute for Clinical Excellence. (2004, November 3). Falls:the assessment and
prevention of falls in older people. Clinical Guidelnies , pp. 1-27.
Robertson, M., N, D., & Scuffham, S. (2001). Economic Evaluation of a Community based
exercise programme to prevent falls. Epidemiol Community Health , 55:600-6.
Rubestein, L. Z., & Josephson, K. (2002). The epidemiology of falls and syncope. Clini Geriatr
Med , 18 (2) : 141–5.
Vellas, B., Wayne, S., Romero, L., Baumgartner, R., & Garry, P. (1997). Fear of falling and
restriction of mobility in elderly fallers. Age Ageing , 26:189-93
