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Exploring the Impact and Prevention of Falls in the Elderly

Introduction

Overview of the Study

Fall is referred to the involuntary and sudden transfer of the body to the ground due to disability and morbidity in the elderly. It is estimated that nearly 1/3rd of the falls occurs among the elderly of 65 years and older each year and nearly half of these cases are recurrent occurrences of fall among the people (Zahedian-Nasab et al., 2021). The risk of fall in the elderly is seen to be 2-3 times more who expresses cognitive impairment of fall history. This is because such individuals are unable to keep the enhanced balance of their body out of hindered health caused by the impairment (Cuevas-Trisan, 2017). In this study, falls regarding elderly is to be explored as it is one of preventable health conditions which is capable of uplifting the well-being of the patients as well as reduce unnecessary hospital admission out of recurrent injury. For this purpose, a background of the study followed by its significance and rationale is to be mentioned. Thereafter, a brief literature review explaining the existing information regarding the topic is to be discussed. The methodology to be followed and the results along with discussion is to be presented. The recommendation developed from the context in the study is to be discussed.

Background of the Study

The NHS mentions that fall in elderly is referred to as the failure of the person in maintaining steady and appropriate sitting, lying or standing position which causes an individual to abruptly recede to a lower position in an undesirable manner (NHS, 2021). There are mainly three types of fall experienced by the elderly one of which is anticipated physiological fall. This nature of fall occurs mostly in-hospital patients who express risk fall able to be determined from their health analysis prior to its occurrence out of the presence of their altered mental state, frequent toileting habit, abnormal gait, involve ion high-risk medication and others (Guirguis-Blake et al., 2018). The other type is unanticipated physiological fall occurs in elderly patients those are at low risk of fall due to lack of idea of the timing of event supporting the occurrence of falls such as sudden stroke, seizure, syncopal episode and others (Grossman et al., 2018). Another type of fall seen in elderly is accidental fall which occurs in them mainly due to environmental hazard and lack of safety measures to reduce the chances of falls (Gazibara et al., 2017).

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The general impact of major fall among the elderly is fracture such as fracture of the wrist, hip, pelvis, humerus and others. The fracture on the hip is considered a major health problem caused due to fall among the elderly (Gazibara et al., 2017). In the study by Nicklett et al. (2017), it is mentioned that 31% of the falls in elderly require the restriction of activities or medical attention. In most cases, soft tissue injury occurs and among them 5% are major soft tissue injury or head trauma. This fall and its impact on the elderly is able to be lowered with effective involvement of preventive measures such as railing on the bed, offering supportive walking equipment, fall risk management and others (Grossman et al., 2018). However, the extent to which falls in elderly occurs in care home and the impact of the fall prevention methods on the patients is not effectively understood. Thus, the current study is developed to access a better understanding of the falls and its prevention impact on the elderly receiving support at the care home.

Significance of the Study

The care home offers accommodation along with personal care to the elderly who are unable to take their own care and needs extra support in executing their daily actions. In the care home, the elderly living is mostly frail and suffering from hindered health issues which makes them incapable to maintain balance and fall (Fragala et al., 2019). This falls among the elderly in care home makes it a major and significant issue to be focussed so that factors responsible for its occurrence in the environment can be identified. The topic is also significant to be focussed to understand the health consequences and its impact on them while coping with the existing health issue. As asserted by Hopewell et al. (2018), the occurrence of falls among the elderly leads them to experience increased care cost and at times increased hospital years. This is because of the additional injury caused by the fall which makes the elderly require additional health care for extended periods. The focus on fall prevention among the elderly residing in care home also makes the topic significant. This is because it would make professionals and nurses understand the techniques used in the care home for fall prevention and additional strategies to be implemented so that better fall management among the elderly can be achieved in the care home (Fasano et al., 2017). The topic is also significant to be discussed as it would help in lowering the overall additional cost of care faced by elderly and hindered well-being out of fall by understanding the fall prevention techniques to be used with greater appropriateness.

Rationale

In the UK, nearly 400,000 people are living in care home who are suffering from various complex health disorder and are not able to manage their own care. In most of them, frailty is high and many of the elderly express high risk of fall (bgs.org.uk, 2019). The number of falls experienced in the care home in the UK are not specified, but the Age UK mentions that nearly 255,000 falls-related emergency hospitals are done in the England of patients who are 65 years and older in 2016 (ukhsa.blog.gov.uk, 2017). The NHS mentions that 1 in 3 elderly who are 65 years and older and 1 in 2 elderly who are above 80 years of age show chances of at least 1 fall each year and most of them may not be serious but may be traumatic for the person (NHS, 2021). It makes fall among elderly as key issue because it is one of the increased preventable health issues which can be limited to ensure enhanced well-being of the elderly in their later years. In 2017, it is reported that 5000 elderly people of 75 years and above in the UK suffered death from fall and it has increased by 70% since 2010 (ageuk.org.uk, 2019). This indicates fall management as a key issue to be focussed on for the elder so that their mortality rate due to the issue can be lowered and avoided since it is preventable health issue.

The falls among the elderly is an issue because it contributes to injury and causes complex fractures to the patients at times. This is because the elderly is seen to have frail bone structure who are suffering from osteoarthritis or experiences hindrance in maintaining balance due to cognitive complication caused by dementia and others (Beunza-Sola et al., 2018). The Age UK reports that in 2017-18 nearly 100,000 people of 65 years and above suffered from hip fractures due to fall (ageuk.org.uk, 2019). As argued by Cheung et al. (2018), falls among the elderly makes them experience increased hospital stay and increased recovery time for the injury. It may make the elderly feel increased lack of independence of care and fear of falling leading them avoid making enhanced physical movement in certain condition. The falls among the elderly is an issue because irrespective of existing fall prevention actions maintained in care homes, increased falls are being reported from the care facilities (Chao et al., 2019). Thus, to understand the effective prevention strategies to be implemented and advanced to be made in care, the current study is essential to be developed.

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The fall and its prevention among elderly have currently become an issue because it is contributing to increased cost in care to be managed by the NHS. It is evident as Age UK mentioned £1.7 billion per year is required to be spent by the NHS in controlling health issues caused by falls among the elderly (ageuk.org.uk, 2019). However, irrespective of the increased expenditure, the falls among the elderly is often dismissed as a major health issue to be focussed in care homes and hospitals. Moreover, as of 2020, nearly 18.9% of the population in the UK are above 65 years and it is going to increased further by 1.6% in 2022 (commonslibrary.parliament.uk, 2021). This indicates that the elderly population are increasing at a steady rate. Falls is not normal health issues among the elderly but is prevalent mostly among elderly people (Han et al., 2021). Therefore, increase in elderly people in the UK may make falls prevalence worse. In addition, a survey by Age UK mentioned 36% of elderly on the UK are mentioning risk of fall to be their major concern (commonslibrary.parliament.uk, 2021). Thus, the current study is important to develop overview of falls among the elderly and analyse its preventive actions in care homes to ensure effective control towards the high prevalence of the preventable health issue for the elderly.

Aim

The aim of the study is to analyse the falls and its prevention among the elderly in care homes.

Objectives

To identify the concept of fall and its prevention among the elderly in the care home

To assess the impact of fall and its prevention among the elderly in the care home

To evaluate the challenges faced in fall and its prevention among the elderly in the care home

To recommend strategies in overcoming the challenges faced in fall and its prevention among the elderly in the care home

Literature Review 2500

Methodology 2000

Results and Discussion 3000

Conclusion 1000

References

ageuk.org.uk 2019, Later Life in the United Kingdom 2019, Available at: https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/later_life_uk_factsheet.pdf [Accessed on: 30 November 2021]

Beunza-Sola, M., Hidalgo-Ovejero, Á.M., Martí-Ayerdi, J., Sánchez-Hernández, J.G., Menéndez-García, M. and García-Mata, S., 2018. Study of fall risk-increasing drugs in elderly patients before and after a bone fracture. Postgraduate medical journal, 94(1108), pp.76-80.

Chao, C.T., Yang, R.S., Huang, W.J., Tsai, K.S. and Chan, D.C.D., 2019. Risk factors for poor functional recovery, mortality, recurrent fractures, and falls among patients participating in a fracture liaison service program. Journal of the American Medical Directors Association, 20(9), pp.1129-1136.

Cheung, W.H., Shen, W.Y., Dai, D.L.K., Lee, K.B., Zhu, T.Y., Wong, R.M.Y. and Leung, K.S., 2018. Evaluation of a multidisciplinary rehabilitation programme for elderly patients with hip fracture: a prospective cohort study. Journal of rehabilitation medicine, 50(3), pp.285-291.

Cuevas-Trisan, R., 2017. Balance problems and fall risks in the elderly. Physical Medicine and Rehabilitation Clinics, 28(4), pp.727-737.

Fasano, A., Canning, C.G., Hausdorff, J.M., Lord, S. and Rochester, L., 2017. Falls in Parkinson's disease: a complex and evolving picture. Movement disorders, 32(11), pp.1524-1536.

Fragala, M.S., Cadore, E.L., Dorgo, S., Izquierdo, M., Kraemer, W.J., Peterson, M.D. and Ryan, E.D., 2019. Resistance training for older adults: position statement from the national strength and conditioning association. The Journal of Strength & Conditioning Research, 33(8).pp.34-56.

Gazibara, T., Kurtagic, I., Kisic‐Tepavcevic, D., Nurkovic, S., Kovacevic, N., Gazibara, T. and Pekmezovic, T., 2017. Falls, risk factors and fear of falling among persons older than 65 years of age. Psychogeriatrics, 17(4), pp.215-223.

Gazibara, T., Kurtagic, I., Kisic‐Tepavcevic, D., Nurkovic, S., Kovacevic, N., Gazibara, T. and Pekmezovic, T., 2017. Falls, risk factors and fear of falling among persons older than 65 years of age. Psychogeriatrics, 17(4), pp.215-223.

Grossman, D.C., Curry, S.J., Owens, D.K., Barry, M.J., Caughey, A.B., Davidson, K.W., Doubeni, C.A., Epling, J.W., Kemper, A.R., Krist, A.H. and Kubik, M., 2018. Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force recommendation statement. Jama, 319(16), pp.1696-1704.

Grossman, D.C., Curry, S.J., Owens, D.K., Barry, M.J., Caughey, A.B., Davidson, K.W., Doubeni, C.A., Epling, J.W., Kemper, A.R., Krist, A.H. and Kubik, M., 2018. Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force recommendation statement. Jama, 319(16), pp.1696-1704.

Guirguis-Blake, J.M., Michael, Y.L., Perdue, L.A., Coppola, E.L. and Beil, T.L., 2018. Interventions to prevent falls in older adults: updated evidence report and systematic review for the US Preventive Services Task Force. Jama, 319(16), pp.1705-1716.

Han, T.S., Yeong, K., Lisk, R., Fluck, D. and Fry, C.H., 2021. Prevalence and consequences of malnutrition and malnourishment in older individuals admitted to hospital with a hip fracture. European Journal of Clinical Nutrition, 75(4), pp.645-652.

Hopewell, S., Adedire, O., Copsey, B.J., Boniface, G.J., Sherrington, C., Clemson, L., Close, J.C. and Lamb, S.E., 2018. Multifactorial and multiple component interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, (7).pp.45-90.

Nicklett, E.J., Lohman, M.C. and Smith, M.L., 2017. Neighborhood environment and falls among community-dwelling older adults. International journal of environmental research and public health, 14(2), p.175.

Zahedian-Nasab, N., Jaberi, A., Shirazi, F. and Kavousipor, S., 2021. Effect of virtual reality exercises on balance and fall in elderly people with fall risk: a randomized controlled trial. BMC geriatrics, 21(1), pp.1-9.

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