Falls
Assessment
History:
Examination:
Management
Prevention:
Source
http://www.racgp.org.au/afp/2012/december/falls-prevention/ (2012)
History:
- Falls hx
- Risk factors (Osteoporosis, urinary incontinence, CVD, diabetes, Parkinson's, arthritis, stroke)
- Pre-syncope/ Syncope hx?
- ADLs?
- Memory?
- Meds review (postural hypo?, benzos, CS - mm weakness)
- Social hx (support, finances)
Examination:
- Gait + full neuro (include strength testing)
- Check feet and footwear
- Single Leg stance x 3 (stand on 1 leg, eyes open, firm ground. <3 stable = impairment)
- Time up and go (sitting on chair --> stand --> walk 3m --> turn around--> walk back to chair --> sit. >15s = impairment)
- Barthel Index (assesses ADL)
Management
Prevention:
- Exercise (2h/ week regular)
- Vit D supplementation (>800IU daily)
- OT review
- Physio assessment (? walking aid)
- ACAT assessment
- Pharm review (Benzo withdrawal)
- Optimise eyesight (eg. cataracts, glasses)
- Hearing assessment
- Personal alarm
Source
http://www.racgp.org.au/afp/2012/december/falls-prevention/ (2012)