ABSTRACT von 1994
OBJECTIVE:
To review the epidemiology and causes of falls
and fall-related injuries in nursing homes and to provide clinicians
with a structured framework to evaluate and treat nursing home residents
at risk for falls.
DATA SOURCES:
All large-scale
published studies documenting incidence, causes, risk factors, and
preventive strategies for falls in nursing homes were reviewed.
RESULTS:
The
mean incidence of falls in nursing homes is 1.5 falls per bed per year
(range, 0.2 to 3.6 falls). The most common precipitating causes include
gait and balance disorders, weakness, dizziness, environmental hazards,
confusion, visual impairment, and postural hypotension. The most
important underlying risk factors for falls and injuries include some of
these same items and others, such as lower-extremity weakness, gait and
balance instability, poor vision, cognitive and functional impairment,
and sedating and psychoactive medications. Many strategies for the
prevention of falls have been tried, with mixed success. The most
successful consider the multifactorial causes of falls and include
interventions to improve strength and functional status, reduce
environmental hazards, and allow staff to identify and monitor high-risk
residents. Strategies that reduce mobility through use of restraints
have been shown to be more harmful than beneficial and should be
avoided.
CONCLUSIONS:
A focused history and physical
examination after a fall can usually determine both the immediate
underlying causes of the fall and contributing risk factors. In
addition, regular evaluations in the nursing home can help identify
patients at high risk who can then be targeted for specific treatment
and prevention strategies.
Quelle:
http://www.ncbi.nlm.nih.gov/pubmed/8053619
Full Text / pdf / RUBENSTEIN et al. - Falls in the nursing home -
http://mcintranet.musc.edu/agingq3/documents/images/Rubenstein_Falls%20in%20the%20Nursing%20Home.pdf
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