Question

Among older adults, falls are the leading cause of injury deaths,...

Among older adults, falls are the leading cause of injury deaths, unintentional injury, and hospital admissions for trauma. In addition, falls can take a serious toll on quality of life and independence.

Further, falls in older age also have serious repercussions on the lives of family and friends.

Which are the components of a post-fall assessment (PFA)? select all that apply and explain your choice in detail.

A. medication review

B. Fall circumstances

C. Documentation of incident report in patient record

D. cardiovascular assessment

E. Mobility assessment

Answer & Explanation
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A. medication review 

This is  a very important  section of risks assessment whereby various  medication classes increases the  fall risk for instance  psychoactive  medication are falls with independent  predictors. However the above medications tend to   alter the  gait and balance,  interfere with  the sensorium and also tend to be  sedating. Other medications such as  diuretics,  antihypertensives  and nonsteroidal antiinflammatory drugs are rarely associated with falls

 

B. Fall circumstances 

A fall history entails determining the  number of falls in the previous year  together with their circumstances such as  the  use of assistive device, ability to get up after a fall, any  premonitory symptoms, footwear, the use of glasses , location, time of the day, medical treatment received if any and  the sustained injuries. in this case  corroboration by  a witness can be of great importance  in an event of recurrent as well as unexplained  falls since such falls  may be as a result of  unrecognized syncope.

 

C. Documentation of incident report in patient record

  documenting a fall history  is among the the quality  indicators of  fall management and  prevention.

 

E. Mobility assessment

An  important  element of  exam is the assessment of  the balance and gait of the patient. however the three strength, balance and gait tests includes the  30- second stand test, the timed up-and -go tests and  the 4- stage balance tests.

 The TUG test entails examining an individual  standing up from  a chair with armrests, turning on their chair, walking 3m  at their initial place, sitting down, turning as well as returning to the chair. therefore a TUG  which lasts  for more or equal to  12 seconds indicates a high  risk of fall.

The 30 second  chair stand tests  examines the  lower extremity balance and strength. however  an individual who is  not able to stand up from a chair  of a knee high without using  an arm shows  an increased risk of fall.

Finally the  tests on the  4-stage  balance examines  a static balance  by making the patient  stand  in 4 positions

 Howeverthese psitions includes single-leg stand, semi-tandem, parallel and tandem. therefore  when one  is unable to conduct a  tandem stand for 10 second then it indicates a fall but when unable to  stand  on  one leg without being assisted for 5 seconds then it shows injurious falls.

 

Step-by-step explanation

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4707663/