Free Essay Sample on A Geriatric Patient

Introduction

The impacts of patient falls are far-reaching for both the patient and society. Notably, the geriatric population is more vulnerable to falling, with an estimated 33% of persons aged 65 and above reporting multiple episodes of falling (Hartholt, Lee, Burns, & van Beeck, 2019). The commonest outcomes of these falls include fractures with consequent functional decline due to reduction or loss in mobility, head injuries, and escalating healthcare expenditure. Additionally, falls are associated with psychological effects that constitute the "post-fall syndrome," which is characterized by hesitancy and loss of confidence in the victim, hence reduced capacity for independent living. Also, the people close to the victim are likely to be distressed, especially if they have similar characteristics. This paper examines the incident of 80-year old Mrs. Smith, who is concerned about her predisposition to falling. This concern is fueled by the reduced balance attributed to multiple chronic co-morbidities, and the distresses borne of experiencing a close friend suffer from a debilitating fracture after falling. Below is a diagnostic, therapeutic, educative, and collaborative response from this encounter with the patient.

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Mrs. Smith’s Major Risk Factors for FallsThe main risk factors for falls in the case of Mrs. Smith are mostly intrinsic. Primarily, these intrinsic factors can be grouped into demographic, factual, and physical inadequacy factors. Of these, age is the major inevitable demographic factor because being 80 years; the patient is at a progressively greater risk of falling, as evidenced by the fact that 75 percent of elderly deaths are attributable to falls (Burns & Kakara, 2018). Another demographic risk factor is living alone. The loneliness and lack of family support could actually be the reason why Mrs. Smith fears and worries of falling due to the experience of her close friend have magnified. The psychological impact of the experience, coupled with the perceived helplessness of living alone, cannot be overstated. This irresistible fear of falls and anxiety results in self-restraint in performing activities of independent living due to reduced movements. Also, reduced movement exacerbates body weakness, which further increases risk of falling.

Epidemiology

The factual or historical epidemiology of falls comprises her pre-existing chronic illnesses and multiple medications. Mrs. Smith suffers from hypertension, type 2diabetes, and osteoarthritis. The pain resulting from these illnesses, and especially arthritis, causes weakness and occasional lack of body balance. Consequently, polypharmacy or the use of multiple prescription medications is another confronting challenge. According toMoßhammer, Haumann, Mörike, and Joos (2016), highlighted drugs that could increase anti-hypertensive drugs, diabetes medications, and the pain medications used to manage arthritis. Thus, the lisinopril, acetaminophen, and diphenhydramine that are prescribed to Mrs. Smith are potential etiologies or exacerbations of falls. The stated prescriptions cause side effect like dizziness. Therefore, Mrs. Smith should be encouraged to adopt a keen observation for dizziness, despite the fact that they have not yet occurred.

Additionally, Mrs. Smith is highly susceptible to falls because of physical factors such as bilateral mild knee pain and unsteadiness on walking. The mild crepitus in motion of her knees has resulted in slower speed of walking, and a wide-based gait with short steps. Besides, she has a mild hearing loss which could be attributed to disturbances in the vestibulocochlear nerve that controls hearing and balance. These physical changes are associated with senescence and its consequent decrease in the body’s physiological or functional activity hence a more increased risk to fall. Lastly, there are environmental hazards that predispose Mrs. Smith to fall. For instance, she occasionally drives to visit her friends, which exposes her to unfamiliar environs and causes an increase in the likelihood to fall. Being geriatric and physically unfit, environmental hazards are a critical risk factor.

Interventions to Minimize the Risk

To prevent future falls and minimize the risk, it is advisable that Mrs. Smith joins a falls prevention program (Keine, Zelek, Walker, & Sabbagh, 2019). This program is purposely meant to help with gaining greater capacity to manage the side-effects of post-pharmacy. For example, the program could help with training on mitigating factors, especially for drugs that cause abnormally low blood pressure and dizziness. Moreover, the professionals running the program can identify unmanageable side effects early enough and advise on reduction or replacement of doses. Such interventions are impossible when the patient lives alone.

Another preventive recommendation for Mrs. Smith is to actively engage in balance training because of her unsteadiness. Research reveals that most falls for diabetic patients are greatly related to poor balance (Hewston & Deshpande, 2016). As a result, engaging in balance tests and training will put her in check. Another preventive measure requires Mrs. Smith to involve her family. She could get a family member to live with or get enrolled for home support. Through the latter, she will get a safety companion who keeps an eye on her by observing and accompanying her. Living alone contributes to loneliness and distress which exacerbates her condition by feeding into her distress and reduced functionality.

Conclusion

All these factors are associated with increasing weakness, hence a greater predisposition to falling. Also, the support and close observation by a home-based care specialist empowers Mrs. Smith to comfortably engage in physical activities. that will help strengthen her muscles, improve gait, flexibility, and balance.

References

Burns, E., & Kakara, R. (2018 ). Deaths from falls among persons aged ≥65 Years — United States, 2007–2016. Morbidity and Mortality Weekly Report (MMWR), 509–514.
https://www.cdc.gov/mmwr/volumes/67/wr/mm6718a1.html

Hartholt, K., Lee, R., Burns, E., & van Beeck, E. (2019). Mortality From Falls Among US Adults Aged 75 Years or Older, 2000-2016. JAMA, 2131-2133.
https://jamanetwork.com/journals/jama/fullarticle/2735063

Hewston, P., & Deshpande, N. (2016). Falls and Balance Impairments in Older Adults with Type 2 Diabetes: Thinking Beyond Diabetic Peripheral Neuropathy. Canadian Journal of Diabetes, 6-9.
https://pubmed.ncbi.nlm.nih.gov/26778679/

Keine, D., Zelek, M., Walker, J., & Sabbagh, M. (2019). Polypharmacy in an Elderly Population: Enhancing Medication Management Through the Use of Clinical Decision Support Software Platforms. Neurology and Therapy, 79–94.
https://link.springer.com/article/10.1007/s40120-019-0131-6

Moßhammer, D., Haumann, H., Mörike, K., & Joos, S. (2016 ). Polypharmacy—an Upward Trend with Unpredictable Effects. Dtsch Arzteblatt International, 627–633.
https://www.aerzteblatt.de/int/archive/article/182230/Polypharmacy-an-upward-trend-with-unpredictable-effects.