Cardiovascular issues
When assessing an older adult who has a history of falls but no cardiovascular issues, it is important to remember that there are many possibilities as to why this may be occurring. Firstly, falls occur more often with old age regardless of other predisposing factors. As a person ages, they are more susceptible and falls are one of the top causes of hospitalization amongst the elderly community (Phelan et al., 2015). Aging leads to decreased muscle strength, unsteady gait and decreased proprioception which all contribute the the increase in fall risks (Appeadu, 2021). Another reason that a person may fall is related to medications that increase the risk of orthostatic hypotension, which is the sudden drop in blood pressure with sudden movements to sit up or stand. Taking these two factors into consideration, while assessing a patient there are some questions that I would personally ask. A medication history would be of importance so asking your patient what medications they are currently taking may help. Some medications contribute to unsteady gait, sedation and postural hypotension which can lead to falls (Phelan et al., 2015). Additionally, asking the patient if they have had a decrease in vision recently or are/have been wearing their glasses if they have them. Also, because the patient has not seen a primary care physician in a year, we are unaware of recent history, so asking the patient of any changes they have noticed within the last year related to their gait and level of consciousness may be beneficial. Lastly, ensuring that the patient has a clear and visible walkway in their home is important. Many falls are simply related to environmental factors such as clutter or unevenness in their home (Phelan et al., 2015). Environmental factors such as tripping and falling over an uneven carpet or some clothes on the floor is a possibility that can be easily adjusted if necessary.
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