N.Y Times had a great article discussing the unpredictable impact of falls in the elderly population.  Because of the complex nature of the difficulties that can result from falls, there is a significant need for nursing homes to invest in adequate fall prevention which always includes hiring competent and caring nurses to supervise at risk residents. Residents who suffers falls sometimes never recover because of muscles atrophying or because of the increased lack of mobility causes pneumonia and other respiratory problems.

Once considered an inevitable part of aging, falls are now recognized as complex, preventable events with multiple causes and consequences, calling for a wide range of interventions, both psychological and physiological, that most patients never receive.

All falls need to be taken as seriously as diabetes because they can be a real warning sign that something serious is wrong.   In the article, Dr. Mary E. Tinetti, a falls expert at Yale University medical school, compared falls to strokes in their harmfulness.  Each year, 1.8 million Americans over age 65 are injured in falls, according to the Centers for Disease Control and Prevention. Some rebound as if the injury never happened. But for some, the fall sets off a downward spiral of physical and emotional problems — including pneumonia, depression, social isolation, infection and muscle loss — that become too much for their bodies to withstand.

Psychological factors can be as devastating as the physical trauma, Dr. Tinetti said. “It’s the fear of falling, the lost confidence. Good walkers stop walking, stop going to church. They become socially isolated and depressed.”

The period of immobility after a fall is particularly dangerous, said Dr. Gray-Miceli, whose research includes studying a group of patients after falls. “Being immobile, you’re not taking deep breaths, you’re more prone to orthostatic pneumonia, or older people can develop urinary incontinence. And that can have a whole cascade of emotional consequences as well as the physical consequences, such as skin breakdown, pressure sores, bladder infection, lung infection.

Patients’ pessimism can be self-fulfilling, because they may not walk to the extent they can. “Their stride becomes shorter,” Dr. Morrison said. “They don’t use their lungs.”


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