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Determinants of Fall Risk and Injury in Hispanic Elderly Living in El Paso Community
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Determinants of Fall Risk and Injury in Hispanic Elderly Living in El Paso Community

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Determinants of Fall Risk and Injury in Hispanic Elderly Living in El Paso Community …

Determinants of Fall Risk and Injury in Hispanic Elderly Living in El Paso Community
Guillermina Solis, PhD, RN, F/GNP
Vanessa Guerrero, RN

Mano y Corazón Binational Conference of Multicultural Health Care Solutions, El Paso, Texas, September 27-28, 2013

Published in Health & Medicine
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  • 1. Guillermina Solis, PhD, RN, F/GNP And Vanessa Guerrero, RN Determinants of Fall Risk and Injury in Hispanic Elderly Living in El Paso Community
  • 2. Objectives • Describe the prevalence of falls & injuries in elderly • Explore effects and consequences of falls injuries and its relation to quality of life • Analyze results of fall risk factors and reported causes of fall injuries • Identify clinical implications of study and value of multidisciplinary research
  • 3. Epidemiology of Aging World 59%, 249 million in developing countries (WHO, 2011) United States 13.3% , 41.4 million in 2011 Baby boomers: Started Jan. 2011 • 10,000 new 65 yr. old/ year Texas 10.9%, 2.9 million El Paso City 11.2%, 74,000 U.S. Census Bureau, 2010
  • 4. Prevalence of Falls • Fourth leading cause of death in U.S. • 1 of every 3 elderly fall yearly • Increase number of fall increase risk of injury • 20-30% sustain injury • Major cause of ER visits and hospital admissions • Common injuries: fractures & TBI • Fear of falling: limit physical activity, isolation • Influences level of independence (CDC, 2012)
  • 5. Significance of Falls and Injuries • Personal Effect • Family • Function • Quality of Life • Cost: Direct and Indirect
  • 6. Causes of Falls Intrinsic: within person • Age • Physical state • Illnesses • Medications Extrinsic: outside person • Social support • Environment • Assistive devices • Walking aids
  • 7. Research Study Purpose: to evaluate the risks for falls in home bound elderly residing in El Paso county utilizing a multidisciplinary approach to evaluate the physical, medical, and environmental components of the participant . Limited studies in Hispanics Methodology: Descriptive study • Inclusion: • Hispanic • 55 years and older • Self-report fall within the last 3months, • Lives in a non-institutionalized setting • Receiving services from a home health agency • Willingness to participate IRB approval: UTEP
  • 8. Process • Recruitment • Coordinating visits • Challenges • Data collection • Home visits • Informed consent • Compensation • Roles of various disciplines • Benefits • Challenges • Perception: participant and professional
  • 9. Demographics (N=30) Age Mean 77.4 Range 58-91 Gender Male: 20% (n=6) Female: 80% (n=24) Education ≤6th grade: 30% 12th grade: 20% Income Majority below poverty Family support Lived alone
  • 10. Chronic Illness • Arthritis 23 78% • Hypertension 21 70% • Diabetes 18 60% • High Chol. 15 50% • Anxiety 13 43% • Heart disease 12 40% • Depression 8 27% • Renal Disease 4 13%
  • 11. Medications • Average number • Prescription: 10.8 • Non-prescription • Over the counter: 1.2 • Alternative: 1.5 • Most used • Anti-hypertensives • Beer’s Criteria • Sedatives
  • 12. BMI BMI (n=30) Range (16-39) Weight Status Below 18.5 (1) Underweight 18.5 – 24.9 (7) Normal 25.0 – 29.9 (11) Overweight 30.0 and Above (11) Obese
  • 13. The fall story: Where did they fall? • 53% Indoor • 47% Outdoor: yard and outside activities like stores, restaurant What were they doing? • Activities: while doing something such as walking, picking up objects, slid off furniture • Tripped with objects When did they fall? • AM: 48% • PM: 37% • Night: 13%
  • 14. TUG and Reach Test TUG (measure of function/balance) • 11 fell outside cut off = 13 seconds • 5 considered high risk = ≥20 seconds Reach test (measure of flexibility) • No deficits identified • All able to extend beyond 6” from baseline
  • 15. Uncorrected Vision • OD (n=29) ≥40 but < 200 = 23 ≥200 = 7 • OS ≥40 but < 200 = 20 ≥200 = 5 • OU ≥40 but < 200 = 20 ≥200 = 2
  • 16. Corrected Vision • OD (n=29) ≥40 but < 200 = 16 ≥200 = 3 • OS ≥40 but < 200 = 14 ≥200 = 3 • OU ≥40 but < 200 = 11 ≥200 = 0
  • 17. SUMMARY • Over 75 greater prevalence • Women a majority • High number of chronic illness • High prevalence Hypertension and Hypoglycemia • Most fall occurred during activity • Resulted in fractures • Vision: unilateral impairment • High Obesity rate • TUG test: lower function
  • 18. Implications for practice Need for comprehensive fall risk assessment • Community • Admission • Discharge Minimize medications Monitor for adverse effects Control of chronic illnesses: BMI Education • Professionals • Patients • Families
  • 19. Prevention • Physical activity • Environment modification • Awareness of medication adverse effect • Control of chronic illness • Communication among health care provideres
  • 20. Future Research Multidisciplinary intervention studies of various age groups Incorporate EBP programs • Experimental studies to evaluate various groups • Longitudinal prevention studies Evaluate various psychological and physical components that affect balance • Sensory • Strength • Mobility • Learning styles • Fear of falling
  • 21. Conclusion Fall risk is multifactorial and requires careful individual evaluation BUT may be lessened by taking a proactive approach …