Guillermina Solis, PhD, RN, F/GNP
And
Vanessa Guerrero, RN
Determinants of Fall
Risk and Injury in
Hispanic Elderly
Living...
Objectives
• Describe the prevalence of falls & injuries in elderly
• Explore effects and consequences of falls injuries a...
Epidemiology of Aging
World
59%, 249 million in developing countries
(WHO, 2011)
United States
13.3% , 41.4 million in 201...
Prevalence of Falls
• Fourth leading cause of death in U.S.
• 1 of every 3 elderly fall yearly
• Increase number of fall i...
Significance of Falls and Injuries
• Personal Effect
• Family
• Function
• Quality of Life
• Cost: Direct and Indirect
Causes of Falls
Intrinsic: within person
• Age
• Physical state
• Illnesses
• Medications
Extrinsic: outside person
• Soci...
Research Study
Purpose: to evaluate the risks for falls in home bound elderly residing in El
Paso county utilizing a multi...
Process
• Recruitment
• Coordinating visits
• Challenges
• Data collection
• Home visits
• Informed consent
• Compensation...
Demographics (N=30)
Age
Mean 77.4
Range 58-91
Gender
Male: 20% (n=6)
Female: 80% (n=24)
Education
≤6th grade: 30%
12th gra...
Chronic Illness
• Arthritis 23 78%
• Hypertension 21 70%
• Diabetes 18 60%
• High Chol. 15 50%
• Anxiety 13 43%
• Heart di...
Medications
• Average number
• Prescription: 10.8
• Non-prescription
• Over the counter: 1.2
• Alternative: 1.5
• Most use...
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
3...
The fall story:
Where did they fall?
• 53% Indoor
• 47% Outdoor: yard and outside activities like stores, restaurant
What ...
TUG and Reach Test
TUG (measure of function/balance)
• 11 fell outside cut off = 13 seconds
• 5 considered high risk = ≥20...
Uncorrected Vision
• OD (n=29)
≥40 but < 200 = 23
≥200 = 7
• OS
≥40 but < 200 = 20
≥200 = 5
• OU
≥40 but < 200 = 20
≥200 =...
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
SUMMARY
• Over 75 greater prevalence
• Women a majority
• High number of chronic illness
• High prevalence Hypertension an...
Implications for practice
Need for comprehensive fall risk assessment
• Community
• Admission
• Discharge
Minimize medicat...
Prevention
• Physical activity
• Environment modification
• Awareness of medication adverse effect
• Control of chronic il...
Future Research
Multidisciplinary intervention studies of various age groups
Incorporate EBP programs
• Experimental studi...
Conclusion
Fall risk is multifactorial and requires careful
individual evaluation BUT may be lessened by
taking a proactiv...
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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
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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Determinants of Fall Risk and Injury in Hispanic Elderly Living in El Paso Community

  1. 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. 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. 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. 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. 5. Significance of Falls and Injuries • Personal Effect • Family • Function • Quality of Life • Cost: Direct and Indirect
  6. 6. Causes of Falls Intrinsic: within person • Age • Physical state • Illnesses • Medications Extrinsic: outside person • Social support • Environment • Assistive devices • Walking aids
  7. 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. 8. Process • Recruitment • Coordinating visits • Challenges • Data collection • Home visits • Informed consent • Compensation • Roles of various disciplines • Benefits • Challenges • Perception: participant and professional
  9. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 19. Prevention • Physical activity • Environment modification • Awareness of medication adverse effect • Control of chronic illness • Communication among health care provideres
  20. 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. 21. Conclusion Fall risk is multifactorial and requires careful individual evaluation BUT may be lessened by taking a proactive approach …

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