HEALTHDoctors get tips on patient falls preventionPhysicians are asked to assess and tailor treatment to avert falls in their older patients.By Victoria Stagg Elliott, amednews staff. May 28, 2001. The 89-year-old woman came to Daniel Brauner, MD, a Chicago-based geriatrician, saying she was falling often and without an obvious cause, such as tripping over an electrical wire or a hole in the sidewalk. Like many elderly patients, she was on numerous medications and walked with an unsteady gait caused by severe arthritis in her legs. Dr. Brauner assessed her medications and considered that the anti-hypertensive may have been making her blood pressure too low and making her more vulnerable to a fall. He recommended an exercise program to help balance. He referred her to a nursing agency that inspected her home and decided to discard all throw rugs, and he recommended a pacemaker to keep her heartbeat steady. "She has a significant history of falls. The frequency of her falls has markedly decreased," Dr. Brauner said. "And the pacemaker would probably reduce them further." Looking for ways to reduce falls in the elderly is common practice for geriatricians, but it is far from common among other doctors, who see the majority of those over 65. To change this, a coalition of medical societies released falls prevention guidelines this month to reduce the mortality and morbidity associated with such incidents. All physicians should assess older patients for falls risk and intervene by providing gait training. They should also review medications, recommend exercise programs that include balance training, and refer for home evaluations, say guidelines released by the American Geriatrics Society, British Geriatrics Society and American Academy of Orthopaedic Surgeons.
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Copyright 2001 American Medical Association. All rights reserved.
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