You are an AGACNP practicing with a hospitalist group at a community hospital. This hospital is in an area that is predominantly populated by retirees. The majority of the patients on your service are over the age of 65.

You are an AGACNP practicing with a hospitalist group at a community hospital. This hospital is in an area that is predominantly populated by retirees. The majority of the patients on your service are over the age of 65.

You are an AGACNP practicing with a hospitalist group at a community hospital. This hospital is in an area that is predominantly populated by retirees. The majority of the patients on your service are over the age of 65.

Falls in Elderly

Impaired balance, or the inability to manage one’s body posture, is a key factor in falls among the elderly. Balance requires both the ability to acquire the proper motor skills to control body movement and the complex integration of sensory information about the location of the body concerning its environment. Although the motor component demands muscular strength, muscle coordination, and response speed, the sensory component involves vision, peripheral feeling, and vestibular sense (Osoba et al., 2019). These two elements are linked by higher-order cognitive processes that enable predictive mechanisms for planning movements and adaptive mechanisms for being able to adjust to the changing demands of a particular task. The cognitive, motor and central processing systems gradually lose function as we age, which also increases our chance of falling.

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Fall and instability in the elderly can be caused by deterioration in any of the above systems. These physiological risk variables have been developed into rating scales and have been addressed either individually or collectively in several successful fall prevention studies. The Comprehensive Geriatric Assessment is the most effective tool for assessing elderly people who are at risk of falling (Falcão et al., 2019).

In primary care settings, fall prevention techniques include exercise, medication reviews, vitamin D supplements, environmental improvements, and behavioral treatment just a few examples. Depending on the results of an initial thorough patient evaluation, these interventions may be given singly, in combination, or without intervention customization. Exercise and Vit D supplementation were suggested as two types of therapies by the US Preventative Services Task Force (USPSTF) in 2012 to reduce the risk of falls in older individuals (Ang et al., 2020). Multifactorial therapies were selectively advised based on the preferences and circumstances of each patient. To offer fall patients successful multifactorial therapies, nurse practitioners should collaborate with the other members of the healthcare team.

References

Ang, G., Low, S., & How, C. (2020). Approach to falls among the elderly in the community. Singapore Medical Journal, 61(3), 116–121. https://doi.org/10.11622/smedj.2020029

Falcão, R. M. de M., Costa, K. N. de F. M., Fernandes, M. das G. M., Pontes, M. de L. de F., Vasconcelos, J. de M. B., & Oliveira, J. dos S. (2019). Risk of falls in hospitalized elderly people. Revista Gaúcha de Enfermagem, 40, e20180266. https://www.scielo.br/j/rgenf/a/qSCPHftJmPhLL6QHLQ5W9dK/abstract/?lang=en

Osoba, M. Y., Rao, A. K., Agrawal, S. K., & Lalwani, A. K. (2019). Balance and gait in the elderly: A contemporary review. Laryngoscope Investigative Otolaryngology, 4(1), 143–153. https://doi.org/10.1002/lio2.252

You are an AGACNP practicing with a hospitalist group at a community hospital. This hospital is in an area that is predominantly populated by retirees. The majority of the patients on your service are over the age of 65.

Describe one of the following common conditions in the complex acute, critical, and chronically ill adult-geriatric population and explain any differences that you would need to take into consideration in the older patient.

1. Encephalopathy
2. Malnutrition
3. Falls
4. End organ aging
5. Polypharmacy
6. Acute pain management
7. Chronic pain management

Include any appropriate environmental or nutritional interventions and discuss any appropriate assistive devices for this particular population.

Support your summary and recommendations plan with a minimum of two APRN-approved scholarly resources.

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