Functional Cognition Part 2: Falls in the Elderly
Presented by Jennifer Bottomley
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Older Adults have always wanted to remain in their home as long as possible. A recent trend in health care and funding focusing on home care rather than admission to a nursing facility makes this possible more than ever before. Home Care Nurses, Occupational and Physical Therapists, and other Home Care Providers will be increasingly asked to be involved in the care of these persons and assist with living situation decisions. This presentation will discuss important aspects of helping older adults stay in their home: cognition, home safety, screening, preventive interventions and resources. The participant will develop an understanding of the relationship between balance, cognition, aging, and the risk for falls. Selection of appropriate interdisciplinary assessment tools to screen for cognitive risk factors will be discussed. Intervention models to guide reduction of fall risks and safety related issues in the environment will be discussed. The impact of physical changes, fear of falling, and cognitive decline will be presented. At the completion of this educational session the participant will be able to select appropriate intervention approaches to address cognitive risk factors, reduce falls, assist the primary caregiver and enhance safe and independent community living.
Meet your instructor
Jennifer Bottomley
Jennifer M. Bottomley, PT, MS, PhD, embodies the characteristics of leadership, having worked on committees and task forces and behind the scenes to advance the goals and vision of the profession of physical therapy for 40 years. Bottomley is an independent geriatric rehabilitation program consultant, advisor, and educator.…
Chapters & learning objectives
1. Falls in the Elderly: Cognitive Impact on Safety
Falling is not a normal part of aging, but the elevated incidence and prevalence of falling highlights a significant problem in the older adult population. Understanding the demographics of the older adult population at risk, where falling most often occurs, how people fall, and the devastating consequences of falling are important considerations for the therapist treating the older adult.
2. Factors Related to Fall: Physical, Functional, Medical & Environmental
For the treating therapist, it is paramount to understand that the causes of falling are often multifactorial, with intrinsic and extrinsic risk factors playing critical roles in exposing the older adult to higher fall risk. Understanding these factors--as well as the age-related physiologic changes associated with falling, the impact of disease states on balance, the importance of nutrition for mitigating fall risk, the role of medications and polypharmacy in increased fall risk, and how the environment elevates fall potential--is important when comprehensively treating the older adult. Using screening tools that require patient self-assessment, as well as clinic balance and mobility testing, helps to better define the problem of fall risk and ultimately provides the therapist with the means to address this complex problem.
3. Cognitive Factors in Falls in the Elderly
Cognition is an often overlooked intrinsic factor that has significant relevance in mitigating fall risk. The older adult with impaired cognition is at higher risk for falling, although in the clinic as well as in the research, this is often overlooked when stratifying fall risk. Understanding the contribution of higher cognitive function such as awareness, executive function, and meta-cognitive skill, and how impairment in these areas have implications for safety and quality of life for the older adult, is very important.
