Overview
These questions are incredibly valuable for elderly patients who are poorly mobile, though are likely to be inappropriate in younger patients who are fit and active.
Ask About
- Steadiness - how steady the patient feels on their feet with or without mobility aids
- Walking aids - whether the patient requires any aids to mobilise, such as a walking stick, 4-wheel walker or rollator frame
- Transfers - whether the patient can transfer from bed to chair or chair to toilet independently, with assistance, or if they require hoist transfers
- Stairs - whether the patient is able to climb stairs independently
- Modifications - whether the patient has had anything added onto their home, such as ramps or toilet / shower rails
Also ask about whether the patient's mobility has changed recently, and why.
Significance
- Poor mobility significantly increases risk of falls, and affects the patient's ability to perform their activities of daily living.
Falls History
Ask About
- Whether the patient has had any falls recently
- What they were doing when they fell
- Why they fell
- Whether the hit their head or other part of the body
- Whether they have pain in any part of their body
- How long they were on the ground for
- How often they fall over
Significance
- Falls in the elderly significantly increase the risk of devastating injuries - especially hip fractures and intracranial bleeds.
Risk Factors for Falling
- Poor vision
- Cognitive impairment
- Past stroke
- Parkinson's disease
- Cerebellar pathology
- Impaired proprioception
- Pain
- Vertigo
- Hypotension
- Medications - especially sedatives, antihypotensives
- Dangerous home environment - e.g. stairs, pets, clutter
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