Lack of Exercise May Cause Falls in the Elderly
Lack of Exercise May Cause Falls in the Elderly
Problem Section
Falls are a major source of death and injury in elderly people. For example, they cause 90% of hip fractures and the current cost of hip fractures in the US is estimated to be about 10 billion dollars (Kato, Izumi, Hiramatsu, & Shogenji, 2006). Ensuring patient safety is one of the main reasons given for use of restraints. However, according to Jech (2006), the use of physical restraints is unlikely to prevent falls. Physical restraints, such as tie-down restraints, wheelchair belts, or bed rails are used to keep the patient safe, to keep patients from wandering off, falling, or if they are being combative. Also, it does not necessarily follow that using restraints in anticipation of harm is beneficial (Berzlanovich, Schöpfer, & Keil 2012). Direct detrimental effects of restraints have been reported by Kato, Izumi, Hiramatsu & Shogenji (2006) including death by strangulation, hypoxic encephalopathy secondary to strangulation, skin abrasions, psychological distress, and decreased socialization. Indirect effects of physical restraints are caused primarily by prolonged immobilization and decreased physical functioning pressure sores, flexion contractures, pneumonia, and biochemical and physiological changes. Use of physical restraints to prevent the patient's disruption of therapy, for example, intravenous lines and nasogastric tubes, often is seen in the acute-care setting. Approximately half of the patients who die in these settings have been physically restrained; many die with the restraints still in place (Berzlanovich, Schöpfer, & Keil, 2012) & (Jech, 2006). Clearly the high morbidity and mortality associated with physical restraints raises questions about their usefulness. Maybe instead of restraining the patients we should consider another alternative to prevent falls. Exercise has been suggested to be a better tool to reduce falls.
Literature Review
An exercise program was developed to
Problem Section
Falls are a major source of death and injury in elderly people. For example, they cause 90% of hip fractures and the current cost of hip fractures in the US is estimated to be about 10 billion dollars (Kato, Izumi, Hiramatsu, & Shogenji, 2006). Ensuring patient safety is one of the main reasons given for use of restraints. However, according to Jech (2006), the use of physical restraints is unlikely to prevent falls. Physical restraints, such as tie-down restraints, wheelchair belts, or bed rails are used to keep the patient safe, to keep patients from wandering off, falling, or if they are being combative. Also, it does not necessarily follow that using restraints in anticipation of harm is beneficial (Berzlanovich, Schöpfer, & Keil 2012). Direct detrimental effects of restraints have been reported by Kato, Izumi, Hiramatsu & Shogenji (2006) including death by strangulation, hypoxic encephalopathy secondary to strangulation, skin abrasions, psychological distress, and decreased socialization. Indirect effects of physical restraints are caused primarily by prolonged immobilization and decreased physical functioning pressure sores, flexion contractures, pneumonia, and biochemical and physiological changes. Use of physical restraints to prevent the patient's disruption of therapy, for example, intravenous lines and nasogastric tubes, often is seen in the acute-care setting. Approximately half of the patients who die in these settings have been physically restrained; many die with the restraints still in place (Berzlanovich, Schöpfer, & Keil, 2012) & (Jech, 2006). Clearly the high morbidity and mortality associated with physical restraints raises questions about their usefulness. Maybe instead of restraining the patients we should consider another alternative to prevent falls. Exercise has been suggested to be a better tool to reduce falls.
Literature Review
An exercise program was developed to
References: Anderson, R., Corazzini, K., Porter, K., Daily, K., R, & Colón-Emeric, C. (2012). CONNECT for quality: protocol of a cluster randomized controlled trial to improve fall prevention in nursing homes risks to patients. Nursing Spectrum 2006). Asakawa, Y., Ikezoe, T., Hazaki, K., Kawano, I., Irie, S.,Kanzaki, H. et al. (1996). Relationship between falls and knee extension strength in the elderly Berzlanovich, A. M., Schöpfer, J., & Keil, W. (2012). Deaths Due to Physical Restraint. Deutsches Aerzteblatt International, 109(3), 27-32 Browne, G. (2006). Special issue of contemporary nurse: advances in contemporary mental health nursing. International Journal Of Mental Health Nursing, 15(4), 279-280. Filho, W. (2004). Effect of an exercise program on functional performance of institutionalized elderly Hiramatsu, T. & Izumi, K. (1998). Shisetsu koureisha no tentou: roujin byouin to roujin hokensisetsu no chigai [The prospective study of falls in institutionalized elderly: the comparison between a geriatric Kato, M., Izumi, K., Hiramatsu, T., & Shogenji, M. (2006). Development of an exercise program for fall prevention for elderly persons in a long-term care facility Gerontol. 1974;29(2):157-61 Slesenger, N