Legionella The risk assessment process is not about creating huge amounts of paperwork; it is about identifying and taking sensible and proportionate measures to control the risks. You may already be taking steps to control the risks, but the assessment process will help you decide whether you should be doing more. You may need to consider different elements of risk when producing your assessment, including:
Metastases to bone Predisposition to falls This includes the risk factors listed above as examples from research literature. Dementia is a particular risk factor for falls. Poor self-protection This is common in the elderly.
Lack of protective subcutaneous fat.
Neurological problems preventing reflex breaking or cushioning of the the fall. Falls associated with loss of consciousness for example, syncope. Motor and sensory problems.
Multiple contributory factors for example, slow and stiff joints, drugs and environmental factors are a common combination of factors. Presentation Falling will present either with injuries or as a result of direct questioning. Many older people do not volunteer that they are falling and guidelines suggest healthcare professionals should routinely inquire about falls in the previous year.
If possible, obtain some collateral history: Was the fall an isolated event or one of many?
If many, is there any pattern? How often do they occur?
Are they becoming more frequent? Does there seem to be any common precipitating factor? What caused the fall? Sometimes the fall is attributed simply to tripping over a loose rug or a trailing electrical cable, for example.
This is not a medical problem but requires a home safety assessment with a visit by a health visitor or other suitably trained professional to identify other risks that require attention.
Frequently, multi-agency home safety assessments can be done simultaneously - eg, identifying fire hazards or home security problems. What was the patient doing at the time? Was it something involving exertion? Did it involve looking up?
Extending the neck to look inside a low cupboard or to do high dusting risks vertebrobasilar insufficiency. Older people should be discouraged from climbing on chairs or ladders since they are more likely to fall in these situations and will fall further, incurring more serious injuries.
Postural hypotension usually occurs on suddenly getting up from sitting or from lying in bed - typically, on getting out of bed to go to the toilet in the night.
Micturition syncope affects men, usually as they stand up at the toilet, attempting to pass urine nocturnally. Does the patient have a sleep disorder? These are reasonably common in older people and may contribute to the risk of falling.
Was there any loss of consciousness? Syncope or blackouts can be associated with cardiac or neurological symptoms. Was there any warning before the fall? Was there any loss of balance?Frequently-asked questions Answers to some common questions about dementia, memory, risk factors and treatments.
This page gives answers to some common questions about dementia, which we hope you will find helpful. It does not replace any advice given to you by doctors, pharmacists or nurses.
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Whilst there are markers which may indicate dementia, at present these are imprecise and may lead to misdiagnosis. Supporting people to live well with dementia Early access to appropriate services has the potential to support people with dementia to remain independent for longer and reduce risks of falls and decline (Alzheimer’s Society, ).