Although falls can occur at any age, the incidence is quite high in the elderly population. While falling does not usually cause a problem in young people, falling in an elderly patient can have very serious and disabling consequences such as hip fracture.
There may be many reasons for falling in elderly patients. Dizziness and imbalance caused by low blood flow to the back of the brain and inner ear disorders, age-related muscle weakness, arthritis in the knees, canal stenosis in the waist, and paralysis are the most common causes. Additionally, excessive medication use in the elderly may also be responsible for falls. Sometimes a single disease, but often several of these at the same time, can be the reason for falling.
The most common behavior in elderly patients after a fall is to reduce their daily activities for fear of falling again. These patients hesitate to go out for fear of falling and confine themselves to their homes. This does not actually protect the patient from falling; on the contrary, the patient, whose muscles become weaker due to inactivity, begins to fall at home.
Considering the complications of falling, such as hip fractures and spinal fractures, which bind the patient to the bed, it is clear that falls in the elderly need to be treated. The most misconception about falls in the elderly is that these patients cannot be treated and they have to live with it. The most important mistake that can be made is to say "He is old and fall" and to restrict the activities in which the patient may fall as treatment.
What kind of treatments should be applied to prevent falls?
The first stage of the treatment is to determine the cause of the fall. should be directed and the main cause should be tried to be eliminated. Although positional vertigo, caused by crystal movement in the inner ear, is frequently encountered, it is the most neglected group. In these patients, dizziness is affected by head movements. The patient begins to feel dizzy in situations that require neck and head movements, such as turning over in bed at night, tying one's shoes, or looking up. With a special examination method, the diagnosis can be made on the examination table without the need for any device, and it is treated with a simple maneuver of a few minutes in the same environment. If the blood flow to the brain is low, medications that increase cerebral circulation are generally used. is called. If there is calcification in the knee and canal stenosis in the waist, cortisone and PRP treatments should be applied to the knee and physical therapy should be applied to the waist. Again, medications and blood sugar control are important, especially in diabetic neuropathies. In addition, the use of many unnecessary medications, which we often see in the elderly, should be prevented.
The second stage and the more important part of the treatment is exercise. The treatment that will literally protect the patient from falls and therefore fractures is exercise. Exercises are performed in two basic ways. The first is strengthening the leg muscles and the other is computer-assisted special balance exercises. Exercises are generally performed as a 1-hour program 2-3 days a week. Strengthening exercises are performed with weight bags and special tires under the supervision of a physiotherapist. Balance exercises are performed both static (standing still) and dynamically on a moving surface. The patient is trained by a physiotherapist in front of a screen with these computer-aided systems. These systems detect the patient's balance very precisely and the patient is operated accordingly. Research shows that these types of balance exercises improve a patient's balance and prevent, or at least significantly reduce, falls. Patients should also continue a home exercise program. These patients should be encouraged and encouraged to move in their daily lives.
It should not be forgotten that falls in the elderly are largely treatable conditions, and these patients should not be abandoned to their fate.
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