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February 25, 2010

Brain Teasers:

1. Can you name four days which start with the letter “T”? 2. Shirley has idiosyncratic tastes. She loves weeds but despises flowers. She adores confetti but hates party decorations. She likes feet but dislikes hands. Based on her preference pattern, would she prefer sitting or standing? Note: The full text of the following article can be found on the Springboard under the Clinical Heading/Resources/Articles:

Clinical Practice Guideline: Prevention of Falls in Older Persons (American Geriatric Society)

Screening and Assessment: * All older individuals should be asked whether they have fallen in the past year. * Older persons presenting with a single fall should be evaluated for gait and balance. * Older persons who have difficulty or demonstrate unsteadiness during the evaluation of gait and balance require a multifactorial fall risk assessment.. The multifactorial fall risk assessment should include the following: + Focused History (history of falls; medication review; history of relevant risk factors (acute/chronic medical problems ex. Urinary incontinence, CVD). + Physical Examination to include assessment of visual acuity. + Functional Assessment: Assessment of ADL’s. Assessment of the individual’s perceived functional ability and fear related to falling. +Environmental Assessment.

Interventions: +Establishment of an appropriate exercise program. +Adaptation or modification of the home environment. +Exercise, particularly balance, strength, and gait training. Flexibility and endurance training should also be offered, but not as sole components of the program. + An exercise program that targets strength, gait and balance, such as Tai Chi. + Vitamin D supplements of at least 800IU per day should be considered in older persons residing in LTC settings who have abnormal gait or balance or who are otherwise at increased risk for falls. Thanks to Christine Namey for sharing the above article. Answers: 1. Tuesday, Thursday, Today , Tomorrow 2. Sitting. She only likes words that contain double letters.

Maxwell Perkins, Director of Clinical Services ~ ~ 971.224.2064dir ~ 503.752.7169cell

Clinical Headlines - Feb. 25, 2010  
Clinical Headlines - Feb. 25, 2010  

+ Focused History (history of falls; medication review; history of relevant risk factors (acute/chronic medical problems ex. Urinary inconti...