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Fall-prevention-exercises-for-seniors

Fall prevention exercises for seniors

We are Open on 22 Aug 2018 Wednesday (Hari Raya Haji) 11-6pm, Whatsapp: 83334466

Fall-prevention-exercises-for-seniorsIn the older age group fall is one of the major cause of health related problem. This is known to be the major cause of injuries (in the age group >65).

Therefore, some steps must be taken in order to prevent this problem. Here we have listed some home based health exercises which will build your strength and will help you to maintain your body balance.
Please ensure that you have a chair, wall – support or bench top nearby you before performing these exercises. These exercises should be done slowly and gently to make sure that you won’t get hurt.

Fall prevention exercises for seniors - Knee Raise1. Knee Raise

  • Keep your arm on some solid material (like table, chair, furniture, etc.) which will help you in getting balanced.
  • Slowly raise your leg up to hip level.
  • Repeat the same with other leg.
  • Repeat this exercise 8 – 10 times.

This exercise helps in climbing the staircase. Moreover, it will help you to get in/out of your car.

 

 

 

Fall prevention exercises for seniors - Side leg raise2. Side leg raise

  • Keep your arms on some solid material (like table, chair, furniture, etc.) which will help you in getting balanced.
  • Stand on one leg and slowly raise your other leg.
  • Repeat the same with other leg.
  • Repeat this exercise 8 – 10 times.

This exercise will help you in moving sideways. This will help you in maintaining your body balance when you have to take stress on your single leg.

 

 

Fall prevention exercises for seniors - Heel - to - toe walking3. Heel – to – toe walking

  • Keep your arm on some solid material (like table, chair, furniture, etc.) which will help you in getting balanced.
  • Stand in such a way that heel of one of your leg touches toe of another leg.
  • Try this exercise by walking slowly through the floor.
  • Repeat the same with other leg.
  • Repeat this exercise 8 – 10 times.

This exercise will help you to go through a narrow space.

Fall prevention exercises for seniors - Step up your Steps4. Step up your steps

  • Hold the railing of staircase firmly.
  • Slowly go a step upward and then downward.
  • Repeat this 8 -10 times.

This exercise will improve your stability while walking through the staircase and other uneven surfaces.

 

 

 

Fall prevention exercises for seniors - Heel raise5. Heel raise

  • Keep your arms on some solid material (like table, chair, furniture, etc.) which will help you in getting balanced.
  • Gently raise your heels and stand on your toe for some time.
  • Then, slowly come back to your normal position.
  • Repeat this 8 – 10 times.

This exercise will help you in climbing the staircase easily.

Fall prevention exercises for seniors - Sit to stand6. Sit to stand

  • Sit down on a chair.
  • Slowly stand up and keep your knees, slightly, apart from each other.
  • You can close your hands if you want to make it a bit harder.
  • After this lower yourself on the chair.
  • Now, repeat this 5 – 6 times a day.

This will help you in sitting down / standing up from a chair / toilet seat / car.

So, here are some of the home based exercises. Hope you’ll implement them in your life and feel the change.

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20 Facts About Senior Isolation That Will Stun You

20 Facts About Senior Isolation That Will Stun You

We are Open on 22 Aug 2018 Wednesday (Hari Raya Haji) 11-6pm, Whatsapp: 83334466

20 Facts About Senior Isolation That Will Stun YouFeelings of loneliness and isolation can lead to serious consequences for senior health. Understanding the causes and risk factors for senior isolation can help us prevent it.

Nobody relishes the prospect of aging without a spouse or family member at their side, without friends to help them laugh at the ridiculous parts and support them through the difficult times. Yet that is just what many North American seniors face. As the baby boomer generation crosses the over-65 threshold, it grows; but many of our aging loved ones are still feeling alone in the crowd.

Statistics on Senior Isolation

According to the U.S. Census Bureau 11 million, or 28% of people aged 65 and older, lived alone in 2010. As people get older, their likelihood of living alone only increases. Additionally, more and more older adults do not have children, reports the AARP, and that means fewer family members to provide company and care as those adults become seniors.

While living alone does not inevitably lead to social isolation, it is certainly a predisposing factor. Yet another important consideration is how often seniors engage in social activities.

Statistics Canada reports that 80% of Canadian seniors participate in one or more social activities on a frequent basis (at least monthly) – but that leaves fully one-fifth of seniors not participating in weekly or even monthly activities.

Social contacts tend to decrease as we age for a variety of reasons, including retirement, the death of friends and family, or lack of mobility. Regardless of the causes of senior isolation, the consequences can be alarming and even harmful. Even perceived social isolation – the feeling that you are lonely – is a struggle for many older people. Fortunately, the past couple of decades have seen increasing research into the risks, causes, and prevention of loneliness in seniors.

Read more: http://www.aplaceformom.com/blog/10-17-14-facts-about-senior-isolation/

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Over 95% of the world’s population has health problems

Over 95% of the world’s population has health problems!!

We are Open on 22 Aug 2018 Wednesday (Hari Raya Haji) 11-6pm, Whatsapp: 83334466

Over 95% of the world’s population has health problemsOver 95% of the world’s population has health problems, with over a third having more than five ailments

Date: June 8, 2015
Source: The Lancet
Summary: Just one in 20 people worldwide (4·3%) had no health problems in 2013, with a third of the world’s population (2·3 billion individuals) experiencing more than five ailments, according to a major new analysis.

In 2013, low back pain and major depression ranked among the top ten greatest contributors to disability in every country, causing more health loss than diabetes, chronic obstructive pulmonary disease, and asthma combined.
Credit: © xy / Fotolia

Just one in 20 people worldwide (4·3%) had no health problems in 2013, with a third of the world’s population (2·3 billion individuals) experiencing more than five ailments, according to a major new analysis from the Global Burden of Disease Study (GBD) 2013, published in The Lancet.

Read More: http://www.sciencedaily.com/releases/2015/06/150608081753.htm

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Interventions for preventing fall in older people living alone

We are Open on 22 Aug 2018 Wednesday (Hari Raya Haji) 11-6pm, Whatsapp: 83334466

Interventions-for-preventing-fall-in-older-people-living-alone

As the people grow older, the risk of fall increases tremendously. These falls can be fatal or non – fatal.

So, here we have listed some of the interventions which must be adopted to prevent falls.

  • Exercises – This is the best method to prevent falls among the people living alone. It has been noticed that the people who do regular exercise are less likely to get injured. This reduces the chances of fracture.
  • Home safety –This is one of the most important among the elderly who are more likely to fall. Home Safety must be taken at the first priority in order to reduce the risk of falls. Anti – Slip shoes must be worn under icy and slippery conditions.
  • Vitamin D treatment –Those who have lesser vitamin D content in their blood must have the food rich in vitamin D content.
  • Foot exercise –The people who suffers from foot pain, fractures, and have difficulty in moving their foot must do ankle and foot exercises in order to reduce the number of falls.

This method helps to your foot function normally.

  • Hip protectors –Hip protector reduces the chances of hip fracture to a greater extent. This ultimately results in better protection from falls.

 

Some Nursing Interventions:

Nursing Interventions include risk for injury, acute pain, Activity intolerance, risk of infection.

  • Risk for injuryThis is related to increased activity.

* It must include massage to eliminate fatigue in legs.

* This also includes compete explanation to patients about the cause of pains and the methods to prevent it.

  • Acute Pain –This is related to fatigue. This is generally implemented to reduce dizziness and headaches.

This includes –

* Explanation about the cause of headache and dizziness.

* Explanation about the various side effects of having large quantity of medicines.

* Head/ neck /shoulder massage.

* Explanation of relaxation techniques.

  • Activity intolerance – This is done to make elderly do their regular activities.

It includes –

* Complete review of daily exercises.

* Teaching and sitting before beginning to stand and walk.

  • Risk for infection –This is done to maintain the state of immunity.

It includes –

* Explanation about proper hygiene.

* Explanation about healthy diet.

* Explanation about adequate of proper minerals and vitamins.

Prevention of falls among older people

Prevention of falls among older people

Items for Assessment for Frail Elderly People
Prevention of falls among older people

So, don’t leave your confidence. And, try to have a safe surrounding.

Get Well Soon

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Why do elderly fall more easily?

We are Open on 22 Aug 2018 Wednesday (Hari Raya Haji) 11-6pm, Whatsapp: 83334466

Why-do-elderly-fall-more-easilyIt is quiet often noted that the risk of falling increases with the age. Old people are likely to fall more than compared to the adults.

A fall might be the result of slippery and wet floors, poor lighting, loose rugs, inconvenient footwear etc.

There are certain chronic problems like eye diseases, inner ear problems, and osteoarthritis which increase the risk of falling.

Also, there are certain other acute problems like heart rhythm disturbance, drug problems, and infections which can often lead to reduced consciousness.

Therefore, we can say that physiological, pathological, and the environment factors are the major cause of falls for the elderly.

 

Risk Factors

Here are some other risk factors which often lead to falls :-

      •  Bone fragility :
        • Reduction in the density of bone mass often increases the risk of falls.
        • Bones becomes so thin that the normal activities began to be avoided.
      • Neurological factors :
      • Loss of sensation :
        • In the old age, neurological sensitivity reduces, which often lead to the risk of falls.
        • It is often noticed that sensation loss is more in the feet, which increases the risk of falls.
      • Drugs :
        • Some drugs lower your blood pressure, mainly while standing. This leads to falls.
        • Some people used to take sleeping pills and other antidepressants which often lead to falls.
        • Some antipsychotic drugs which are taken for the treatment of Parkinson’s disease often lead to falls.
        • Insulin and certain diabetic drugs also increase the chances of falling.
        • Calcium antagonists which lowers the heart rate is also included in this list.

 

So, here are some of the drugs which should be taken only when prescribed by your Doctor. Never take medicines on your own. This might cause a negative impact to your life.

      • Visual Defects : Here are some of the eye (visual) defects which can also lead to falls :
      • Glaucoma : It mainly occurs due to the high fluid pressure inside the eyes. This generally occurs after 40 years of age. It cannot be avoided.  So, it is recommended to visit your optometrist.
      • Contaracts : These are the cloudy areas that cover some part of the lens. Contaract formation begins form the middle age. Common symptoms include blurred vision, glare in headlights or sun lights. However, contarat can be removed through a surgery. It is better to take proper check – up within frequent interval of time in order to prevent any miss – happening.
      • Unpleasant Environment
      • Uncomfortable footwear
      • Improper lighting
      • Improper cleanliness
      • Spills on the floor
      • Loose rugs
      • Improper walking aids

Complication –

      • Fracture
      • Head Injury
      • Fear of falls
      • Hospitalization
      • Muscle Breakdown

What to do?

If you encounter these falls to your elders (loved ones). Just don’t ignore it. Try to consult your physician, doctor. This problem might be curable.

So, don’t ignore it. Consult the Doctor before it becomes severe.

Moreover, give your parents a healthy diet. Try to give them food which is rich in calcium, and other vitamin contents.

“Healthy diet with the healthy mind keeps the doctor away.”

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Type of falls in the age group of 65+

Falls and injury statics for senior and elderly

We are Open on 22 Aug 2018 Wednesday (Hari Raya Haji) 11-6pm, Whatsapp: 83334466

The rate of fall increases tremendously each year.

      • Around one third of the population in the age group of 65 falls each year. This risk of fall increases with increase of age. It has been noticed that in the age group of 80, around half of the population suffers from falls.
      • Most of the falls are unreported. Most of the people ignore falls. They think that this is the natural signs of age.
      • It has been noticed that those who are discharged from the hospital (who were admitted for hip fracture)(around 53% of the elderly) are likely to fall again within the next few months.
      • Around 87% of the fractures among the elderly are due to falls.
      • 25% of the people are admitted in the hospitals because of falls. 40% of the people admitted are no longer capable of independent living. And, 25% of them die within a year.
      • Most of the falls don’t cause any injury but around 47% of the internal injuries due to falls cannot be cured without assistance.
      • Those who are unable to get up on their own after falls, have a negative impact on their lifestyle. The breakdown of the muscle cell starts within 30 – 60 minutes of fall. This can lead to pneumonia, hypothermia, dehydration and other related problems.

Injuries in Canada

      • Around 4.27 million Canadians within the age group of 12 or above suffers from injury which is severe enough to limit their daily activities. There has been an increase in injuries up to 2% as compared to that in 2001(15% in the year of 2009 – 2010). Moreover, this is assumed to grow up to 18% by the end of 2020.
      • Young people in the age group of 12 – 19 have the highest chances of getting injured. 27% of this age group (12 – 19) suffers from injury which is twice as compared to adults (14%), and thrice as compared to senior citizens (9%).
      •  66% of the injuries among young people are caused due to sports. Among adults (20 – 64) 47% of the injuries are caused due to sports and work. Whereas among older generation (>64) 55% of the injuries are caused due to falls.
      • Overall, if we see, then most of injuries are caused due to falls.
Fall related Hospitalization in the age group of 65+

Fall related Hospitalization in the age group of 65+

Falls and injury statics for senior and elderly

Fall related Hospitalization rates

Type of falls in the age group of 65+

Type of falls in the age group of 65+

What are the factors that cause falls?

Factors associated with falling

Factors associated with falling

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Activity Centre Promoting Active Ageing Opens in Jurong West (Channel News Asia, Singapore)

We are Open on 22 Aug 2018 Wednesday (Hari Raya Haji) 11-6pm, Whatsapp: 83334466

The centre, run by a voluntary welfare organisation, houses a community gym and dental centre. Seniors will be able to take part in activities such as calligraphy. Another centre will be built in Toa Payoh in October.

5 Jul 2015, Channel News Asia, Singapore, Activity centre promoting active ageing opens in Jurong West

http://www.channelnewsasia.com/news/singapore/activity-centre-promoting/1962114.hmtl

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Common injuries due to elderly falls

Common injuries due to elderly falls

Falls are the most common cause of injuries among senior people and the top reason for a hospital admission for trauma. Advanced age substantially increases the likelihood of hospitalization after a fall. Falls account for 88% of all fractures among people aged 60 years or older.

As the brain ages, its dura becomes tightly adherent to the skull, which makes epidural (extradural) haematomas uncommon. A progressive loss of brain volume leads to an increase in the space around the brain that is thought to protect it from contusions, but makes subdural haematomas more likely. Patients over the age of 55 years who are anticoagulated have a higher frequency of isolated head trauma, more severe head injury and a higher mortality. Even mild head injuries, particularly in patients with pre-existing cognitive impairment, may lead to permanent neurological damage. If there is a skull fracture and an associated hemiparesis, a traumatic intracranial haematoma should be assumed and not a stroke. Similarly, confusion lasting more than 12 hours after head injury, even in a patient with no skull fracture, is an indication for a CT scan. Any deterioration demands immediate action and a CT scan should be obtained in all patients who are unconsciousness for more than 5 minutes after head injury. The outcome is extremely poor in elderly patients who have sustained head injuries sufficient to cause immediate coma that persists after correction of hypoxia and hypovolaemia. Neurosurgical intervention is not warranted for most of these patients.

Rib fractures often complicate even mild blunt trauma to the chest in old people. The presence of fractured ribs on the chest X-ray is an important indicator of severity of injury and outcome, as mortality increases with increasing number of rib fractures. Because they are poorly tolerated, these patients must be watched carefully and the need for mechanical ventilation frequently reassessed. Those with more severe blunt chest trauma, such as those with penetrating injuries, are managed in the same way as younger patients.

It must be remembered that old people are intolerant of shock and unnecessary laparotomy. Their assessment therefore demands a sense of urgency and a high degree of clinical acumen. Those who have a history or clinical evidence of previous major abdominal surgery should have a CT or ultrasound scan of the abdomen rather than diagnostic peritoneal lavage.
In old people with multiple injuries, fractures must be stabilised to permit optimal positioning and movement, both for immediate management and later rehabilitation. While isolated fractures of the humeral shaft are managed conservatively, there is no logic to such management in a patient with leg injuries who will need to use a walking frame or crutches for mobilisation. The aim of treatment should be to undertake the least invasive, most definitive procedure with a view to early mobilisation as soon as other problems permit. Prolonged inactivity and disuse may seriously limit the eventual functional outcome.

Hip fracture is an increasingly common problem in Europe. In the UK around 70,000 patients suffer a hip fracture each year increasing at approximately 5% per annum and projected to reach 120,000 cases per year by 2015. Seventy-five percent of patients are over 75 years of age and 80% are female. The average length of stay in hospital is 30 days, with a 30-day mortality of about 10%. Hip fractures account for 20% of all orthopaedic bed occupancy. There are now a number of recommendations for ‘best practice’ for the management of this increasing burden on healthcare. The following are based on the Scottish Intercollegiate Guidelines Network.

Elderly patients have a particularly high mortality rate and are extremely vulnerable to less than optimal management. A system of trauma care must be prepared to cope with this group of patients and their special needs. The trauma team must be aware of the anatomical and physiological changes that accompany ageing and how these factors, together with the effects of co-existing illnesses and medications, make special demands on their skills. Oversights and thoughtlessness in initial management of patients may have serious adverse consequences on recovery and eventual hospital discharge. Elderly patients should be informed of what is happening and, where possible, be encouraged to participate in treatment decisions. Not all old people are demented. This does not mean they should necessarily receive identical treatment to younger people; instead, they must be managed in a way that is appropriate to their needs in the light of the likely outcome.

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Types оf Elderly Housing and Facilities

Types оf Elderly Housing and FacilitiesIndереndеnt Living Facilities usually offer ѕmаll араrtmеntѕ wіth ѕоmе meals included іn the рrісе. A реrѕоn whо lіvеѕ іn an Indереndеnt Lіvіng Facility is еxресtеd tо mаnаgе their dаіlу care nееdѕ оn their own, but thе ѕtаff wоuld readily recognize іf needs increased and аѕѕіѕt thе resident іn оbtаіnіng thе needed hеlр. Sоmе facilities have extra саrе services аvаіlаblе fоr additional сhаrgе to hеlр thе rеѕіdеnt “age in place.” Othеrѕ may ask a rеѕіdеnt to mоvе оut іf their nееdѕ еxсееd thе ѕсоре оf that particular facility. Limited trаnѕроrtаtіоn іѕ usually provided although mаnу rеѕіdеntѕ аrе ѕtіll drіvіng when thеу еntеr аn Indереndеnt Lіvіng Fасіlіtу. Thеѕе fасіlіtіеѕ mау соѕt аnуwhеrе frоm lеѕѕ than $1,000 реr month tо over $5,000 per month dереndіng uроn the luxury amenities аnd lосаtіоn.

Aѕѕіѕtеd Lіvіng Fасіlіtіеѕ uѕuаllу оffеr hоtеl ѕіzе rooms wіth thе орtіоn to share a rооm оr pay extra fоr a рrіvаtе rооm. Three mеаlѕ аnd ѕnасkѕ аrе usually рrоvіdеd аѕ раrt оf thе price. Rеѕіdеntѕ аrе еxресtеd tо nееd ѕоmе assistance with their dаіlу саrе needs. Medication administration is strictly ѕuреrvіѕеd. The Stаtе lаwѕ dісtаtе who саn lіvе іn an Aѕѕіѕtеd Living. Thе Stаtе dоеѕ not wаnt Aѕѕіѕtеd Living facilities to hоuѕе nursing home саndіdаtеѕ or Nursing Hоmеѕ to аdmіt реорlе who соuld funсtіоn juѕt аѕ well іn аn Assisted Living Fасіlіtу. Aѕѕіѕtеd Lіvіng rеѕіdеntѕ muѕt bе аblе tо walk аnd trаnѕfеr ( from bеd to chair or сhаіr to ѕtаndіng) with thе assistance оf only one other person. An Assisted Lіvіng rеѕіdеnt саn bе lеft аlоnе in thеіr rооm fоr twо hоurѕ оr mоrе. Nurѕеѕ аіdеѕ are оn duty аrоund thе clock. Rеgіѕtеrеd nurѕеѕ оr Lісеnѕеd Practical Nurѕеѕ are оn dutу аt lеаѕt durіng thе dауtіmе. Many mеdісаl ѕеrvісеѕ mау mаkе rоundѕ аnd visit rеѕіdеntѕ at least monthly. It is nоt unсоmmоn for an Aѕѕіѕtеd Living rеѕіdеnt to never hаvе to leave thе buіldіng fоr a mеdісаl оr bеаutу appointment. Prices mау rаngе frоm undеr $1200/mоnth to оvеr $8,000/ mоnth, оnсе аgаіn depending upon the аmеnіtіеѕ. Mеdісаіd has a рrоgrаm саllеd the Mеdісаіd Wаіvеr whісh саn рау раrt оf the соѕt оf thе Aѕѕіѕtеd Lіvіng. Hоwеvеr, fundѕ hаvе bееn hіѕtоrісаllу lіmіtеd аnd wаіtіng lіѕtѕ саn be long. The Vеtеrаn Aіdе аnd Attеndаnсе Pеnѕіоn іѕ dеѕіgnеd tо fіnаnсіаllу аѕѕіѕt ԛuаlіfіеd vеtеrаnѕ whо need the ѕеrvісеѕ оf аn Aѕѕіѕtеd Lіvіng facility

Dementia Sресіfіс Fасіlіtіеѕ аrе designed еѕресіаllу for thе mеmоrу іmраіrеd rеѕіdеnt. The building, flооrрlаn, furnіѕhіngѕ, déсоr, асtіvіtу рrоgrаm аnd even thе lighting hаvе bееn scientifically еngіnееrеd to enhance the lіfеѕtуlе оf rеѕіdеntѕ with dеmеntіа. Many Aѕѕіѕtеd Living Facilities аnd Nurѕіng Hоmеѕ оffеr a dеmеntіа рrоgrаm or dеmеntіа unit, but thеrе are еntіrе facilities whісh specialize in thіѕ unіԛuе population. Dеmеntіа Sресіfіс Fасіlіtіеѕ саn bе еіthеr Aѕѕіѕtеd Lіvіng Fасіlіtіеѕ or Nursing Hоmеѕ. Thеу аrе secure іn оrdеr to рrеvеnt rеѕіdеntѕ frоm wandering оff the рrореrtу аnd gеttіng hurt оr lоѕt. The price fоr this еxtrа level оf care іѕ uѕuаllу about $1,000 to $2,000 mоrе реr month thаn a nоn-ѕресіаltу buіldіng.

Nurѕіng Hоmеѕ аrе Stаtе regulated and аrе іnѕресtеd аt lеаѕt annually. A person who nееdѕ a nursing hоmе gеnеrаllу саnnоt live ѕаfеlу іn an Aѕѕіѕtеd Living environment. A tурісаl rеѕіdеnt іѕ either whееlсhаіr bound or bеd bоund. Thоѕе who саn wаlk around frееlу mау nееd thе nursing home еnvіrоnmеnt bесаuѕе thеу nееd соnѕtаnt mеdісаl ѕuреrvіѕіоn. The mеdісаl соmроnеnt of this еnvіrоnmеnt іѕ similar tо a hospital оr hоѕрісе ѕеttіng. The emphasis іѕ оn rеhаbіlіtаtіоn or сuѕtоdіаl саrе rather thаn ѕосіаlіzаtіоn аnd activities. The ICP Mеdісаіd Prоgrаm (іnѕtіtutіоnаl care рrоgrаm) wіll рау for thе room, bоаrd аnd mеdісаl соѕtѕ оf thоѕе residents whо mееt thе fіnаnсіаl аnd mеdісаl criteria. It іѕ роѕѕіblе to plan in аdvаnсе tо help аn еldеr mееt these ѕtrісt criterion.

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Reduce dangers in the home for Elderly

Common injuries due to elderly falls

Common injuries due to elderly falls

Falls are the most common cause of injuries among senior people and the top reason for a hospital admission for trauma. Advanced age substantially increases the likelihood of hospitalization after a fall. Falls account for 88% of all fractures among people aged 60 years or older.

As the brain ages, its dura becomes tightly adherent to the skull, which makes epidural (extradural) haematomas uncommon. A progressive loss of brain volume leads to an increase in the space around the brain that is thought to protect it from contusions, but makes subdural haematomas more likely. Patients over the age of 55 years who are anticoagulated have a higher frequency of isolated head trauma, more severe head injury and a higher mortality. Even mild head injuries, particularly in patients with pre-existing cognitive impairment, may lead to permanent neurological damage. If there is a skull fracture and an associated hemiparesis, a traumatic intracranial haematoma should be assumed and not a stroke. Similarly, confusion lasting more than 12 hours after head injury, even in a patient with no skull fracture, is an indication for a CT scan. Any deterioration demands immediate action and a CT scan should be obtained in all patients who are unconsciousness for more than 5 minutes after head injury. The outcome is extremely poor in elderly patients who have sustained head injuries sufficient to cause immediate coma that persists after correction of hypoxia and hypovolaemia. Neurosurgical intervention is not warranted for most of these patients.

Rib fractures often complicate even mild blunt trauma to the chest in old people. The presence of fractured ribs on the chest X-ray is an important indicator of severity of injury and outcome, as mortality increases with increasing number of rib fractures. Because they are poorly tolerated, these patients must be watched carefully and the need for mechanical ventilation frequently reassessed. Those with more severe blunt chest trauma, such as those with penetrating injuries, are managed in the same way as younger patients.

It must be remembered that old people are intolerant of shock and unnecessary laparotomy. Their assessment therefore demands a sense of urgency and a high degree of clinical acumen. Those who have a history or clinical evidence of previous major abdominal surgery should have a CT or ultrasound scan of the abdomen rather than diagnostic peritoneal lavage.

In old people with multiple injuries, fractures must be stabilised to permit optimal positioning and movement, both for immediate management and later rehabilitation. While isolated fractures of the humeral shaft are managed conservatively, there is no logic to such management in a patient with leg injuries who will need to use a walking frame or crutches for mobilisation. The aim of treatment should be to undertake the least invasive, most definitive procedure with a view to early mobilisation as soon as other problems permit. Prolonged inactivity and disuse may seriously limit the eventual functional outcome.

Hip fracture is an increasingly common problem in Europe. In the UK around 70,000 patients suffer a hip fracture each year increasing at approximately 5% per annum and projected to reach 120,000 cases per year by 2015. Seventy-five percent of patients are over 75 years of age and 80% are female. The average length of stay in hospital is 30 days, with a 30-day mortality of about 10%. Hip fractures account for 20% of all orthopaedic bed occupancy. There are now a number of recommendations for ‘best practice’ for the management of this increasing burden on healthcare. The following are based on the Scottish Intercollegiate Guidelines Network.

Elderly patients have a particularly high mortality rate and are extremely vulnerable to less than optimal management. A system of trauma care must be prepared to cope with this group of patients and their special needs. The trauma team must be aware of the anatomical and physiological changes that accompany ageing and how these factors, together with the effects of co-existing illnesses and medications, make special demands on their skills. Oversights and thoughtlessness in initial management of patients may have serious adverse consequences on recovery and eventual hospital discharge. Elderly patients should be informed of what is happening and, where possible, be encouraged to participate in treatment decisions. Not all old people are demented. This does not mean they should necessarily receive identical treatment to younger people; instead, they must be managed in a way that is appropriate to their needs in the light of the likely outcome.

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Singapore Top 500 Enterprises 2018

Singapore Top 500 Enterprises 2018

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