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Balance and Falls


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What is Balance and Falls?

According to the medical dictionary, balance is the ability to maintain a line of gravity or a postural control. A balance disorder occurs when you feel unsteady, floating, or dizzy, even you are at a standstill or lying down. Certain medical conditions, a side effect of medication, or a problem in the inner ear or the brain are what causes loss of balance. What is vertigo? It is the most common type and symptom of a balance disorder. It is described by a person as if the world is literally spinning around them, or there is a presence of constant spinning sensation. A fall is coming down freely, under the influence of gravity. Falls can happen to everyone, but it is most rampant in the elderly. It is one of the reasons why children of the elderly decide to move their parents into a care home.

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What are the Causes of Balance and Falls?

Balance problems increase as people age. Falls are usually caused by a combination of numerous risk factors that impairs our ability to perform normal tasks. Physical risk factors The following are just some of the examples of physical risk factors that increase the risk of falling:

  1. Old age
  2. Chronic pain
  3. Arthritis
  4. Diabetes
  5. Parkinson's disease
  6. Generalised muscle weakness
  7. Alzheimer's disease
  8. Dehydration
Environmental risk factors
  1. Improper footwear
  2. Slippery surfaces
  3. Incorrect usage of mobility or walking aids
  4. Home hazards like loose carpets or flooring, dark stairways or hallways

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How is Balance and Falls Diagnosed?

Since balance problems and falls are becoming more prevalent as people age, it is, therefore, important to become observant to the balance and gait pattern of your loved ones. Informal assessment begins with observation. Upon checkup, the healthcare provider must consider the following questions as guidelines in diagnosing balance problems and falls:

  1. Does the patient need help in walking down the hall or getting up from the chair to the examination table?
  2. Is the gait pattern smooth and continuous, or is halting and unstable?
  3. Does the balance problem caused by ill-fitting shoes?
  4. The "Get Up and Go" is used to evaluate the patient movement. It requires the patient to get up from the chair and return to sitting position after the patient has walked 3 metres. The Tinetti Balance and Gait test is a standardised examination of mobility and stability. It uses a picture of the degree of difficulty the patient is experiencing. Balance test includes assessing the patient's ability to sit, stand and turn. Maintenance of balance is tested by nudging to disrupt the patient's natural stance and by removing patient's horizon reference (Eyes are closed during this assessment). In balance problems, gait testing is done by evaluating each side of the foot for swing of step length and clearance. Each foot must completely clear the floor and each step completely ahead of the other foot.

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How can Balance and Falls be Prevented?

The following are the steps to follow in preventing balance problems and falls among the elderly:

  1. Set a doctor's appointment when balance problems become imminent. It is not safe to self-diagnose. Doctor's can help you or your loved one to draw up an individualised fall-prevention plan for maximum safety and security.
  2. Physical activity can go along way in preventing falls and balance problems. Daily exercise keeps the blood pumping in areas where blood supply are needed the most. In the case of balance problems and falls among the elderly, just imagine that blood is the oil or lubricant needed for the engines (Body) to work smoothly. If a simple routine exercise is not plausible due to existing medical conditions, seek your doctor's advise first.
  3. Wear sensible shoes. Be sure that your footwear is just the right size.
  4. De-clutter and fall-proof your home. Install necessary railings to aid in walking, standing or sitting. Fix uneven floor surfaces. Ensure that carpets are laid out evenly to eliminate tripping hazard. Remove unnecessary furniture.

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How is Balance and Falls Treated and Managed?

Treating or managing balance problems and falls among elderly includes the use mobility aids and devices like cranes, walking sticks or walkers. Family members can request for a prescription for a cane as soon as you recognise that your loved ones are having balance problems. Each mobility aid (Cane, walking sticks, walker, wheekchair) must be measured for the patient. Health teachings can maximise the effects of using the mobility aids. It is therefore important that patients are instructed on how to properly utilise their mobility aids. In some cases where mobility aids aren't enough to ensure patient's safety, physical therapy is the next step. Physical therapy assists the patient in the proper use of mobilty aids. Physical therapists can draw up rehabilitation and conditioning programs for you or your loved ones.


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