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ELDERLY FRACTURES

TUDOLAKO LECTURE IV

POPULATION AGEING

Indonesian Population 2010

FRACTURES OSTEPOROSIS ELDERLY DEGENERATIVE DECREASE OF ALL ORGANS FUNCTIONS LIMITED MOTION .

CAPACITY FUNCTIONAL OF LIFE CYCLE Lifestyle behavior. social-economy. and environment STARTING OF LIFE THE END OF LIFE .

20-30% MODERATE TO LIMIT MOBILITY AND SEVERE DEPENDENCE NEARLY. ANKLE & FOOT FRACTURES 17% can lead to WRIST AND HAND FRACTURES 14% can lead to SPINE FRACTURES Approximately 50% HIP FRACTURE LEAD TO IMMOBILITY and 18% of restricted activity days-12% of people bed- bound for life Armis-2011 . LOWERLEG. 30-50% SOFT TISSUE INJURY OVERALL. 30% HIP. THIGH. CONSEQUENCY OF ELDERLY FRACTURE APPROXIMATELY. KNEE.

AND SAFE IN HEALTHY LIFESTYLE? Armis-2011 . GOAL OF THE STUDY HOW THE ELDERLY PEOPLE ACHIEVE TO STAY ACTIVE. INDEPENDENCE.

independent. To identify fall risk factors in healthy lifestyle of elderly people 4. OBJETIVES The medical student should able: 1. To build awareness of community and government that elderly people to stay active. To achieve how elderly people feel better. and independent for life in the community 3. To implement fall prevention in healthy lifestyle of elderly people Armis-2011 . and safe is an important 2. active.

PERCENTAGE OF FALL Armis-2011 .

FALL-RELATED INJURY RATE Armis-2011 .

FATAL FALL RATE BY AGE AND SEX GROUP Armis-2011 .

FATALITY RATE BY SEX PER 1000 POPULATION 1993-2003 Armis-2011 .

HIP FRACTURE HOSPITALIZATION RATES .USA Armis-2011 .

LOCATION OF FALLS Armis-2011 .

HIP ELDERLY FRACTURES PROBLEM: Increased mortality Longterm disability Loss independence .

FOOT PROBLEMS • 30% elderly peoples have foot problems and have two-fold increased risk of falling include:  Severe bunion  Toe deformity  Ulcer  Deformed nails  Hallux valgus deformity  Impaired tactile sensitivity Armis-2011 .

MEDICATION INTAKE (LIFESTYLE) Armis-2011 .

MEDICATION INTAKE (LIFESTYLE) Armis-2011 .

INCLUDING INJURY AND REDUCED QUALITY OF LIFE Armis-2011 . PHYSICIAN BIAS A FALL OF ELDERLY PEOPLE AS A LOSS OF BALANCE AND PHYSICIAN ALWAYS REFER TO THE CONSEQUENCE OF FALLING.

BEHAVIORAL RISK •INACTIVITY FACTORS (LIFESTYLE) •MEDICATION SIDE EFFECT •ALCOHOL and CIGARETTE USING III. SOSIAL-ECONOMIC LOW INCOME RISK FACTORS LACK OF HEALTH SERVICES INADEQUATE SOCIAL INTERACTION MINIMAL COMMUNITY RESOURCES . FALL RISK FACTORS IN ELDERLY(8) I. BIOLOGICAL RISK •MOBILITY PROBLEM FACTORS •CHRONIC HEALTH PROBLEM •VISION PROBLEM •LOSS OF SEN SENSATION OF FEET II. ENVIRONMENT RISK •HOME AND ENVIRONMENT HAZARD FACTORS •INCORRECTED ASSISTED DEVICES •POORLY DESAIGNED PUBLIC SPACE IV.

CONCLUSION “ FALL PREVENTION IS THE BEST STRATEGY IN HEALTHY LIFE OF ELDERLY PEOPLE” COSTLY FATALITY RATE PREVENTABLE Armis-2011 .

FALL PREVENTION PROGRAM PLANNING 1. To provide information to elderly peoples Armis-2011 . To define the effective program 2.

participation and security to enhance quality of life as people age ACTIVE AGEING .PLANNING STRATEGY OF FALL PREVENTION the process of optimizing opportunities for health.

PLANNING STRATEGY OF FALL PREVENTION .

OPNION OF FALL PREVENTION COMMUNITY GOVERNEMENT ELDERLY PEOPLE ORGANIZARTION SUPPORTING .

FALL PREVENTION PROGRAM .

EFFECTIVE EDUCATION COMPONENTS  PROFESSIONAL INSTRUCTOR  PROBLEM SOLVING AND GOAL SETTING  LENGTH OF EDUCATION  GROUP VS INDIVIDUAL  VISUAL AID  MATERIAL DESIGN CLEARLY  PRESENTATION WITHOUT JARGON OR ABBREVETIONS  EFFECTIVE EDUCATION .

Exercise program: Tai Chi. Reduced medication 4. Vision correction 5. Education falls risk factors and prevention strategies for elderly people 2.EFFECTIVE EDUCATION PROGRAM OF FALL PREVENTION (2001) 1. Balance exercises 3. Strengthening exercises. Home safety Armis-2011 .

EFFECTIVE EDUCATION PROGRAM OF FALL PREVENTION (2011) 1. Exercise program: Tai Chi. and environment adaptation Armis-2011 . Home safety 6. Strengthening exercises. Education falls risk factors and prevention strategies for elderly people 2. Reduced medication 4. Vision correction 5. Balance exercises 3. Correction foot problems. shoes.

IMPLEMENTATION PRACTICE HISTORY TAKING  FALL RISK FACTORS EVALUATION: Biological. or Socio-economic risk factors  GAIT ASSESSMENT  LOSS OF CONCIOUSNESS  FEVER  BLOOD PRESSURE ABNORMALITY Armis-2011 . Environment. Bihavioral.

IMPLEMENTATION PRACTICE PHYSICAL EXAMINATION (I HATE FALLING)  I mean INFLAMATION  H mean HYPOTENSION  A mean AUDITORY  T mean TREMOR  E mean EQUILIBRIUM Armis-2011 .

IMPLEMENTATION PRACTICE PHYSICAL EXAMINATION (I HATE FALLING)  F mean FOOT  A mean ARRYTHMIA  L mean LACK OF DISCREPANCY  L mean LACK OF CONDITION  I mean ILLNESS  N mean NUTRITION  G mean GAIT Armis-2011 .

CONCLUSION: RISK FRACTURE IS NEGATIVE HEALTHY LIFESTYLE ADVICES: Healthy diet Active physical and social lifestyle Adequate Calcium Exposure sunlight/vit. D Weight bearing exercise Avoid alcohol & smoking .

CONCLUSION: RISK FRACTURE IS POSITIVE Have they the risk Have they had factors of falling a fracture Have they risk After low energy osteoporosis trauma They are willing and capable of taking treatment to reduce osteoporosis Assess bone density Consider investigation Fall assessment If result influence For cause fracture And treatment management Calcium and vit.D Specific treatment Balance and coordination training Health lifestyle advices .

ANY QUESTIONS?? Armis-2011 35 .