Falls in institutionalized older adults: risks, consequences and antecedents

Araújo, Antonio Herculano de; Patrício, Anna Cláudia Freire de Araújo; Ferreira, Milenna Azevedo Minhaqui; Rodrigues, Brenda Feitosa Lopes; Santos, Thayná Dias dos; Rodrigues, Thays Domingos de Brito; Silva, Richardson Augusto Rosendo da

doi:10.1590/0034-7167-2017-0107

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RESEARCH • Rev. Bras. Enferm. 70 (4) • Jul-Aug 2017 • https://doi.org/10.1590/0034-7167-2017-0107 linkcopy

Falls in institutionalized older adults: risks, consequences and antecedents

Caídas de personas mayores institucionalizadas: riesgos, consecuencias y antecedentes antecedents

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective: To analyze the occurrence of falls in institutionalized elderly addressing the risks, consequences and antecedents.

Method: Cross-sectional study carried out with 45 older adults in Long-Term Care Facilities for the Older adult in João Pessoa, Brazil, in June and July 2016. A socio-demographic questionnaire and the Berg Balance Scale were applied, classifying as risk of fall scores lower than 45. Descriptive statistics and tests were conducted: independent t-test, Anova (Tukey), Chi-square, Mann Whitney. Statistically significance was p <0.05. Data were processed in SPSS version 19.0.

Results: A total of 66.7% (30) falls occurred, 20% (9) of them in the external area, with 66.7% (30) of the participants having hypertension as a previous disease and, as consequence, the fracture was highlighted with 11.2% (5). The Berg Scale had different scores when compared to the falls suffered by the elderly and previous diseases influenced the occurrence of falls (p <0.05).

Conclusion: It is necessary to implement public financing policies or partnerships that allow environments adaptations aiming at reducing the risks of falls.

Descriptors:
Accidental Falls; Homes for the Aged; Risk; Aged; Nursing

Variables	n	%
Marital Status
Single	19	42.2
Widowed	20	44.4
Divorced	5	11.1
Married	1	2.2
Level of Education
Illiterate	16	35.6
Literate	13	28.9
High School	8	17.8
Higher Education	5	11.1
Complete Primary Education	3	6.7
Children
No	26	57.8
Yes	19	42.2

Previous disease	n	%
Diabetes mellitus
Yes	15	33.3
No	30	66.7
Hypertension
Yes	30	66.7
No	15	33.3
Acute myocardial infarction
Yes	2	4.4
No	43	95.5
Osteoporosis
Yes	5	11.1
No	40	88.9
Arthritis
Yes	9	20
No	36	80
Arthrosis
Yes	9	20
No	36	80
Labyrinthitis
Yes	2	4.4
No	43	95.6

Variables	n	%
Location of the fall
External area	9	20
At home	1	2.2
Did not answer	7	15.6
Room	6	13.3
Cafeteria	1	2.2
In the street	6	13.3
Referral
Family health unit	2	4.4
Local treatment	18	40
Hospital	10	22.2
Consequences
Cut on arm	2	4.4
Cut on face	1	2.2
Pain	3	6.7
Fracture	5	11.2
Inflammation of the coccyx	1	2.2
Dislocation of arm	1	2.2
Fear of falling	1	2.2

Variables	n	%
Use of medication
Yes	37	82.2
No	6	13.3
Did not answer	2	4.4
Amount of medication used
Not reported or none	8	17.8
One	5	11.1
Two	6	13.3
Three	7	15.6
Four	10	22.2
More than four	9	20
Drug class
Analgesic	8	17.7
Anxiolytic	8	17.7
Antihypertensive	30	66.5
Antianemic	1	2.2
Anticholinergic	5	11
Antidiabetic	12	26.6
Anti-inflammatory	1	2.2
Antiparkinson	4	8.8
Antipsychotic	7	15.4
Anti-ulcers	4	8.9
Diuretic	16	35.6
Hypnotic	2	4.4
Neuroleptics	5	11
Bone calcium regulator	1	2.2
Vasodilator	5	11
Antiarrhythmic	1	2.2
Anticonvulsant	4	8.8
Antidepressant	2	4.4
Antiemetic	2	4.4
Vitamin	1	2.2
Antilipemic	6	13.2
Beta blocker	2	4.4
Antineoplastic	1	2.2
Phytotherapy	1	2.2

Variables	Test	p value	Hypothesis
Age	Independent t-test	0.645	Accepted H₀: The mean age of the elderly who fell is the same. Age did not influence the falls.
Amount of medication	Anova (Tukey)	0.834	Accepted H₀: The mean amount of medication among the elderly is equal when correlated to falls. The amount of medication did not influence the falls.
Previous diseases	Chi-square	0.05	Rejected H₀: Previous diseases influenced the occurrence of falls.
Berg Scale	Mann Whitney	0.007	Rejected H₀: The Berg Scale presented different scores when compared to falls in older adults

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Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[TFN1] Note:

[TFN2] * It is important to note that there were older adults who used more than one medication of the same type.