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Preventing night-time falls in people with lower urinary tract symptoms

February 8th, 2019

 

Falls are a significant risk in the elderly, with 30% of falls resulting in moderate to severe injuries.1 The risk of falls may be attributed to a combination of factors including existing medical conditions, medications, vision impairment and general cognitive or functional decline. Medical conditions that contribute to falls risk include arthritis, low blood pressure (causing dizziness or light-headedness), osteoporosis, dementia, nocturia and incontinence among others.2

“1 in 2 residents in aged care facilities fall every 6 months” 

Common urological conditions that have been associated with falls include:3

  • Lower urinary tract infections
  • Urinary incontinence
  • Overactive bladder
  • Prostatic disease

More than 1/3 of all infections in nursing homes are urinary tract infections” 

Symptoms of lower urinary tract infections such as increased frequency and urgency to urinate, nocturia (needing to visit the restroom more than once during the night)5 and incontinence are significant risk factors for falls.6 Lower urinary tract infections have commonly been associated with a general decline in cognitive function6 and confusion7. Having to urinate urgently, frequently, during the night, or leaking before reaching the toilet can all lead to the individual making potentially unsafe choices to get to the bathroom on time.

“Fall and hip fracture risk is increased in elderly patients with nocturia.” 

Strategies to minimize the risk of falls caused by urinary symptoms:2

  • Ensure the underlying medical condition is being addressed with appropriate treatment in consultation with a physician.
  • Have vision checked by an optometrist at regular intervals.
  • Ensure appropriate footwear is being worn.
  • Review all medications as some may cause side effects such as drowsiness, confusion or dizziness.
  • Ensure adequate lighting in the walkways on the way from the bedroom to the bathroom.
  • Fix non-slip mats and hand rails in the bathroom to assist in safe transfer.
  • Consider the use of bedside commodes, or absorbent underwear if the person is unable to get to the bathroom in time at most occasions.

Click HERE to download “5 ways to ‘FALL-PROOF’ night time bathroom visits infographic.

References:

  1. Waldron N, Hill AM, Barker A. Falls prevention in older adults. Australian Family Physician. Vol 41, No.12, Dec 2012 (930-935) Available from: https://www.racgp.org.au/afp/2012/december/falls-prevention/ Accessed: 20Nov2018.
  2. ‘Falls can be prevented – A guide to preventing falls for older people’ Australian Govt Dept of Health and Aging. Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/phd-pub-injury-dontfall-cnt.htm Accessed: 20Nov2018
  3. Soliman Y, Meyer R, Baum N. Falls in the Elderly Secondary to Urinary Symptoms. Rev Urol. 2016;18(1):28-32.
  4. Rowe TA, Juthani-Mehta M. Urinary tract infection in older adults. Aging health. 2013;9(5):10.2217/ahe.13.38.
  5. Prince D, Pedler K, Rashid P. Nocturia – A guide to assessment and management. Australian Family Physician Vol 41, No.6, June 2012 (399-422). Available from: https://www.racgp.org.au/afp/2012/june/nocturia-a-guide-to-assessment-and-management/ Accessed 20Nov2018
  6. Hunter KF, Voaklander D, Hsu ZY, Moore KN. Lower urinary tract symptoms and falls risk among older women receiving home support: a prospective cohort study. BMC Geriatr. 2013 May 15;13:46. doi: 10.1186/1471-2318-13-46.
  7. Urinary Tract Infections (UTIs) in Older Adults. Available from: https://www.healthline.com/health/uti-in-elderly#utis Accessed 20Nov2018.

 

Dementia and the Ageing Eye

September 24th, 2018

Using colour to build a dementia-friendly environment

Dementia is an umbrella term for a large group of illnesses which cause a progressive decline in a person’s physical and neurological function.1 Today, it is the single greatest cause of disability in older Australians (aged 65 years and older) with an estimated 425,416 Australians living with dementia.2

Developing a support system for people with dementia involves building a ‘dementia-friendly’ environment that caters to their individual requirements.3 It is important to recognise the role that such a support system plays in enabling maximum engagement in everyday life.

People impacted by dementia undergo a variety of changes including loss of memory, social skills, coordination, and vision among others. For example, they may face deterioration to some aspects of their vision, such as their field of vision, acuity (clarity), pupil dilation, reaction to light, depth perception, eye-head coordination, and colour perception.4

Changes in vision and its impact may vary between individuals and it is imperative that these changes be recognised and addressed.

The use of visual aids and the strategic use of colour in everyday objects can play an integral role in providing enhanced access and orientation with their surroundings. Consideration of lighting and colour can also play a key role in ensuring the environment is suitable for people living with dementia.

The use of contrasting colours in everyday objects such as a red rimmed plate on a white tablecloth, or a blue toilet seat on a white background can allow key objects to be distinguished more easily. Conversely, the use of similar colour hues such as whites and creams can allow certain objects to be ‘hidden’ from view, such as switchboards.5

People with dementia may also show a loss of depth perception. ‘Busy’ patterns on the floor or other surfaces may be seen to confuse or act as an obstacle or barrier. Shadows can sometimes be perceived as a change in level or height and can contribute to falls risk. These risks  can be minimised or eliminated by ensuring even and adequate lighting around the rooms.5

Some people may even find reflections from mirrors to be confronting or frightening and is often best avoided.5

This September being Dementia Awareness Month, you can also make a big difference for people impacted by dementia, their families and carers by visiting www.dementiafriendly.org.au and signing up to become a Dementia Friend today, and learning more about how you can create a safer environment.1

Click here to view our range of Dementia Aids.

References:

  1. Dementia Australia ‘What is Dementia?’. Available from https://www.dementia.org.au/about-dementia/what-is-dementia. Accessed 7 Sept 2018.
  2. Dementia Australia ‘Key Facts and Statistics’. Available from https://www.dementia.org.au/statistics. Accessed 7 Sept 2018.
  3. Fleming, Richard, Fiona Kelly, and Gillian Stillfried. “‘I Want to Feel at Home’: Establishing What Aspects of Environmental Design Are Important to People with Dementia Nearing the End of Life.” BMC Palliative Care 14 (2015): 26. PMC. Web. 11 Sept. 2018.
  4. Armstrong RA “Alzheimer’s Disease and the Eye”. Journal of Optometry. Vol2. Num3. July-Sept 2009, 101-158.
  5. Dementia Australia – Help Sheets. Available from: https://www.dementia.org.au/resources/help-sheets Accessed 11 Sept 2018.