الفهرس | Only 14 pages are availabe for public view |
Abstract Older people make up a large and increasing percentage of the population. As people grow older they are increasingly at risk of falls and fear of falls and consequent injuries. This thesis was conducted to determine prevalence of fear of falls and its risk factors in elderly living in community and in nursing homes. It is a comparative study conducted on 100 resident in 4 nursing homes in Cairo and another 100 in community 60 years and older; both males and females. The study showed that the prevalence of fear of falls in nursing homes in Cairo 51% higher in comparison to in community 26% , it also showed that the significant risks that associate with fear of falls are dementia, depression, functional impairment in ADL and IADL, multiple co morbidities and malnutrition. Fall risk factors can be classified as intrinsic or extrinsic. Intrinsic factors are related to the persons’ functional and health status, such as status of ADL or IADL, visual impairment, balance disorders, foot problems, insomnia, hypotension, dizziness, presence of cardiovascular disease and perceived general health. Extrinsic factors are related to environment, such as poor lighting, slippery floors, lack of handrails in corridors, and uneven and obstructed walking surfaces. Iatrogenic factors are that part of extrinsic factors related to treatment. Previous studies have shown that the risk of falls increases proportionally as the number of risk factors increases. Fear of falls is one of the major issues relating to the overall health of elderly. It is also common among elderly fallers, and has been associated with impaired mobility and decreased functional status. As a result, older adults who have fallen are at greater risk of becoming institutionalized regardless of whether they have experienced an injurious falls. Major risk factors of fear of falls related to a variety of physical, psychological and functional changes that occur in older adults. Advanced age, female, history of falls, gait and balance impairment, medication use, polypharmmacy history of falls, cognitive impairment, depression a poorer health status increased the risk of fear of falling, sensory impairment, insomnia Also in nursing homes: urinary incontinence, sleep problem, nutritional deficiency such as vitamin D deficiency Fear of falls occurs more often in nursing homes as nursing home residents are generally frailer than seniors living in the community. They tend to be older, have more cognitive impairments, depressed and have greater limitations in their activities of daily living. They also tend to have more chronic illnesses, be physically dependent and malnourished. Fear of falling may be a reasonable response to certain situations, that may lead elderly persons to be cautious, and can contribute to fall prevention through careful choices about physical activity so, fear rep-resents a reasonable reaction to possible danger and has few negative consequences as long as physical and social mobility remains unaffected. Finally we found that environmental risk factors increase the risk of nursing home fear of falls especially the indoors factors, modification of this factors are very important way to decrease falls and fear of falls. Also there are no appropriate nursing homes safety measurements to prevent fear of falls |