One of the assessment questions I ask when interviewing one of our patients is “Have you fallen in the past 3 months”? It is a part of a standard assessment questionnaire. Our electronic medical record can be set so that it always has to be answered. To my surprise, often patients answer “yes”. The populations mostly saying yes are 65-75 year olds.
As we get older our vision starts to change. The ability to see in low light decreases and it makes walking in dim hallways or night driving a challenge. The light we see lessens due to the pupil shrinking. The lens of our eye thickens and can turn a yellow color. A patient described it to me as “having a dark pair of yellow sunglasses on all the time”.
Recommendations that I give my patients are to aide them in the fall prevention. These include de-cluttering hallways in their homes and making sure all the small rugs in the house are removed. I have found that the use of a red light for a night light instead of a white light cuts down the glare and patients can then see better in the hallways. For outside, I also recommended the use glow strips on their stairs and entrances to their homes, garages and yards. If the patient is still driving, limiting nighttime driving would be a best choice for all involved. We discuss when they last had their eyes examined. One of my patients said “we do not think of those things all the time we just figure it is old age”. Getting an exam is a good way to be proactive to prevent an eye complication. Once examined, the patient can be aided by a simple pair of glasses or a surgical procedure to improve one’s vision and prevent falls. To expedite this process, I have the ability to do a direct transfer of the patient to the Eye Care Center at our clinic, so they can easily make their appointment.
Kenneth James, Jacqueline Gouldbourne, Chloe Morris, and Denise Eldemire-Shearer wrote an very good paper on “Falls and Fall Prevention in the Elderly: Insights from Jamaica.” They were effective in writing about the use of electronic data bases and electronic health records in the research of their paper. These same healthcare informatics resources can be used to identify and address falls in the seniors that may occur in almost any given community.
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