Ageing is the process of becoming older. It represents the accumulation of changes in a human being over time, encompassing physical, psychological, and social change (CAPMAS, 2015). Geriatrics is a term which refers to taking care on older population. Worldwide, people aged more than 65 years is called an elderly; however in Egypt the old age is considered to begin after 60 (Mostafa, 2013).
Fall can be defined as a sudden, unintentional change in position causing an individual to land at a lower level, on an object, the floor, or the ground, other than as a consequence of sudden onset of paralysis, epileptic seizure, or overwhelming external force. Although accidental falls in the elderly have been the subject of extensive research during the past 20 years, it is still a major health problem in a rapidly ageing global population. Falls are responsible for two-thirds of the fatalities resulting from unintentional injuries. Approximately 20% of accidental falls require medical attention, and 5% results in a fracture or other serious injuries (Stevens et al., 2012).
The risk indicators examined include demographic factors, neuromuscular function, disease and fall history, psycho-logical impairments, types and numbers of medications, the physical environment, functional disabilities, and social handicaps. Gait disturbance and muscle weakness also are common causes. Dizziness, vertigo, drop attacks, pos¬tural hypotension, visual impairment, and syncope also are known to cause falls. The incidence of falls rises with age and the worsening of general fitness. Regardless of the reasons, falls in advanced age have serious physical, mental, and socio-economic consequences. Falls usually result from the interaction and interference of factors categorized in four domains: physical, psychological, socio-economic and environmental factors (Bartley and Shiflett, 2010).
History of fall and gait or balance deficits increases the risk threefold. Other high-risk situations that can cause or contribute to falls are use of an assistive device, visual deficit, and arthritis, impaired activities of daily living, depres¬sion, cognitive impairment, and age older than 80 years (Lakatos et al., 2009).
Use of four or more medications has been strongly associated with an increased risk of falls. In particular, the usage of psychotropic medications, cardiac drugs including class 1 A antiarrhythmic agents, digoxin, diuretics, and anticon¬vulsants have been implicated in increasing the risk of falls (Lindus, 2012).
Extrinsic risk factors that describe the size of the impact environmental factors have on the risk of falling among older people is uncertain. Older people often have problems slipping or tripping, lacking good balance or right¬ing mechanisms for preventing the falls. Extrinsic risks include: environmental hazards, footwear and clothing, and inappropriate walking aids or assistive devices. Environmental hazards are the leading cause of falls, accounting for about 25 to 45 percent in most studies (Avendano et al., 2009).
The nurse has an important role in evaluating and educating patients, caregivers, and co-workers on strategies to reduce fall accidents. Individualized interventions can be planned when the nurse has direct contact with the clients and their caregivers during routine doctor visits. Encouraging home assessments can find hazards in the home, en¬vironmental and behavioral, to be identified and corrected with appropriate referral and advice. The nurse can also educate co-workers about certain factors that contribute to a client’s risk of falls while staying in a healthcare setting (Center for Disease Control and Prevention, 2015)
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