| Background:Fall in the elderly means it is difficult to maintain upright posture stability and fell to the ground when the elderly is standing or walking. Fall is the most common and the most severe injury in the elderly. It not only brings physical and psychological problems for patients, but also brings a heavy burden to the family and society.Objectives:To survey the elderly people aged 60 and above in the Community of Jing’an Temple Street of Shanghai and the primary caregivers and the staff of health service center in the community and the cadres of the streets and RC, Trying to find out the risk factors for falls about the individuals, families and communities, To find out modifiable risk factors for falls in communities, the requirements of the people.To understand the necessity and feasibility of providing falls prevention services in community.Subjects and methods:The Subject of quantitative research include 388 the elderly people aged 60 and above in the Community of Jing’anTemple Street of Shanghai(About 10% of the elderly people aged 60 and above in the Community), exclude the cognitive impairment and long-term bedridden patients. The object of qualitative research include 5 staffs of health service center in the community,10 people over age 80 and their families (or a nanny),1 Streets cadre,1 neighbourhood committee cadre.(Key objects include elderly people of empty nester, living alone and the elderly of chronic disease or low vision). The number of interviews followed saturation principle.Results:1. The fall of the distribution and the incidence of falls:surveyed 388 elderly people, In these people, there were 84 people fall in the past 1 year. Falling incidence was 21.6%. one people falls 14 times who is the most times, he had a stroke, and a severe heart disease and cataracts, and associated with brain atrophy, his balance function and gait are abnormal, action is not convenient, he seldom go out, has no ability to care for himself and needs someone to care him. Two people fall down five times each, one of them with 12 kinds of chronic diseases, hearing and eyesight is bad, the action is not convenient, He needs a cane to help walking, usually needs to take antihypertensive, anti-inflammatory and analgesic and psychotropic drugs, the other has seven kinds of chronic diseases.56 people fall down 1 time (accounting for 66.7% of the number of falls),15 people fall down 2 times (accounting for 17.9% of the number of falls),7 people fall down 3 times (accounting for 8.3% of the number of falls),6people fall down 4 times more (accounting for7.1% of the number of falls). Fall often occur in the spring (accounted for 27.4%). Most occurred in outdoor.2. The consequences:there were 65% of the elderly (55people) injury because of fall, 30.9% of the elderly’s(26 people) soft tissue be wounded,19.1%of the elderly (16 people) were fracture, epidermal injury were 10 people (11.9%).Falling impact on psychology and behavior:In the 84 elderly,33 elderly (40.7%) daily activity were reduced,25 elderly (29.8%) had depression, irritable, stubborn, worry, apathy, self-confidence decline and other negative emotions.Conclusions and Suggestions:Conclusions:1 The incidence rate of falls among elderly urban community-dweller in Beijing was high, which had caused serious consequences and become a heavy burden to both family and society. It also had become a major issue in public health seriously influencing older people’s health and quality of life.2. In the elderly, falls resulted from both intrinsic and extrinsic factors including biological factors, behavioral and psychological factors, social factors and environmental factors.3. Individual risk factors of falls in older people is some chronic diseases such as lumbar disease, orthostatic hypotension, diabetes, taking psychotropic drugs; family risk factors are no toilets handrails; community risk factors is the small protruding obstacles. In health education, community for the elderly in fall prevention to improve family nursing and community environment is expected to reduce the incidence of falls.4 The demand and feasibility of community preventive services of falls in older people:the survey found that prevention of falls in older people demand a clear cell protruding obstacles, retrofitting toilets handrails, missionary medicine correctly, strengthening health education.Suggestions:Prevention of falls in older people should face all the elderly community residents, family, community health workers and the whole society should participate in the prevention of falls in older people. Intervention principle should be the implementation of multifaceted interventions aimed at the existing risk factors; intervention service providers should be street community management, community general practitioners, old families and caregivers. |
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