Giving
UC Davis Medical Center opens Geriatric Falls clinic
Elderly people who experience recurrent falls and those who sustain injuries as the result of a fall are being referred to a new Geriatric Falls Evaluation and Management Clinic at UC Davis Medical Center. The clinic is held every Wednesday from 8:30 a.m. to noon in Physical Therapy, Suite 1100, Ellison Ambulatory Care Center, 4860 Y Street, Sacramento.
The clinic is co-directed by physical therapist Janet Retke and family physician Richard Brunader, who has worked with geriatric patients for the past 13 years and developed a comprehensive approach to fall treatment that includes complete assessment, evaluation and follow up.
"Over the years, I've seen a lot of patients who have fallen more than once," Brunader said. "In this clinic, we've put a lot of thought into how we can prevent recurrent falls. During the initial 1 1/2 hr. assessment, we investigate what caused the fall to determine whether it was mechanical, balance, circulatory disease, medications or other contributing factors. Most falls are multifactorial in etiology, so assessment and intervention need to be multifactorial."
At the first appointment, the physical therapist conducts a gate and balance assessment, and the physician provides physical and neurological exams. The care team also reviews the patient's daily living status by gauging frailty, medications, incontinence, social history, assistive devices, as well as any care given in the home. "Sometimes a small investment in home repair can reduce the risk of another fall by 25 to 30 percent," Brunader said. "Our goal is to develop a knowledge base about what's good for the patient."
During the second clinic appointment, the care team discusses medical management and recommendations for physical therapy rehabilitation, ongoing exercise routines or a fall exercise class for the elderly. "Many exercise classes are 10-week programs and have shown a reduction in falls," Brunader said. "Even a 90-year-old patient can improve strength and balance." Brunader said one-third of the elderly fall every year, and most do not seek help from a health-care organization. About 1 percent of these falls result in a hip fracture.
"We know that people with a history of falls are more likely to fall again. When you look at the cost of treatment and recovery, it's quite expensive. By comparison, patients who participate in a comprehensive clinic can reduce the incidence of falls by 20 to 60 percent," Brunader said.
The clinic is co-directed by physical therapist Janet Retke and family physician Richard Brunader, who has worked with geriatric patients for the past 13 years and developed a comprehensive approach to fall treatment that includes complete assessment, evaluation and follow up.
"Over the years, I've seen a lot of patients who have fallen more than once," Brunader said. "In this clinic, we've put a lot of thought into how we can prevent recurrent falls. During the initial 1 1/2 hr. assessment, we investigate what caused the fall to determine whether it was mechanical, balance, circulatory disease, medications or other contributing factors. Most falls are multifactorial in etiology, so assessment and intervention need to be multifactorial."
At the first appointment, the physical therapist conducts a gate and balance assessment, and the physician provides physical and neurological exams. The care team also reviews the patient's daily living status by gauging frailty, medications, incontinence, social history, assistive devices, as well as any care given in the home. "Sometimes a small investment in home repair can reduce the risk of another fall by 25 to 30 percent," Brunader said. "Our goal is to develop a knowledge base about what's good for the patient."
During the second clinic appointment, the care team discusses medical management and recommendations for physical therapy rehabilitation, ongoing exercise routines or a fall exercise class for the elderly. "Many exercise classes are 10-week programs and have shown a reduction in falls," Brunader said. "Even a 90-year-old patient can improve strength and balance." Brunader said one-third of the elderly fall every year, and most do not seek help from a health-care organization. About 1 percent of these falls result in a hip fracture.
"We know that people with a history of falls are more likely to fall again. When you look at the cost of treatment and recovery, it's quite expensive. By comparison, patients who participate in a comprehensive clinic can reduce the incidence of falls by 20 to 60 percent," Brunader said.