Ashley Gay, RPh – Consultant Pharmacist
I am often asked to review resident’s medication therapy as a cause of falls. I always look for recent medication changes first but a fall can also be a sign of a new or underlying medical problem that needs treatment. Older adults who fall are at a higher risk of future falls. The following things should be checked when falls begin:
- Assessment for new illnesses such as UTI, dehydration, anemia, pneumonia, heart problems like atrial fibrillation, or strokes.
- Blood tests should be ordered such as urinalysis, electrolytes, glucose, complete blood counts, chest x-rays. Seizure medication levels should be tested, when applicable, to rule out toxicity. Low Vitamin D levels can also contribute to fragile bones.
- Blood pressure and pulse readings when resident is standing and sitting. Blood pressure and cardiac medications may need to be adjusted. Low pulse is a common cause of falls. Sometimes a simple change in class of antihypertensive medications is all that’s needed.
- Medication Review
- Sedatives, sleep medications, seizure medications
- Diabetes and Blood pressure medications
- Anticholinergic medications. Most commonly used for allergies, overactive bladder, vertigo, itching, certain types of antidepressants. Common examples include Benadryl, hydroxyzine, oxybutynin, dicyclomine, and amitriptyline to name a few.
- Opiate Pain Medications
- Pain levels should be evaluated if gait and balance are a concern
- Evaluation of underlying heart or neurological conditions
- Vision Checks if not performed recently
Please don’t hesitate to contact your facilities Consultant Pharmacist if you would like a detailed review of medication therapy.