Abstract
We had three elderly patients on hemodialysis therapy from 1988 to 1989 who experienced falls.
We therefore examined the reasons for falls in elderly patients. We conducted a survey which focused on “walking” in 172 outpatients who were on hemodialysis therapy. The age range of the respondents was from 13 to 78 years. We also conducted “sit down upon the heels and stand up tests” and “stand on one leg tests” in order to assess brown of the legs, ROM, and balance. We discuss the results related to age, hemodialysis history, and diagnosis, and conclude the factors related to falls.
With regard to the survey, 47.6% respondents answered that they experienced falls or near falls after being on hemodialysis therapy. In the group over 60 years of age, more than 45% had had falls. The most common place for falls was in the road. The second most common place was uneven surfaces such as ladders and threshholds. The third most common place was inside the house. Falls were markedly common when their care giver was not present.
The most common reason for walking dysfunction was moving disability of the legs. This was very evident for patients who had received hemodialysis therapy for a long time. The results of the “stand on one leg test” were lower than the Japanese average. In the group over 60 years of age, only 17% could stand still for more than 5 seconds. Diabetes patients'results were generally worse.
We found the 3 factors influencing falls among elderly patients who were on hemodialysis therapy were: 1. Envioronmental factors the absence of a care giver, on the road, uneven surfaces, and inside the house. 2. Patient factors-moving disability and dysfunction of senses owing to age, poor eye-sight and poor balance because of diabetes. 3. Hemodialysis therapy factors-visiting the hospital 3 times a week, disturbance of balance, limitation of ROM and stiffness of the body because of long term hemodialysis therapy.
