病院・施設における認知症高齢者の転倒リスク評価と予防対策

抄録

Older adults with dementia (OAwD) present serious fall risks, potentially affecting other risks, that dramatically increase the chances of falling. The severity of these risks may vary across time depending upon a variety of factors. The individual fall risk seen in dementia involves executive function disorders, including excretion behaviour related with visual space recognition, functional disorder, and attention–deficit disorder.

Upon hospitalization, OAwD are often in a confused, unconscious, or agitated state that may lead to an increased chance of falling during their stay. Although healthcare professionals are trained to address the medically significant physiological risks presented by OAwD, their high risk of falling is often neglected. Furthermore, the side effects of psychotropic medication and the experience of delirium can cause OAwD to fall while walking due to a disturbance of consciousness.

Via the implementation of person–centred care in geriatric institutions, healthcare staff practiced appropriate palliative care targeting the behavioural and psychological symptoms of dementia and tailoring to the individual needs of OAwD, and they were able to effectively reduce the occurrence of falls.

The following results, including the assessment of fall risk related to the executive functional disorder of dementia and person–centred care for fall prevention, have been proven to be effective methods to reduce the occurrence of falls in OAwD.