Falls in the elderly.

A substantial number of elderly persons living at home fall each year. Falling can lead to both physical and psychological harm, causing some to place unwarranted restrictions on themselves based on their fear of falling again. There are many causes of falls, including age-related changes in physical status, certain pathological states and environmental hazards. Thorough assessment of the patient who has fallen includes both a detailed history and a physical examination aimed at determining the extent of injury as well as the cause of the fall. Armed with this information, the nurse practitioner can design a fall-prevention educational program that fits the patient's specific needs. Fall-prevention education is appropriate for all elderly patients, not only those who have a history of falling.