Causes of Increased Risk of Falls and Injury

• Stiff, awkward movements caused by damage to areas of brain that control muscle movement:
• Difficulty getting out of bed
• Stooped or leaning posture and shuffling gait as disease progresses
• Apraxia, with inability to make or coordinate movements
• Overmedication: Changes in drowsiness, walking, posture, stiffness, agitation, falling, increased postural hypertension
• Visual problems:
• Cataracts
• Increased near- or farsightedness
• Inability to distinguish between similar color intensities (may have difficulty identifying railings that are same color as walls; may stumble into walls of color intensity similar to that of floor)
• Poor depth perception
• Blurred vision (may be side effect of medication, anticholinergic action)
• Hearing problems: May not hear approaching machinery or people
• Agnosia: May bump into furniture, not recognizing what it is
• Diminished or absent pain perception:
• Inability to recognize or communicate injury (for example, patient may try to walk on broken leg)
• Only manifestation may be change in behavior
• May burn self while smoking
• Sundowning syndrome (increased confusion at night) with night restlessness, wandering
• Any factor, including concurrent delirium, that increases confusion and disorientation

Source: Gorman, L., Raines, M., & Sultan, D. (2002). Psychosocial nursing for general patient care (2nd ed). Philadelphia: FA Davis.