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Clinical care and management
J03 Falls in institutionalized patients with huntington's disease: large numbers, minor consequences
  1. S Adema,
  2. T Stor
  1. Atlant Care Group, Apeldoorn

Abstract

Background For more than 25 years, the Atlant Care group offers specialized long term care for Huntington patients. To monitor and improve quality of care, all incidents in our nursing home are registered and evaluated. Incidents (like aggression, falls, and choking) can have serious consequences for the patient involved. In some cases there are consequences for other patients, for staff or volunteers. Falls occur more frequently than other incidents in our ward, and are subject of this survey.

Method A retrospective analysis was made of all reported falls and possible injuries in patients with Huntington's disease residing in our 31 bed unit over 2007 and 2008. We investigated whether the level of disability influenced the occurrence of falls. Patients were divided into four categories: 1 walks independently, 2 walks with aid, 3 uses wheelchair, still able to transfer 4 wheelchair-bound.

Results During the two years of this survey, 42 patients (18 women, 24 men) stayed in our 31 bed unit. 219 falls were reported. The majority of patients fell at least once. Injuries were reported in less than 10% of the falls, and most were minor injuries, such as local swelling, abrasion or hematoma. In one patient the fall resulted in a ruptured finger-tendon (mallet finger) and two patients had a head wound that required stitching. No fractures or other serious injuries were reported. Two thirds of the falls occurred among wheelchair-using patients, still able to perform transfers from wheelchair to bed, or bathroom.

Conclusion Many falls occurred, but no major consequences for patients (or staff) were observed. Patients who are disabled to the extent that they use a wheelchair, but are still able to stand up, are most at risk. The great number of falls in our unit may be explained by several factors: the disease itself, the frequent use of antipsychotic and tranquilizing medication, and the acceptance of risks by patients and staff. The relatively young age, predominance of male patients in our unit, the adapted interior of the unit, and the falls taking place inside the building may explain the limited consequences of falls.

  • Falls
  • Huntington's disease
  • institutionalized
  • nursing home

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