MANAGEMENT OF GERIATRIC NURSING IN ELDERLY AT RISK OFFALLS AND DECLINING AUTONOMY: A CASE REPORT

Abstract

Background: Falls are a common issue among the elderly, leading to reduced functional independence, disability, and a lower quality of life. Identifying fall risk factors early is essential for preventing injuries and preserving older adults' functionality. This case report demonstrates gerontological nursing care based on Comprehensive Geriatric Assessment (CGA) for elderly individuals at risk of falls. Case Summary: An 84-year-old man living in the community underwent a gerontological nursing assessment. He presented with intermittent shortness of breath, a productive cough, dizziness, and visual disturbances. His medical history included smoking and cataract surgery. While he was mostly independent, he often depended on nearby objects for support and exercised caution in his activities. Investigation and Diagnosis: Examination revealed a blood pressure of 150/60 mmHg, a pulse of 90 bpm, a respiratory rate of 26 breaths per minute, and crackles. The Mini- Mental State Examination (MMSE) score of 18 indicated possible cognitive impairment, and the Barthel Index score of 19 showed mild dependency. A Timed Up and Go Test (TUGT) result of 14.3 seconds indicated an increased fall risk, and the Mini Nutritional Assessment (MNA) highlighted malnutrition risk. The patient was diagnosed with multifactorial fall risk and mild dependency in daily activities. Management: Nursing interventions included educating the patient on fall prevention, modifying the home environment, supporting independence, managing respiratory symptoms, and involving family in care. Outcome: During follow-up, no falls or significant clinical declines occurred. The patient maintained independence in daily activities, with family actively involved in fall prevention. Conclusion: This case emphasizes that fall risks can be identified early through the CGA approach, with multidimensional nursing care enhancing safety and functional independence for older adults in the community.