Comprehensive Geriatric Care Plan for Fall Risk and Alcohol Use

Mr. Jones is a 67-year-old male who was recently treated in the ER following a fall in his home, where he received six stitches. His brain CT scan was negative, and all sutures were removed without complication. His wife reports that he consumes alcohol nightly. Mr. Jones has not received treatment from a primary care provider for several years. Mr. Jones’s fall, along with additional alcohol use, are concerns that must be outlined in detail. This discussion outlines appropriate diagnostics, screenings, and treatment plans, incorporating community resources from Upland in California.

Diagnostic and Screening Considerations

Alcohol Use Screening

Given that Mr. Jones consumes alcohol daily, it would be essential to conduct an AUDIT to assist in determining whether he fits the diagnosis of alcohol use disorder. Chronic use of alcohol among older adults predisposes them to complications of health problems, including cognitive impairment and falls, among other serious issues identified as pivotal concerns in care, as stated by White et al. (2022).

Fall Risk Assessment

The patient also has a problem with falls, which is a common problem in older adults. The falls may indicate an imbalance or an environmental concern. A timed up-and-go test will help evaluate his mobility and balance (Sakthivadivel et al., 2022). A home safety evaluation regarding any fall risks, including loose carpeting or pets, must also be done.

Cognitive Screening

Given the association of alcohol with cognitive decline, the mental status of Mr. Jones needs to be assessed. He will require an MMSE or Montreal Cognitive Assessment for memory, orientation, and executive function (Wang et al., 2022).

Treatment Plan

Alcohol Use Counseling and Intervention

If the AUDIT results are positive for a problem with drinking, then Mr. Jones would benefit from alcohol reduction counseling (Botwright et al., 2023). Another method used to elicit his readiness to change is motivational interviewing. This also may need a referral to an outpatient alcohol counseling service or a local Alcoholics Anonymous meeting. One of the resources in Upland, California, is Inland Valley Recovery Services for outpatient services on disorders about substances.

Fall Prevention Strategies

Mr. Jones should also be recommended to a physical therapist to incorporate strength and balance training to reduce the possibility of falls in the future. Home modification additions, such as grab bars and improved lighting, will greatly reduce risks (Montero-Odasso et al., 2022). San Bernardino County Aging and Adult Services offers several fall prevention programs and home safety evaluations.

Chronic Disease and Medication Review

As Mr. Jones has not been with a PCP for several years, it is pertinent to perform a complete review of his chronic disorders and current medications. Liver function testing secondary to alcohol, vaccination status, and providing flu and pneumonia shots will be used in the care of this patient.

Community Resources in Upland, California

Apart from the Inland Valley Recovery Services, Mr. Jones is also entitled to alcohol management-related services. He could avail himself of social activities offered by the Upland Senior Center to minimize his isolation, which could be a factor in his drinking. Also, the San Antonio Community Hospital has programs for geriatric fall prevention and chronic disease management. In addition, the San Bernardino County Health Department provides education resources and preventive services for older adults.

Conclusion

The management of Mr. Jones’ care will include complete assessments of the use of alcohol, the risks of falls, and his cognition. Local resources can help provide access for Mr. Jones to receive alcohol counseling and fall prevention services to maintain his health while minimizing risks. These effects ultimately improve his quality of life through continued care and support provided within the community.

References

Botwright, S., Sutawong, J., Kingkaew, P., Anothaisintawee, T., Dabak, S. V., Suwanpanich, C., Promchit, N., Kampang, R., & Isaranuwatchai, W. (2023). Which interventions for alcohol use should be included in a universal healthcare benefit package? An umbrella review of targeted interventions to address harmful drinking and dependence. BMC Public Health, 23(1). https://doi.org/10.1186/s12889-023-15152-6

Montero-Odasso, M., Van Der Velde, N., Martin, F. C., Petrovic, M., Tan, M. P., Ryg, J., Aguilar-Navarro, S., Alexander, N. B., Becker, C., Blain, H., Bourke, R., Cameron, I. D., Camicioli, R., Clemson, L., Close, J., Delbaere, K., Duan, L., Duque, G., Dyer, S. M., . . . Zijlstra, G. a. R. (2022). World guidelines for falls prevention and management for older adults: A global initiative. Age and Ageing, 51(9). https://doi.org/10.1093/ageing/afac205

Sakthivadivel, V., Geetha, J., Gaur, A., & Kaliappan, A. (2022). Performance-oriented mobility assessment test and timed up and go test as predictors of falls in the elderly – A cross-sectional study. Journal of Family Medicine and Primary Care, 11(11), 7294. https://doi.org/10.4103/jfmpc.jfmpc_1294_22

Wang, G., Estrella, A., Hakim, O., Milazzo, P., Patel, S., Pintagro, C., Li, D., Zhao, R., Vance, D. E., & Li, W. (2022). Mini-mental state examination and Montreal cognitive assessment as tools for following cognitive changes in Alzheimer’s disease neuroimaging initiative participants. Journal of Alzheimer’s Disease, 90(1), 263–270. https://doi.org/10.3233/jad-220397

White, A. M., Orosz, A., Powell, P. A., & Koob, G. F. (2022). Alcohol and aging – An area of increasing concern. Alcohol, 23(2). https://doi.org/10.1016/j.alcohol.2022.07.005

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Comprehensive Geriatric Care Plan for Fall Risk and Alcohol Use

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