CASE:
Mrs Tan, 80 year old Chinese lady admitted to hospital post fall- was found on the bathroom floor and was unable to get up. Before falling, she attempted to get up from toilet bowl after passing motion but her knees buckles after one to two steps. There was no loss of consciousness. As she was unable to get up and did not have a pendent-alarm, she had to wait four hours before daughter come home from work. Ambulance was called and she was brought to accident and emergency unit. She also reported feeling lower limb weakness over the past few days
Past medical history: Hypertension, Type 2 Diabetes, Atrial Fibrillation, bilateral osteoarthritis knees with TKR on right knee one year ago, history of fall within the last 6 months were two falls- indoor, loss balance, no loss of consciousness
Premorbid history: She was independent with her activity of daily living. Indoor, she was a furniture walker and mobilise independently. In the community, she walked with walking-stick independently with frequent rest every 30 metres due to (L) knee pain. Her daughter will push her on wheel-chair for
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Therapy programme will include strengthening, balance training and endurance training. Dietitian will also have a role to play to ensure adequate nutrition and education on proper diet to patient. Prior to discharge a home assessment would be conducted by the occupational therapy and recommendation will be given on necessary modification (5, 7). Functional activity training will also be incorporated to mimic home environment and achieve patient’s need and goals. Patient will also be given a home exercise programme and referred to community rehabilitation team for follow-up (6). If possible, the patient’s medical social worker or the discharge liaison officer should make a follow-up call to enquire on the recommended modification and to find out how patient is coping at home