Geriatric Falls Clinic: For Evaluation and Follow-up for the Treatment and Prevention of Falls
The Geriatric Falls Clinic involves a multidisciplinary assessment, including screening of vision, medical conditions, polypharmacy, nutritional status, mental alertness, physical function, balance and strength.
After the assessment, a summary letter will be provided to the patient and physician. The Falls Clinic is advised for any elderly patient who has had a fall or fracture, has balance problems, or is at high risk for falls.
Before the Appointment
The patient should plan to arrive 15 minutes early and wear comfortable shoes. The patient will meet separately with a nurse practitioner and a physical therapist. The appointment will last about 90 minutes.
The patient should bring the following to the evaluation:
- All medicine in original containers, including over-the-counter medicines
- Medical records for care obtained outside the Cleveland Clinic’s hospitals and family health centers (including results of bone mineral density tests)
- Lab tests from the past two years
- Details of past falls, prior evaluations, illnesses, surgeries and allergies
- Current insurance information
Clinical nurse specialist Anne Vanderbilt, MSN, CNS, CNP, will talk with the patient about health issues, nutrition and living environment as related to falls, evaluating for the following:
- Medical conditions
- Neurological issues
- Multiple medications
- Safe living environment
A physical therapist will assess the patient’s physical function, balance and strength and, if appropriate, recommend a physical therapy program tailored to the patient’s needs. The patient can go to any Cleveland Clinic facility to carry out this program. The team will generate a summary of recommendations for the patient and primary care provider and facilitate testing and referrals to other specialists if needed. A follow-up appointment typically is requested in six weeks.
Scheduling an Appointment
To schedule an appointment, please call 216.444.5665 or 800.223.2273, ext. 45665.
A Coordinated Approach for Evaluation and Treatment
At Cleveland Clinic's Aging Brain Clinic, patients have access to medical specialists who work together to evaluate, diagnose and offer treatment options for complex, age-related conditions and brain diseases.
The primary medical team includes physicians who specialize in geriatric medicine, neurology and neurosurgery. Experts in other medical specialties, such as urology and vascular medicine, as well as professionals in social work, nutrition, psychiatry and neuropsychology, are involved as needed.
Patients undergo a comprehensive evaluation, which may include laboratory tests and diagnostic imaging, to detect subtle problems - even difficult-to-diagnose conditions - associated with aging or illness. For example, some patients suffer symptoms related to the mix of medications they take. Some older adults demonstrate dementia-like symptoms due to cerebrovascular disease.
Chemical or metabolic disorders, such as hypothyroidism or vitamin B12 deficiency, may cause dementia-like symptoms. Still others have symptoms that mimic those of dementia, Alzheimer's or Parkinson's disease when, in reality, they suffer from a relatively unknown brain condition called adult onset normal pressure hydrocephalus or NPH.
Many Brain Conditions are Treatable
Because many older adults have complex symptoms or conditions that are difficult to diagnose, too often they go untreated. Yet many conditions including conditions of an aging brain--are highly treatable using leading-edge technology and therapies available at Cleveland Clinic.
Some of these brain conditions include:
Traditionally, cerebrovascular disease, which includes carotid and cerebral atherosclerosis, intracranial aneurysms, stroke and stroke-related conditions, has been treated only with open surgery. Today, several minimally invasive, endovascular treatment options are available, including stent technology.
Dementia, characterized by a severe decline in cognitive function, comes in many forms, the most common of which is Alzheimer's disease. If a diagnosis of probable or possible Alzheimer's disease can be made, treatment
may include medications to enhance memory function and behavior, or palliative medicine and therapy to help control symptoms and improve quality of life for this common devastating disease of the aging brain .
Movement Disorders/Parkinson's Disease
Essential tremor and Parkinson's disease are progressive neurological movement disorders. Although there is no cure for these movement disorders, patients may be helped with medications or an FDA-approved pacemaker-like device that delivers mild, electrical stimulation to block the brain signals that cause tremors.
Normal Pressure Hydrocephalus
The three main symptoms of NPH - difficulty walking, mild dementia and impaired bladder control - so closely resemble those of other age-related diseases, patients often are misdiagnosed. Treatment involves the surgical implantation of a shunt, which diverts the excess cerebrospinal fluid from the brain or spinal canal to another part of the body where the fluid is easily and safely absorbed. Neurosurgeons at Cleveland Clinic use an improved method of implantation, which has resulted in better outcomes and fewer complications.
Based on the brain symptoms, concerns and health history, a patient is scheduled to see the most appropriate specialist within the Aging Brain Clinic. You will need to hand-carry all of your records and brain imaging films with you to your appointment. When a patient first arrives, he or she completes a screening questionnaire and is interviewed by a nurse. Next, a medical specialist evaluates the patient. Any necessary laboratory, imaging or other diagnostic testing for referrals to other specialty services at Cleveland Clinic. The team sends reports to the patient's primary care physician when requested.
Although our schedulers will do their best to make sure waiting time is kept to a minimum, patients should plan to spend the entire day at the Aging Brain Clinic. The goal is to provide a comprehensive assessment and treatment plan in a convenient manner for patients and their families.
Leading Edge Research
More than 100 neuroscience clinical research trials are currently under way at Cleveland Clinic, many of which involve cerebrovascular disease, movement disorders and diseases associated with aging brains and bodies. Clinical and experimental studies involve investigation of disease and new modes of diagnosis and treatment.
Help Is Available
Oftentimes serious symptoms in older adults are overlooked or accepted as part of the normal aging process. This isn't always true. Help is often available, and the earlier a problem is found, the better the chance for a successful outcome.
Understanding Health Information
Medical terms and concepts can be confusing. If after your appointment you need additional help understanding the medical information or instructions that were given to you, please ask to speak with a nurse educator. Our team can provide you with information related to a specific illness or disease, diagnostic tests, and medical and surgical treatments. You also can get information on support groups and other community resources that may help you and your family. You may contact our Center directly at 216.444.8091.
For an appointment at Cleveland Clinic's Aging Brain Clinic, please call 216.444.5665.
Special Service for Out-of-Town Patients
Cleveland Clinic's Medical Concierge program is a special complimentary service for patients who travel to The Cleveland Clinic from outside Northeast Ohio. Our patient care representatives will facilitate and coordinate the scheduling of multiple medical appointments; provide access to discounts on airline tickets and hotels, when available; make reservations for hotel or housing accommodations; and arrange leisure activities.