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Falls in care home resident — DGM MCQ

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HardFallsFalls in care home residentDGM

An 89-year-old woman in a residential home has had two falls while walking to the dining room. She has macular degeneration, urgency incontinence and moderate dementia. Staff report new agitation at night; urine dipstick is positive for leucocytes but she has no fever or dysuria. What is the most appropriate assessment?

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Correct answer: B — Multifactorial falls assessment including delirium screen and continence review

The falls are likely multifactorial, with vision, continence, cognition, possible delirium and medicines needing systematic review. A positive dipstick without urinary symptoms in an older care-home resident does not justify treating asymptomatic bacteriuria. Comprehensive assessment avoids anchoring on a single abnormal test.

Reference: NICE NG249; NICE CG103