Ways professionals can reduce falls
Assess all the factors
A multifactorial assessment can identify the factors that put an older adult at risk of falling and assist in identifying the interventions to reduce falls. Research has found that many health care providers fail to identify and evaluate older adults at risk of falling in their clinical practices. Wenger and colleagues, found that only 34% of older patients receive any fall evaluation.
An assessment should be performed by a professional with appropriate skills and training (e.g. physician, nurse practioner, physical therapist, occupational therapist, or pharmacist). Consider these factors in your assessment
History of falls
- Activity performed/setting at the time of the fall
- Frequency of falls
- Symptoms at the time of the fall
- Previous injuries and consequences
Medication review
Review of prescribed and over-the-counter medications.
Visual acuity testing
Gait and balance assessment
Examination of gait, balance and lower extremity joint function.
Functional assessment
- Limitations of activities of daily living
- Limitations of instrumental activities of daily living
Physical examination
- Examination of basic neurological function, including mental status, muscle strength, lower extremity peripheral nerves, proprioception, reflexes, test of cortical, extrapyramidal, and cerebellar function
- Assessment of basic cardiovascular status including heart rate and rhythm and orthostatic blood pressure
- Examination of the feet
Laboratory testing
Choice of laboratory tests should be driven by the older adult's history of falls and physical exam elements.
Fall risk evaluation and interventions for older adults may be reimbursable.