FALLS ARE THE LEADING CAUSE OF FATAL AND NON-FATAL INJURIES FOR OLDER AMERICANS! DID YOU KNOW THAT 1 in 3 AMERICANS AGED 65+ FALLS EVERY YEAR.  Health care professionals can help prevent falls!

The Centers for Disease Control and Prevention has created the Stopping Elderly Accidents, Deaths, & Injuries (STEADI) Tool Kit for health care providers.  The kit includes fall related assessment tests, case studies, and educational handouts.  Continuing education credit is also available on the STEADI website which can be accessed HERE.

 

 

 Other resources:

 

 

The 5 Big Questions to Ask

The 5 Questions To Ask:

1. History of Falls

  • Have you had any falls within the past year?
    • If so, how many?
    • Were you injured from your fall?
      • If so, did you seek medical attention?
    • If you haven't had any falls, have you had any stumbles within the past year?

2. Home Hazards

  • Have you stumbled on anything inside or outside your home?
    • Do you have things that will help you in your home like handrails in your bathroom?
    • Do you have things that may get in the way like poor lighting, throw rugs, little pets, or something else that might cause you to stumble in your home?
    • Do you have outside challenges like stairs into the home, unlevel surfaces, inclined driveways, or clutter in the yard?

3. Strength and Balance

  • Do you feel unsteady walking indoors?
  • Do you feel unsteady walking outdoors?
  • Do you use an assistive device to walk indoors or outdoors? (eg cane, walker)
  • Do you have difficulty going from sit to stand?
  • Do you feel dizzy as if the room is spinning or moving or light-headed on a regular basis?

4. Polypharmacy

  • Do you take >4 medications daily or any of the following?
    • Antidepressants
    • Antianxiety or tranquilizers
    • Narcotic pain medicine
    • Cardiovascular medications

5. Vision

  • Do you have trouble seeing even with glasses?

 

Address the underlying risk factor(s) in order to provide tailored patient/client-specific interventions.

Who Is At Risk?

Odd ratios and relative risk from:
Tinetti M, Kumar C.The patient who falls "it's always a tradeoff". JAMA.2010;303(3):258-266.

Increase in Risk as a Result of
the Presence of a Risk Factor

(Relative risk numbers represent multiple studies.)
Risk FactorRelative Risk (RR)
History of previous falls 1.9-6.6
Polypharmacy
(>4 medications daily)
1.1-2.4
Age >80 1.1-1.3
Multiple co-morbidities no data
Reduced Sensation no data
Decreased Muscle Strength 2.2-2.6
Vision defects 1.5-2.3
Home/Environmental Hazards no data
Gait abnormalities/Balance impairments 1.2-2.2
Cognitive/memory problems 2.8
Urinary Incontinence no data
Symptoms of dizziness no data
Postural hypotension
Systolic: >20mmhg
Diastolic:>10mmhg
2.0
Abnormal heart rate and rhythm no data
Female 2.1-3.9
Receiving IV therapy and/or oxygen no data
Post major medical procedure no data

 

The greater number of risk factors, the greater the risk of falling.

Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319(26):1701-1707.

Relative risk is the risk of the outcome in one group compared with another group.

Example of relative risk: An individual with a history of falls would be 1.9-6.6 times more likely to fall than an individual without a history of falls.

Zhang J, Yu K. What's the relative risk? JAMA. 1998; 280(19): 1690-1691.