Have You Identified Your Patients at Risk for Falling?

As a healthcare provider, your patients trust and depend on you to treat their health conditions as well as to help prevent them. Familiarizing yourself with the factors that put your patients at risk for falling will help you to identify patients at risk for falling and prescribe a program that is tailored to their needs.

Falling is often the result of many complex and interconnected risk factors. Risk factors for falling can be internal or external.

Risk Factors

Internal Risk Factors           Considerations

Cardiovascular                      Dysrhythmias

Neuromuscular                      Lower-extremity weakness, loss of movement, functional

                                              decline, hypotension, CVA, Parkinson’s, stroke, neurological

                                              disorders, seizure disorder, syncope, unsteady gait, chronic/

                                              acute conditions Lower-extremity weakness, loss of movement,

                                              functional decline, hypotension, CVA, Parkinson’s, stroke,

                                              neurological disorders, seizure disorder, syncope, unsteady

                                              gait, chronic/acute conditions

Orthopedic                            Joint pain, arthritis, hip fracture, limb amputation, osteoporosis,

                                              foot disabilities

Perceptual                             Impaired hearing/vision, somatosensory deficits/neuropathies,

                                              dizziness/vertigo

Psychiatric or cognitive        Delirium, cognitive decline, dementia, Alzheimer’s disease,

                                             depression, wandering, confusion/disorientation, fear of falling

Medication side effects         Hypotension, muscle rigidity, impaired balance, extrapyramidal

                                              symptoms (tremors, uncontrolled movements), decreased alertness

External

Risk Factors                       Considerations

Medications                          Anti-hypertensives, diuretics, laxatives, anti-psychotic agents,

                                             antihistamines, tranquilizers, narcotics, hypnotics, H-2 blockers,

                                             proton pump inhibitors, anti-diabetic agents, anti-coagulants,

                                             aspirin and other non-steroidal anti-inflammatories

Appliances and devices       Pacemaker, assistive devices, restraints, poorly fitting

                                             wheelchair

Environmental hazards        Glare, poor lighting, slippery floors, uneven surfaces, foreign

                                             objects, patterned carpets, reaching, incontinence, crowded

                                             area

Other                                   Suboptimal care, fall in last 30 days, multiple diagnosis, history

                                            of falls, sleep disorders

Reducing falls in older adults often require multifaceted interventions in order to be successful. Additionally, a program should also be tailored to the patients’ needs because risk factors vary among patients.

Prior to prescribing a fall prevention program, it is recommended that healthcare professionals complete a falls assessment on their patient. Please refer to the Tools page to access resources commonly used to aid with a fall risk assessment. Additionally, the Guideline for the Prevention of Falls in Older Persons, published by the American Geriatrics Society is useful resource for healthcare providers.