fall risk checklist

by Rein Tideiksaar, PhD

Use this fall risk checklist to help develop a full fall risk assessment for an elder.

Factors	Recommended Interventions
Recent Fall(s)	Obtain Fall History; circumstances of fall (s): Symptoms associated with fall (s) Previous falls (past 3 months) Location of fall (s) Activity at time if fall (s) Time of fall (s) Trauma associated with fall (s) Evaluate for presence of osteoporosis and treat as appropriate. Ask about falls/evaluate fall risk on regular basis.
Sensory Reduced vision (cataracts, glaucoma, and macular degeneration)	Evaluate vision and treat as appropriate. Physical/occupational therapy home safety evaluation
Underlying Medical Conditions Orthostatic Hypotension Bladder Dysfunction (urge incontinence, nocturia, frequency) Muscle Weakness (especially lower extremities) Foot Disorder Degenerative Joint Disease (especially hips/knees) Peripheral Neuropathy Gait & Balance Disorder	Evaluate medical conditions and treat as appropriate.
Psychological Status Depression/Anxiety Cognitive Impairment Safety Awareness (Judgment) Fear of Falling	Depression/cognitive assessment. Treat identified conditions.
Medication Status 4 or > Prescription Medications Medication Noncompliance Psychotropic Medications, Sedatives, Anti-hypertensives (including diuretics)	Review need for medications. Reduce dosages or eliminate as appropriate Simplify patient's medical regimen.
Functional Status Ambulation Impairment Transfer Impairment Balance Impairment Uses cane or walker	Identify and treat responsible medical conditions. Muscle strengthening and balance exercises. Assistive ambulation device (cane, walker). Physical/occupational therapy home safety evaluation.