Centers for Disease 

Control and Prevention

National Center for Injury 

Prevention and Control

Preventing Falls 

in Older Patients

Provider Pocket Guide

Key Facts about Falls:

• 1/3 of older adults (age 65+) fall each year.

• Many patients who have fallen do not talk about it.

If you hear: You can say:

Precontemplation Stage

Falling is just a 

matter of bad luck. 

As we age, falls are more 

likely for many reasons, 

including changes in our 

balance and how we walk.

Contemplation Stage

My friend down the 

street fell and ended 

up in a nursing 

home.

Preventing falls can prevent 

broken hips & help you 

stay independent.

Preparation Stage

I’m worried about 

falling. Do you think 

there’s anything I can 

do to keep from 

falling?

Let’s look at some factors 

that may make you likely to 

fall & talk about what you 

could do about one or two 

of them. 

Action Stage

I know a fall can be 

serious. What can I 

do to keep from 

falling and stay 

independent?

I’m going to fill out a 

referral form for a specialist 

who can help you improve 

your balance.

Talking with your Patient about Falls

For more information, go to:

www.cdc.gov/steadi

This is What You Can Do:

RITUAL:

CS256024A

Review self-assessment brochure

 Identify risk factors 

Test gait & balance

Undertake multifactorial assessment

Apply interventions

Later, follow-up 

2015
Key Steps for Fall Prevention 

1. Be proactive—ask all patients 65+ if they’ve 

fallen in the past year.

2. Identify & address fall risk factors: • Lower body weakness • Gait and balance problems • Psychoactive medications • Postural dizziness • Poor vision • Problems with feet and/or shoes • Home safety

3. Refer as needed to specialists or community 

programs.

4. Follow-up with patient within 30 days.

Key Fall Interventions • Educate patient • Enhance strength & balance • Modify medications • Manage hypotension • Supplement vitamin D +/- calcium • Address foot problems • Optimize vision • Optimize home safety

Algorithm for Fall Risk Assessment & Interventions

Low Risk Moderate Risk High Risk Conduct multifactorial risk assessment • Review Stay Independent brochure • Falls history • Physical exam including: - Postural dizziness/ postural hypotension

- Medication review- Cognitive screen- Feet & footwear- Use of mobility aids- Visual acuity check

HIGH RISK

Individualized fall 

interventions

• Educate patient• Vitamin D +/- calcium• Refer to PT to enhance 

functional mobility & improve strength & balance 

• Manage & monitor hypotension• Modify medications• Address foot problems• Optimize vision• Optimize home safety

Follow up with HIGH RISK 

patient within 30 days

• Review care plan• Assess & encourage fall risk 

reduction behaviors

• Discuss & address barriers 

to adherence

————

Transition to maintenance exercise program when patient is ready

Patient completes Stay Independent brochure

Gait, strength or balance problem

YES to any key question

Screen for falls and/or fall risk

Patient answers YES to any key question:• Fell in past year? If YES ask, 

- How many times? and,- Were you injured?

• Feels unsteady when standing or walking?• Worries about falling?

Injury No injury

1 fall 0 falls

MODERATE RISK 

Individualized fall 

interventions

• Educate patient • Review & modify medications• Vitamin D +/- calcium• Refer to PT to improve gait, 

strength & balance 

or

 refer to a community fall 

 prevention program

LOW RISK

Individualized fall 

interventions

• Educate patient• Vitamin D +/- calcium• Refer for strength & balance 

exercise (community exercise or fall prevention program)

NO to 

all key 

questions

No gait, 

strength 

or balance 

problems*

≥ 2 falls

Evaluate gait, strength & balance

• Timed Up & Go (recommended)• 30 Second Chair Stand (optional)• 4 Stage Balance Test (optional)

*For these patients, consider additional risk assessment (e.g., medication review, cognitive screen, syncope)