Stay Independent

 

 

 

 

 

 

 

 

 

 

Integrating Fall Prevention into Practice
 

Working as a multidisciplinary team, healthcare providers can help identify and 

manage patients at risk of falling. You can help reduce falls by screening all 

older persons once a year for previous falls and/or balance problems. 

For those who screen positive, perform a fall risk assessment, and help patients understand 

and act upon the findings using proven prevention strategies. 

Identify community • Have staff contact providers of senior services.

exercise and fall • Identify community exercise and fall prevention programs for seniors.

prevention programs • Compile a resource list of available programs.

Assessments and/or 

Interventions 

Identify who in your 

practice can do this 

What it involves ..... 

Screen all older 

patients for falls 

• Have patient complete the Stay Independent

brochure, or ask the patient these 3 questions:

Have you fallen in the past year? 

Do you feel unsteady when standing or walking? 

Do you worry about falling? 

Identify modifiable fall 

risk factors • Review the Stay Independent brochure, and take a falls history. brochure, and take a falls history.

Evaluate gait, lower 

body strength, and 

balance 

Address identified 

defi cits 

• Administer one or more gait, strength, and balance tests:

- Timed Up and Go Test (Recommended) Observe and record patient’s

postural stability, gait, stride length and sway.

- 30-Second Chair Stand Test (Optional)

• As needed, refer to a physical therapist (PT), or recommend a community

exercise, or fall prevention program.

Conduct focused 

physical exam 

Address modifiable 

and/or treatable risk 

factors 

- Examine feet and evaluate footwear. Look for structural abnormalities,

1. 

• In addition to a customary medical exam:

- Assess muscle tone, look for increased tone, and hypertonia (cogwheeling).

- Screen for cognitive impairment and depression.

deficits in sensation, and proprioception.

- If needed, refer to podiatrists or pedorthists.

Assess for and manage • Check supine and standing blood pressure using 1-page protocol, Measuring

postural hypotension Orthostatic Blood Pressure.

• Recommend medication changes to reduce hypotension.

• Monitor patient as he/she makes recommended changes.

• Counsel patient, and give the brochure, Postural Hypotension: What it is and

How to Manage it.

Review and manage 

medications • Monitor patient as he/she makes recommended changes.

Stop, switch, or reduce the dose of psychoactive medications when possible.

Increase vitamin D • Recommend a daily vitamin D supplement.

Assess visual acuity, Administer brief vision test. 

and optimize vision • Refer to ophthalmologists or optometrists.

Address home safety, • Counsel patient about reducing fall hazards. Give the CDC brochure,

and how to reduce fall 

hazards 

Check for Safety.

• Refer to OT to assess safety and the patient’s ability to function in the home.

Educate about what • Educate patient about fall prevention strategies.

causes falls, and how to 

prevent them 

• Give the CDC brochure, What YOU Can Do to Prevent Falls.

• Recommend exercise, or community fall prevention program.

2. 

3. 

2017

Stopping Elderly Accidents, 

Deaths & Injuries

 

 

 

 

- 4-Stage Balance Test (Optional)

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2017