Q&A: Fall Risk Assessments
My doctor has recommended I see her for a fall risk assessment. Can you tell me what is involved in these assessments?
The American Geriatrics Society recommends that all people age 65 years and older have a fall risk assessment every year. Research suggests that these assessments can significantly reduce your risk of falling if all the risk factors identified in the assessment are addressed.
Your doctor will ask whether you have fallen in the past—if you have, she will clarify the circumstances (where you were, what you were doing, and what time of day you fell). Helpful details include what type of shoes you were wearing, since footwear can contribute to falls; whether you wear bifocal or trifocal glasses (and were wearing them when you fell); and whether you use an assistive device, such as a cane (and if you were using it when you fell). Your doctor also will want to know whether you were able to get up and whether you were injured (and, if so, whether you received medical treatment). Your fall risk assessment will incorporate some simple tests of your physical strength and how well you walk. Your balance also will be assessed by having you adopt several progressively more challenging positions while standing. As an example, being unable to stand on one leg for 5 seconds without assistance has been shown to predict more serious falls that are more likely to cause injuries. Older adults with impaired cognition also are more likely to fall, so your assessment may include cognitive testing.
Your doctor also may arrange for an occupational therapist (OT) to visit you at home to carry out a fall risk assessment of your environment. He or she will look for tripping hazards, such as throw rugs, and inadequate lighting.
The Centers for Disease Control and Prevention (CDC) has developed an algorithm called STEADI (Stopping Elderly Accidents, Deaths, and Injuries) to guide doctors in assessing fall risk in older adults. You can find out more about it at the CDC website (http://www.cdc.gov/steadi/).
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