Assessment Of Falls Risk In Older People (Page 2 of 2) in pdf

Assessment Of Falls Risk In Older People Page 2

(Side 2)

Suggestions for further assessment, referral options and interventions

Assessment by nurse or doctor

Risk factor present

Further assessment

Referral Options

Interventions

1) History of falling

Review incident(s),

Occupational

Discuss fear of falling and

in the previous year

identifying

Therapy

realistic preventative measures.

precipitating

Physiotherapy

factors.

Falls Clinic/ICT (1)

2) Four or more

Identify types of

General Practitioner

Review medications,

medications per day

medication

Falls Clinic (1)

particularly sleeping tablets (see

prescribed.

for more

Ask about

information on medication and

symptoms of

falls

dizziness.

Discuss changes in sleep

patterns normal with ageing,

and sleep promoting

behavioural techniques.

3) Balance and gait

Can they talk while

Occupational

Teach about risk. And how to

problems

walking? (2)

Therapy

manoeuvre safely, effectively

Do they sway

Physiotherapy

and efficiently.

significantly on

Falls Clinic/ICT (1)

Physiotherapy evaluation for

standing?(3)

range of movement, strength,

Do basic balance

balance and/or gait exercises.

test such as Timed

Transfer exercises.

Up & Go test

Evaluate for assistive devices.

Consider environmental

modifications (a) to compensate

for disability and to maximise

safety, (b) so that daily

activities do not require

stooping or reaching overhead.

4) Postural

Two readings taken

District Nurse

Offer extra pillows or consider

hypotension (low

1. After rest five

Practice nurse

raising head of bed if severe.

blood pressure)

minutes supine

General Practitioner

Review medications.

2. 1 minutes later

Falls Clinic (1)

Teach to stabilise self after

standing

changing position and before

Drop in systolic BP

walking.

Avoid dehydration

20mmHg and or drop in

diastolic 10mmgHg

or more

1. Consider Falls Clinic/ Intermediate Care Referral Form.

2. While the patient is walking ask them a question but keep walking while you do so. If the patient stops

walking either immediately or as soon as they start to answer, they are at higher risk of falling.

3. The patient stands between the assessor and the examination couch (or something they can safely hold

on to). First assess if the person sways significantly (raises arms or compensates foot placement) while

standing freely. Then ask the person to take their weight on to one leg and try to lift the other foot off

the floor by about an inch (allow a few practice attempts).

Assessment Of Falls Risk In Older People Page 2

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