Keep Minnesotans Right Side Up.

Professional Home

Screening

Multifactorial Assessment

Assessment Tools

Research on Assessment Tools

Risk Factors

Interventions by Risk Factor

Reimbursement

Research

Information for Adults

Interventions...Actions You Can Take

Reducing falls among adults requires completing a comprehensive falls risk assessment and identifying the risk factors that may put an individual at risk of falling. Following the identification of risk factors, a health care professional can recommend intervention strategies and actions that address each risk factor and the unique situation of the adult.

Multifactorial assessments and interventions, tailored to each individual, are the most effective in reducing fall rates. As a single intervention, exercises that include gait and balance as well as lower body strengthening have also been proven to reduce falls in adults.

Prevention of Falls in Older Persons AGS/BGS Clinical Practice Guidelines available at: http://www.medcats.com/FALLS/frameset.htm

Here are intervention strategies organized by risk factor:
Risk Factor Intervention Strategy
Muscle weakness Evaluate and assess.

Refer as needed to physical therapy and/or occupational therapy for assessment and treatment. Treatment may include an exercise program that includes gait, balance, and lower body strengthening exercises.
Gait, balance or both Evaluate and assess.

Refer as needed to physical therapy, occupational therapy, home care, and/or medical equipment suppliers.

Treatment may include an exercise program that includes gait, balance, and lower body strengthening exercises.

Recommend professionally delivered home safety evaluation to reduce environmental hazards and identify home modifications to maximize safety.Encourage adult to have cane, walker or gait device fitted properly to ensure correct form.
Medications

Review prescribed and over-the-counter medications.

Evaluate for proper dose, route, compliance, interactions and side effects that may increase the adult’s risk of falling.

Taper medications to the lowest effective dose.

Reduce the total number of medications when possible.

Educate the adult about their medications, possible side effects, and when those side effects should be reported. Encourage adult to bring list of all prescribed and over-the-counter medications to each visit and to keep list current.

Learn the prescription medications that increase the risk of falls for patients 65 and older.

Postural hypotension
Evaluate and assess.

Review medications.

Encourage good hydration habits.

Educate adult on how to rise slowly from a seated or supine position.
Hazards inside and
outside the home
Educate adult about environmental hazards.

Recommend professionally delivered home safety evaluation to reduce environmental hazards and identify home modifications to maximize safety.
Cardiovascular disorder Evaluate and cardiovascular assessment. Treat medical condition as needed.
Foot problems or Inappropriate footwear Recommend self-examination of the feet and regular foot care.

Educate adult about foot problems and proper footwear.  Suggest supportive shoes with non-slip soles and wide low heels.
Cognitive impairment Evaluate and assess to determine whether or not there is cognitive impairment.

Recommend home health care services if needed. 
Visual impairment Visual acuity testing.

Recommend visit to eye doctor to test vision and make sure eye glasses prescription is up-to-date.  Eye doctor may also test for conditions of the eye that may impair vision. 
Limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) Evaluate and assess to determine whether or not functional impairment exists.

Recommend visit to physical therapy for evaluation of gait and possible need for assistive devices.

Recommend home health care services. 
Fear of falling

Screen adults perceptions of their abilities to perform their ADLs and IADLs, as well as their fear of falling.

Encourage adult to be physically active.

Refer to A Matter of Balance class.

Osteoporosis Screen and treat as indicated. 

Aging Services of Minnesota Falls Prevention & Reduction Champion’s Toolkit

Minnesota Hospital Association Call to Action Safe from FALLS

Falls, Wandering, and Physical Restraints:  Interventions for Residents with Dementia in Assisted Living and Nursing Homes

Fall risk evaluation and interventions for adults may be reimbursable.