Taking Charge | Good Medical Care for the Elderly and How To Get It

Some factors place a person more at risk for falls than others. Each of the risk factors below is weighted. Put a check in front of each risk factor that your loved one has, then add up the total points. If your loved one scores more than six points, identify him or her as at-risk for falls. You will then need to evaluate ways in which to manage your loved one’s risk of falls.

Assessment of Risk of Falls

Sensory Deficits:

	Impaired speech/language barrier (1 point)
	Impaired vision (2 points)
	Impaired hearing (1 point)

Bowel or Bladder Problems:

	Incontinence (1 point)
	Diarrhea (1 point)
	Frequency (voiding every two hours or less) (1 point)

Medications:

	Antihypertensive (2 points)
	Narcotics (1 point)
	Sedatives/Hypnotics (1 point)
	Psychotropic medications (2 points)
	Antianxiety medications (1 point)
	Antiseizure medication (1 point)

Altered Mental Status:

	Confusion/delirium (1 point)
	Hallucinations (1 point)
	Seizure within last two months (5 points)

Previous History of Falls:

	Prior to admission (within one month) (4 points)
	Fall during this admission (6 points)


Impaired Mobility, such as:
	Dizziness (5 points)
	Muscular weakness (5 points)
	Amputee (1 point)
	Paresis (hyperactive reflexes) (1 point)
	Uses walker (1 point)
	Uses wheelchair (1 point)
	Uses crutches (2 points)
	Uses cane (2 points)

TOTAL: _______

(More than 6 points? Find ways to reduce her risk for falls.)

Date: _______ Time: ______