This is a brief video on fall risk for geriatric populations, including screening, assessment, and interventions for fall risk. This video follows the CDC guidelines.
ADDITIONAL TAGS:
Centers for Disease
Control and Prevention
National Center for Injury
Prevention and Control
As a healthcare provider, you are already aware
that falls are a serious threat to the health and
well-being of your older patients.
More than one out of four people 65 and older fall each year, and
over 3 million are treated in emergency departments annually for
fall injuries.
The CDC’s STEADI initiative offers a coordinated approach to
implementing the American and British Geriatrics Societies’ clinical
practice guideline for fall prevention. STEADI consists of three core
elements: Screen, Assess, and Intervene to reduce fall risk.
The STEADI Algorithm for Fall Risk Screening, Assessment, and
Intervention outlines how to implement these three elements.
Information about falls
Case studies
Conversation starters
Screening tools
Standardized gait and
balance assessment tests
(with instructional videos)
CDC’s STEADI tools and resources can help you screen, assess, and intervene to reduce
Educational materials for
providers, patients, and caregivers
Online continuing education
Information on medications
linked to falls
Clinical decision support for
electronic health record systems
Algorithm
for Fall Risk Screening, Assessment, and Intervention
RESOURCE
You play an
important role in
caring for older
adults, and you
can help reduce
these devastating
injuries.
Additional tools and resources include:
your patient’s fall risk. For more information, visit www.cdc.gov/steadi.
Stopping Elderly Accidents, 2019 Deaths & Injuries
STEADI Algorithm for Fall Risk Screening, Assessment, and Intervention among Community-Dwelling Adults 65 years and older
Available Fall Risk
Screening Tools:
START HERE SCREEN for fall risk yearly, or any time patient presents with an acute fall.
• Stay Independent: a 12-question tool [at risk if score 4]
Important: If score 4, ask if patient fell in the past year
(If YES patient is at risk)
• Three key questions for patients [at risk if YES to any question]
Feels unsteady when standing or walking?
Worries about falling?
Has fallen in past year?
If YES ask, “How many times?” “Were you injured?”
1
SCREENED NOT AT RISK SCREENED AT RISK
ASSESS patient’s modifiable
risk factors and fall history.
PREVENT future risk by recommending
effective prevention strategies.
• Educate patient on fall prevention
• Assess vitamin D intake
If deficient, recommend daily
vitamin D supplement
• Refer to community exercise or fall
prevention program
• Reassess yearly, or any time patient
presents with an acute fall
2
Common ways to assess fall risk
factors are listed below:
Measure orthostatic blood pressure
(Lying and standing positions)
Ask about potential home hazards
(e.g., throw rugs, slippery tub floor)
Identify medications that increase fall risk
(e.g., Beers Criteria)
Evaluate gait, strength, & balance
Common assessments:
• Timed Up & Go
• 30-Second Chair Stand
• 4-Stage
Balance Test
Check visual acuity
Common assessment tool:
• Snellen eye test
Assess vitamin D intake
Assess feet/footwear
Identify comorbidities
(e.g., depression, osteoporosis)
Centers for Disease
Control and Prevention
National Center for Injury
Prevention and Control
3 INTERVENE to reduce identified risk factors using effective strategies.
Poor gait, strength, & balance observed
• Refer for physical therapy
• Refer to evidence-based exercise or fall prevention program (e.g., Tai Chi)
Medication(s) likely to increase fall risk
• Optimize medications by stopping, switching, or reducing dosage of medications that increase fall risk
Reduce identified fall risk
• Discuss patient and provider health goals
Below are common interventions used to reduce fall risk:
• Develop an individualized patient care plan (see below)
Orthostatic hypotension observed
• Stop, switch, or reduce the dose of medications that
increase fall risk
• Educate about importance of exercises (e.g., foot pumps)
Home hazards likely
• Refer to occupational therapist to evaluate home safety
• Establish appropriate blood pressure goal
• Encourage adequate hydration
• Consider compression stockings
Visual impairment observed
Refer to ophthalmologist/optometrist
Stop, switch, or reduce the dose of medication
affecting vision (e.g., anticholinergics)
Consider benefits of cataract surgery
Provide education on depth perception
and single vs. multifocal lenses
Feet/footwear issues identified
Provide education on shoe fit, traction,
insoles, and heel height
Comorbidities documented
Optimize treatment of conditions identified
Vitamin D deficiency observed or likely
Recommend daily vitamin D supplement
Refer to podiatrist
Be mindful of medications that increase fall risk
FOLLOW UP with patient in 30-90 days.
Discuss ways to improve patient receptiveness to the care plan and address barrier(s)
