Falls are the leading cause of injuries in elderly adults, even in senior living, yet it isn’t standard practice for senior living providers to ask their residents about accidental falls. With an older adult falling every second of every day, it’s essential to conduct fall risk assessments. Studies show assessment, treatment and follow-up can effectively reduce falls.

There are many factors that can increase fall risk. Assessing fall risk should include at a minimum:

  • History of accidental falls
  • Impaired gait or mobility
  • Visual impairment or dizziness
  • Chronic medical conditions such as diabetes, osteoporosis, arthritis or Parkinson’s disease
  • Medications associated with elderly falls
  • Orthostatic hypotension
  • Incontinence
  • Altered mental status or cognitive limitations
  • Foot problems/pain
  • Home fall hazards such as poor lighting, clutter and slippery floors
  • Use of assistive devices
  • Tethering to IV lines or other equipment

As part of a comprehensive fall risk assessment process, several important questions need to be asked:

  1. Have you had a fall in the past 12 months, or are you afraid you might fall?

Conducting a falls history is a standard part of fall risk assessments. Patients are more likely to fall if they have fallen in the past year. Once an older adult has a fall, they often become overly cautious and restrict their activities, which creates a cycle of increased fall risk. Even if there is no history of a fall in the past, a fear of falling can lead to inactivity and balance problems that increase the risk of falling.

With less than half of older adults telling their doctor if they fall, it’s important for health care providers to educate patients on what a defines a fall.  The World Health Organization defines a fall as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level.


If an older adult says they have fallen in the past year, it’s important to follow up with questions about:

  • The number of accidental falls
  • Circumstances surrounding the fall
  • Premonitory symptoms
  • Ability to get up after an elderly fall
  • Any injuries sustained
  • Any medical treatment received
  • Fear of falling again
  1. Have you had any loss of balance where you stumble or trip, even if you don’t fall down or get injured?

Many older adults think of an accidental fall as a significant event that causes injury. When asked if they’ve fallen or are afraid of falling, many underestimate their risk. They may not recognize that a near-fall is an important indicator of their level of functioning and that they can take steps to mitigate their fall risk.

It isn’t enough to ask if the resident has had a fall, many older adults will say they haven’t fallen because they didn’t tumble down the stairs and get injured. But they may have tripped over the dog or fallen into a wall and caught themselves. We have to get more specific because they don’t realize it’s an issue.

Asking questions and listening attentively are just part of fall prevention. We have to observe using all five senses, not just what is being told to us.  For example, how does the patient get up from the table? Talking to their family member or caregiver can also produce valuable insights.

  1. Have you stopped doing things you enjoy?

Many older adults don’t realize they’ve changed their routine to accommodate their fear of falling. As people age, they often stop doing things they love, even basic activities of daily living.

  1. What do you want to be able to accomplish?

It’s important for health care providers to prioritize each patient’s specific wants and needs. There’s an assumption that when you get old, you fall. This doesn’t have to be the case.  People are quick to limit older adults’ lives because it’s easier to tell them to always use a walker or avoid certain activities. What we need to ask is, ‘What do you want to be able to do?’ and set up a program to get them there.”

  1. What medications are you currently taking?

Medication review is a critical part of a fall risk assessment. Certain medications, such as blood pressure drugs, sedatives, antidepressants, antipsychotics and some pain relievers, can increase the risk of falls. If an older adult takes four or more medications a day, the side effects also can increase their fall risk. In some cases, lower doses or alternative medications may be necessary.


Senior Living providers can help reduce elderly falls by referring older adults to home health services.  Occupational Therapists for home modifications and physical therapists to treat balance and mobility problems.

Home health care is a valuable resource that can help with several evidence-based fall prevention strategies including:

  • Balance and strength exercises with a physical therapist
  • Environmental assessment and modification by an occupational therapist for safe functioning at home
  • Management of medications and chronic medical conditions with skilled nursing
  • Speech therapy to improve cognition, nutrition and hydration
  • Social work for counseling and support
  • Assistance with activities of daily living from home health aides


Falling doesn’t have to be part of aging. If you’re residents are afraid of falling, Aegis can help Senior Living residents rebuild confidence and preserve independence.


Call us today for information on our Senior Living Falls Prevention Program 480-219-4790

Download the following printable to see how our Home Health Care staff can assist you with preventing falls:
FallPrevention (1)

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