Let’s Prevent Falls! 

By Kathryn Stambaugh | Geriatric Services Director 

Thursday September 22 is Falls Prevention Awareness Day. This day is set aside for a reason. One-third of adults over age 65 and half of adults over age 80 fall each year. Forty percent of falls result in minor injuries and 10% result in major injuries. Even minor falls often lead to reduction in activity, isolation, and functional decline – all of which impact quality of life and increase the likelihood of future falls and nursing home placement. 

Common risk factors include previous falls, gait, and balance impairments, decreased muscle strength, vision impairment, four or more psychotropic meds, depression, orthostasis, being over 80 years old, cognitive impairment, and arthritis. The more risk factors, the greater the risk of falling. 

The good news: While falls are a major cause of morbidity and mortality among older adults, many falls are preventable. 

Most falls are the result of the cumulative effects of multiple impairments – not a single cause – so a multifactorial approach to fall prevention is key. The CDC has developed a tool called STEADI, which can be found here and in Epic’s screening tab.  

Here are some steps to take in clinic to address fall risk: 

  1. Ask patients if they have fallen or are afraid of falling. These evidence-based questions are prompted annually in Care Gaps for patients aged 65+. 
  1. If a patient reports a fall, get more information. What happened? Confirm a fall vs syncope. Check gait and balance using a tool such as the Timed Up and Go (which is available as a flowsheet in Epic and can be completed by a trained MA). 
  1. Share fall prevention resources with patients: 
    My Mobility Plan (Home Safety Checklist) 
    What You Can Do To Prevent Falls  
  1. For recurrent falls or a gait disturbance, complete a multifactorial fall assessment or refer to LifeLong’s Geriatrics consult service. 
    To request a Geriatrics consult, route a telephone encounter with any relevant background and your specific consult questions to pool “P SA185 Geriatric Consult Over 60” or directly to Michael Goldrich, MD.   
  1. Learn more about fall prevention! 
    Inservice by Dr. Mike Harper of UCSF (31-minute video of presentation to Over 60 team)  
    Mary Tinetti, MD, “The Patient Who Falls” (JAMA. 2010 Jan 20; 303(3):258-266) 

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