Are You at Risk for Falling?

Have you ever wondered what your risk for falling is?  Are you concerned about a loved one falling?
There are several different fall risk assessments and tools healthcare professionals utilize to determine someone’s risk for falling.  One that we use often in home health care is the MACH (Missouri Alliance for Home Care) 10 Fall Risk Assessment Tool.  This tool has been validated for community-dwelling elders.

The MACH 10 Fall Risk Assessment Tool incorporates ten core elements to assess falls risk.

1.  Are you 65 years or older?     Yes __1__   No__0__
 Fall facts from the CDC (Centers for Disease Control and Prevention)
• One-third of people 65 and older fall each year.
• 1 out of 5 falls causes a serious injury such as a head trauma or fracture.
• Over 2 million older adults are treated in emergency departments for nonfatal fall injuries each year.
2.  Do you have 3 or more co-existing documented medical diagnosis?     Yes __1__   No__0__
To answer this question correctly, include only those diagnoses that have been documented by a physician.  There are certain chronic conditions that are associated with falls including arthritis, diabetes, stroke, Parkinson’s, incontinence, and dementia; however, the diagnoses for this question are not limited to these chronic conditions.
3.  Have you had a fall within the last 3 months?     Yes __1__   No__0__
Two-thirds of elderly who fall will fall again in 6 months.  So please inform your health care provider of any falls so they can help you prevent a future fall.
Did you know that people define falls differently.    A fall is not just an event where you end up on the floor with an injury or when you can’t get yourself up.  A fall is any unintentional change in position resulting in coming to rest on the ground or at a lower level.  This includes a fall onto a chair, into the wall, or onto a bed.
4.  Are you incontinent?      Yes __1__   No__0__
Do you have trouble making it to the bathroom on time? This includes urinary frequency and urgency.  Falls happen when people are rushing to get to the bathroom.  When people get up in a hurry, they often forget their walking device or use it incorrectly.  Flooring also plays a role.  Usually there is a transition from carpeted surface to linoleum or tile in the bathroom which poses a hazard,  especially if the person is wearing only socks on their feet.
5.  Do you have any visual impairment?     Yes __1__   No__0__
People with vision impairments are more than twice as likely to fall as people without visual impairments.  Objects that are not seen cannot be avoided.  Vision is one of the sensory inputs that contribute to one’s balance.   Yearly vision checks by an eye doctor are recommended as part of a falls prevention program.
6.  Is your functional mobility impaired?     Yes __1__   No__0__
A person who has a functional mobility impairment may include those who need help getting bathed or dressed, need help preparing meals, or have difficulty walking.  They may have impaired sensation, foot problems, arthritis, pain, impaired coordination, or fear of falling.
7.  Are there environmental hazards that are putting your safety at risk?     Yes __1__   No__0__
This includes clutter, throw rugs, cords, poor illumination, inappropriate footwear, pets, and hard to reach items.  Please refer to a previous blog “Home Safety 101” to decrease the risk of environmental hazards in your home.
clutter and Daisy1
8.  Are you taking 4 or more prescriptions medications—any type?     Yes __1__   No__0__
This includes all prescriptions even prescriptions for over the counter medications.  There are certain drugs that are associated with a higher falls risk including sedatives, anti-depressants, tranquilizers, narcotics, anti-hypertensives, anti-anxiety drugs, anti-cholinergic drugs and hypoglycemic drugs.  If you are on any of these medications it does not mean you have to stop them to decrease your falls risk.  It does mean you should discuss these medications with your doctor and if there are any precautions you need to take.
9.  Do you have pain that is affecting your level of function?     Yes __1__   No__0__
Pain usually alters the way you move and may affect your balance.  Someone who has pain is more likely to be afraid to move leading to a sedentary life.  Inactivity leads to de-conditioning and weakness which also contributes to your falls risk.
10.  Do you have a cognitive impairment?     Yes __1__   No__0__
Cognitive impairments include dementia, Alzheimer’s, or other memory deficits.   This question also includes those who use poor judgment.  Sometimes when we get older, we don’t like to admit that we cannot do things like we could when we were younger.  If you are unsteady walking and you continue to climb up that ladder to get on the roof or on that step stool to reach something on the top shelf, you are placing yourself at risk for falling.
A score of 4 or more is considered at risk for falling for community dwelling elderly.
* Remember for this tool to be valid and accurate the MACH 10 Fall Risk Assessment needs to be performed by a trained professional.
But if you completed this tool on your own for you or a loved one and scored a 4 or more you need to discuss your falls risk with your healthcare provider.
The good news is that you can take action to decrease the risk for falls.
  • You can increase your home safety by eliminating environmental hazards.
  • If your walking or balance is impaired, discuss with your doctor the best interventions for you.  Physical and occupational therapists have special training to help improve your mobility and balance.
  • Perform a thorough medication review with your doctor including all prescription medications, over the counter medications, and supplements.
  • If you are starting to become more forgetful, there are interventions you can do to help improve your memory.  Occupational and speech therapists can assist with memory training.
Please don’t believe the myth that you are too “old” to change or that falls are “just a part of getting older”.  You have the power to advocate for yourself and prevent a fall or injury.
Happy Day!  Here’s to Keeping you Upright and Safe!

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