[AndreaMichael]

We want to obtain some critical evaluation of the use of Risk Assessment Tools for predicting falls in the elderly? We have a rehab unit which mostly has over 65's. Does anyone have experience with a tool that reasonably accurately predicts the liklihood of falls so prevention strategies might be implemented??

[sue_rehn]

Originally posted by AndreaMichael:
We want to obtain some critical evaluation of the use of Risk Assessment Tools for predicting falls in the elderly? We have a rehab unit which mostly has over 65's. Does anyone have experience with a tool that reasonably accurately predicts the liklihood of falls so prevention strategies might be implemented??

Here is some information you may be able to use. I found it while looking for Safety resources for the elders.
"
Falls in Older Persons: Prevention and Management by Rein Tideiksaar (Baltimore, Md.: Health Professions Press, 1998). Aimed at institutionally based healthcare professionals, this book offers an introduction to falls, describes prevention and management approaches and provides a comprehensive bibliography of recent research.

Preventing Patient Falls by Janice E. Morse (Thousand Oaks, Calif.: SAGE Publications, 1996), designed for nurses, other clinicians and health-facility administrators, includes the Morse Fall Scale for gauging risk of falls.

Balance Testing in Older Adults (Fall Prevention Project, Temple University, Philadelphia). This video and accompanying manual introduces three balance tests used by healthcare professionals to detect fall risks, reduce falls and provide rehabilitation for older adults. Also available are the Fall Prevention Program Manual on developing presentations on fall prevention for older adults, and the consumer-orientated brochures "In-Home Safety Check" and "Check It Out," available in nine languages. Contact Roberta A. Newton at (215) 707-4897; e-mail: rnewton@thunder.temple.edu; website: http://www.temple.edu/older_adult.

Remembering When: A Fire and Fall Prevention Program for Older Adults (Quincy, Mass.: National Fire Protection Association Center for High-Risk Outreach, 1999). Developed in cooperation with the Centers for Disease Control and Prevention, Atlanta, Ga., this manual contains materials such as a trivia game; a home safety checklist; and cards for overhead transparencies that can be used to conduct prevention presentations. Contact the National Fire Protection Association, 1 Batterymarch Park, Quincy, MA 02269. "
Hope it helps
sue-rehn

[salmi]

Hi guys, we use this tool in our Hospital. I hope it will help. It needs some corrections, comments are most welcomed.

Risk Factors & scores:

1.Medications
. Two or more. [Score 2]
. One drug.[Score 1]
. Recent change in medication. [Score 1]
2.Activity/Mobility.
. Confined to chair. [Score 3]
. Visual impairment.[Score 1]
. Gait disorders. [Score 1]
. Balance disorders. [Score 1]
3.Elimination
. Independent & incontinent. [Score 5]
. Needs help.[Score 3]
4.Previous falls.
. 1-2 falls. [Score 2]
. 3 or more. [Score 5]
5.Length of stay.
. 0-2 days. [Score 2]
. More than 3 day. [Score 0]
6.Mental status.
. Confused / Disoriented. [Score 2]
. Confused sometimes. [Score 5]
7.Age.
. 70+ [Score 1]. .
. 60-70 yrs. [Score 2]


If patient scores 10 or more He/She should be deemed to be in the “ High Risk” category.

[moonshadeau]

something with your post salmi is that I could never figure out why someone who was between 60 and 70 would trigger a higher score than someone who is 70+. Any one know the theory on that?

[salmi]

Its maybe because after 70 yrs of age patient will move less than the one 60-70 of age. Some of them will be confined to bed. In our country the average age is 70 years. I think that’s why…

[debbyed]

We use a scale pretty much like the one Salmi posted. It's pretty accurate.

[salmi]

debbyed can you post the scale you are useing?

[moonshadeau]

There are many 80-90 year old that move faster than I do. My grandfather is 76 years old and still plays spike volleyball with the 30 year olds 5 times a week. I just don't think that is much of a trigger.

The scale that we use

Medications in listed category >2 (2)points
hypoglycemics, anti-hypertensives,sedatives,diuretics,etc

History of fall in last 6 months (1) point

Drainage device (1)point

Unsteady gait (1)

incontinence? this last one I am drawing a blank


This is the scale that we use at my hospital, I am not saying that this one is any better than any other.

[debbyed]

That will take awhile. I am currently enjoying a much needed vacation. I'll try to remember to pick up a copy when I return.

[Cubby]

IT IS TACKY FOR SURE, BUT WITH MANY YEARS IN LONG TERM CARE THE ONE AXIOM I HAVE TAKEN AS MY OWN CAME FROM THE BOOK "THE HOUSE OF GOD" 'GOMERS GO TO GROUND.'
I HAVE CAME UP WITH NEW INNOVATIVE IDEAS TO KEEP MY GERIATRIC POPULATION SAFE,AND SOMETIMES IT WORKS-FOR A DAY OR TWO. NO MATTER WHAT YOU TRY "GOMERS GO TO GROUND."