Assessment and management of fall risk in primary care settings

Abstract

Falls among older adults are neither purely accidental nor inevitable; research has shown that many falls are preventable. Primary care providers play a key role in preventing falls. However, fall risk assessment and management is performed infrequently in primary care settings. This article provides an overview of a clinically relevant, evidence-based approach to fall risk screening and management. It describes resources, including the STEADI (Stopping Elderly Accidents, Deaths, and Injuries) tool kit that can help providers integrate fall prevention into their practice.

Keywords: Accidental falls; Aged; Community health services; Preventive health services/organization and administration; Primary prevention; Risk assessment and management; Secondary prevention; Wounds and injuries.

Fig. 1

Falls result from an interaction between factors in the individual (intrinsic) and the environment (extrinsic). ^a Factors that may be modifiable with intervention.

Fig. 2

STEADI (Stopping Elderly Accidents, Deaths, and Injuries) algorithm. ^a For patients who screen positive for falls but have no gait, strength, or balance problems, consider additional risk assessment (eg, medication review, cognitive screen, syncope). PT, physical therapist. (From Centers for Disease Control and Prevention. Algorithm for fall risk assessment & interventions. Available at: http://www.cdc.gov/homeandrecreationalsafety/pdf/steadi/algorithm_fall_risk_assessment.pdf. Accessed November 11, 2014.)