Observing Risk For Falls Fall History
P Previous falls or near-falls
A Activity at time of fall
T Trauma, physical, and psychological
Notes:
When obtaining a fall history and/or assessing for falls, the above information will be important. Asking the older person to tell you about the fall can provide the needed information. This information may help to determine the cause of the fall, specific risk factors, and any impairments the person may have developed that could have led to the fall.
Did the person experience any symptoms prior to the fall such as dizziness, or lightheadedness. Determine if any symptoms are new to the person. This may help to determine if the person is suffering from an acute illness, such as an infection.
Having a previous fall or near fall can increase the risk of falling. Knowing the location of the fall can help you identify any environmental factors in the home that may have contributed to the fall. (Has the furniture been rearranged, was the floor wet or was the walkway cluttered?) Knowing what activity the person was doing at the time of the fall could help to identify any underlying disease. For example, a fall while standing could indicate hypotension, or a fall while reaching for something may indicate a balance problem.
The time of the fall may help to determine the cause of the fall. A fall at night might be related to poor vision or poor lighting. If the fall occurred after taking medication, a reevaluation of the dosage, or timing of the medication may help to prevent further falls.
Evaluation of any injuries or trauma that occurred as a result of the fall such as bruises on one side of the body, fractures of the upper body or pressure sores may help to determine the cause of the fall. Addressing fears of future falling and resulting decrease in mobility should also be evaluated and discussed with the older adult. As we discussed earlier, fear of falling can lead to an increase in weakness and dependence on others to perform activities of daily living. Both of these can also lead to an increased risk of falling.