Key priorities for implementation

The following recommendations have been identified as priorities for implementation.

Preventing falls in older people

  • Older people in contact with healthcare professionals should be asked routinely whether they have fallen in the past year and asked about the frequency, context and characteristics of the fall/s. [2004]

  • Older people who present for medical attention because of a fall, or report recurrent falls in the past year, or demonstrate abnormalities of gait and/or balance should be offered a multifactorial falls risk assessment. This assessment should be performed by a healthcare professional with appropriate skills and experience, normally in the setting of a specialist falls service. This assessment should be part of an individualised, multifactorial intervention. [2004]

Preventing falls in older people during a hospital stay

  • Regard the following groups of inpatients as being at risk of falling in hospital and manage their care according to recommendations to

    • all patients aged 65 years or older

    • patients aged 50 to 64 years who are judged by a clinician to be at higher risk of falling because of an underlying condition. [new 2013]

  • For patients at risk of falling in hospital (see recommendation, consider a multifactorial assessment and a multifactorial intervention. [new 2013]

  • Ensure that any multifactorial assessment identifies the patient's individual risk factors for falling in hospital that can be treated, improved or managed during their expected stay. These may include:

    • cognitive impairment

    • continence problems

    • falls history, including causes and consequences (such as injury and fear of falling)

    • footwear that is unsuitable or missing

    • health problems that may increase their risk of falling

    • medication

    • postural instability, mobility problems and/or balance problems

    • syncope syndrome

    • visual impairment. [new 2013]

  • National Institute for Health and Care Excellence (NICE)