Falls Prevention

All older patients presenting to the ED should be routinely asked if they have fallen in the past year


  • Those considered at risk of falling should be observed for balance and gait deficits and considered for their ability to benefit from interventions to improve strength and balance. Tests of balance include:
    • Timed Up 'n Go (TUG)

Beware those who:

  • Have fallen more that once
  • More that 5 medications
  • Needed assistance to get up off floor

Consider referring recurrent fallers or high risk patients to the CREST or geriatric out patients. Multifactorial assessment may include:

  • identification of falls history
  • assessment of gait, balance and mobility, and muscle weakness
  • assessment of osteoporosis risk
  • assessment of the older person’s perceived functional ability and fear relating to falling
  • assessment of visual impairment
  • assessment of cognitive impairment and neurological examination
  • assessment of urinary incontinence
  • assessment of home hazards
  • cardiovascular examination and medication review


Falls Risk Factor Modification
Intrinsic Fall Risk factors Extrinsic Fall Risk factors
Previous fall/fear of falling Footwear or foot problems
Advanced age Home hazzards
Chronic conditions Improiperuse of assistive devices
Cognitive impairmenty Multifocal eyeglasses
CVS abnormalities New glasses prescription
Gait and balance problems Substance use
Orthostatic hypotension (measuring)
link to falls assessment print version

Content by Dr Íomhar O' Sullivan. Last review Dr ÍO13/01/23.