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Falls among older people cause significant mortality and morbidity, thus presenting a serious issue for older people and health and social care professionals alike. The simple occurrence of a fall conceals the range of physical, psychological, social and environmental factors, which can contribute to this event. Research advocates that professionals should engage with health promotion and develop individualised preventions in order to minimise risk of falling. In this study, a multi‐disciplinary, falls prevention initiative was developed with older people who had recently fallen. The initiative started with a common assessment but was followed by a variable, individualised programme of different interventions. The older people involved were assessed pre‐ and post‐intervention, using a questionnaire checklist, on several different dimensions associated with falling. Outcomes were assessed in terms of reduction in risk and the incidence of falls, both of which were found to be statistically significant in several of the identified dimensions post‐intervention. Consequently, it could be estimated that approximately 44 falls were prevented through this nine‐month initiative. This study would support the integration of this falls prevention initiative into routine community care practice through the existing over‐75 health check and the development of a specialised falls team. Further research would be beneficial to follow up whether the reduction in the incidence of falling is sustained over time. Enhanced participation of user, carer, voluntary and community partners is recommended as this would allow older people themselves to play an active role in improving their own well‐being and that of others.

The purpose of the study is to assess the usability and acceptability of FallCheck, a Web app that allows users to complete home-hazard assessments within their own home, with a group of people at risk of falling and their carers.

This mixed method study used an online survey followed by semi-structured telephone interviews to collect both qualitative and quantitative data. A Think-Aloud study was used to test usability of the Web app through structured tasks.

Findings showed that FallCheck was easy to use with few usability issues. The Web app was deemed appropriate to use by people at risk of falling (young or old) or by carers if appropriate. The depth of knowledge provision and breadth of content was acceptable, and many participants reported subsequently making changes to their home environment to reduce their risk of falling. Overall, the majority of participants reported feelings of improved confidence and safety with an increased awareness of fall risks and a reduction in fear of falling at home.

FallCheck has good acceptability and usability with people at risk of falling and their carers and has the potential to improve access to home-hazard assessment and affect behavioural change regarding fall risk hazards and behaviour.

This study describes successful use of an app that may be helpful in identifying home-hazards and making changes to reduce risk of falls, particularly in the absence of occupational therapy intervention and has the potential for integration into falls care pathways.

The purpose of this paper is to compare the ability of the Morse Fall Scale (MFS) and Farmer's fall-risk assessment tool (FFAT) to identify correlations between risk factors and falls among older adult long-term care (LTC) facility residents.

This was a correlational retrospective study. 200 medical records of older adults hospitalized in a LTC facility in central Israel, from January 2017 to January 2018, were examined.

Of all the residents, 75% and 99.5% of the residents were identified as having a high fall risk according to the MFS and FFAT, respectively. Only 12.5% of residents actually fell. MFS score was weakly correlated with actual falls (odds ratio = 1.035). It was also found that all fallers fell during their first week at the facility.

Future research should explore the ability of the tools to capture changes in the fall risk by repeat assessments, as this has not been examined in the present study.

The MFS and FFAT tool may have little value in assessing fall risk in older adult LTC facility residents. Therefore, nurses should perform a clinical evaluation of each individual patient. In addition, nurses should place a particular emphasis on fall risk and prevention during the first week following admission.

The findings of the present study raise doubts regarding the utility of the common practice of assessing fall risk in older adult LTC facility residents using the tools MFS and the FFAT, thus emphasizing the need to adopt a different approach.

Falling was distinguished as leading cause of fatal and non-fatal injuries among elderly; there is a lack of information regarding the falling risk factors in developing countries. The purpose of this paper is to investigate the falling risk and correlated factors in community-dwelling elderly.

This cross-sectional study was performed on 280 elderly using a multi-sectional questionnaire in Karaj, Iran. The simple stratified random sampling was used. Adult who were over the age of 60, living independently, able to ambulate independently and safely, no cognition problem and speaking in Persian entered in the study. Exclusion criteria were residing in assisted living facility or unwilling to participate. Several statistical tests including logistic regression analysis were used to analyse the data.

The mean age of participants was 69.55±8.82 and 51 per cent of them were female. The results showed that there are significant differences between low-, medium- and high-risk groups regarding age, marital status, diabetes, blood pressure and osteoarthritis (p<0.05). Due to finding, the main predictors to higher chance of falling were age (OR=1.61; 95% CI 1.025–1.097), marital status (OR=1.485; 95% CI 1.170–1.279), vision acuity (OR=1.603; 95% CI 1.297–2.223), activities of daily living (OR=2.10; 95% CI 1.047–3.859), heart disease (OR=1.448; 95% CI 1.268–1.728), osteoarthritis (OR=1.238; 95% CI 1.711–2.127), falling history (OR=1.026; 95% CI 1.015–1.089) and medication (OR=5.975; 95% CI 1.525–23.412).

Better understanding of falling risk factors can lead to the implementation of effective preventive intervention, thus reducing public health expenditure, and improving the quality of life.

This study was conducted for the first time to assess the risk of falling in older people in Iran.

Screening for fall risks is an important part of fall and fracture prevention. This study aims to investigate cross-sectional inter-instrumental agreement and participants’ preferences of the self-rated Falls Risk Questionnaire (FRQ) and Activities Specific Balance Confidence 6 items (ABC-6). This study also aimed to compare FRQ and ABC-6 scores in older adults with and without a history of falls.

Through an online and snowball sampling survey, 114 respondents were recruited from six countries. Respondents were asked to perform FRQ and ABC-6 surveys.

The mean respondent age was 67 years, and 44.8% reported falls in the past year. The mean of rescored FRQ and ABC-6 scores were 68.6% and 66.2%, respectively. The FRQ and ABC-6 scores for fallers were lower than non-fallers. Bland and Altman’s method indicated the mean −2.6 and two standard deviations 20.9 differences between ABC-6 and FRQ, which means an overall agreement between these tools. Most of the respondents, 36% had no preference between ABC-6 and FRQ, 34% preferred none, 21% preferred the ABC-6 and 9% preferred the FRQ for screening future falls risk.

Both ABC-6 and FRQ can distinguish between fallers and non-fallers, and findings of this study can be used to support the use of the FRQ for falls screening in older adults.

The purpose of this paper is to determine the association between patients who talked to their doctor about their risk of falling, or occurrence of balance problem. This study analyzed a secondary data set based on the Medicare Health Outcomes Survey (HOS) for the Medicare Advantage patients of 65 years and older. This study guided by two hypotheses that: patients who talked to their doctor about falling or balance problem are more likely to have fallen in the past than those who did not talk to their doctor about their fall risk; and patients talking to their doctor about a fall or balance problem are more likely to receive an early intervention such as patient education to prevent a future fall.

This study utilized a secondary data set to test its hypotheses. The Centers for Medicare and Medicaid Services (CMS) is dedicated to monitoring the quality of care provided to Medicare population in a managed care setting. Inter-University Consortium for Political and Social Research conducts the HOS to measure outcomes of quality improvement interventions developed by CMS in collaboration with the National Committee for Quality Assurance for Medicare Advantage Organizations (MAOs). The measures are focused on assessing the physical functioning and mental health being of Medicare beneficiaries and are aligned with reporting evidence of standards of care. Medicare HOS is administered in each Spring surveying a random sample of Medicare beneficiaries from MAOs that have a minimum of 500 enrollees; the cohort is surveyed again two years later as a follow-up measurement.

Reporting of a fall or balance problem is a critical component in fall prevention strategies. This study analyzed the distribution of beneficiaries who talked with their doctor about a fall or balance problem to understand if personal disposition (i.e. social class – educational level, gender, and race) would have been a factor in patients communicating with their doctor about their risk factors. The study found that 67.77 percent of patients who talked with their doctor about a fall or balance problem have at least a high school education compared with 32.23 percent who have less than a high school education or GED.

All patients who responded to the survey and fulfilled the inclusion criteria were included in the study. Therefore, the data presented a limitation due to a self-report of no doctor visits, which could indicate inopportunity for provider-patient communication to take place. Additionally, such an information on fall or balance problem, including actual fall occurrence in the past 12 months, was based on self-report that could present inaccuracy since the elderly population tend to have diminished or poor memory, which may also be problematic.

Although this specific interaction starts with patient reporting of a health problem such as a fall or balance problem, provider must take a proactive approach in deploying prevention strategies, such as to conduct a comprehensive fall-risk assessment regardless of a report of a fall history by the patient. Further investigation of this study is recommended to ascertain pre-dispositional factors that affect patient communication, in order to address any barriers that could impede patient-provider collaboration. Nonetheless, enhancing patient-provider communication is fundamental to any quality intervention strategies such as fall prevention.

Another key finding in this study is that patient communication facilitates fall prevention. Patients who talked to their doctor about their fall or gait problem were provided with patient education on how to prevent falls by their doctor. The provider is informed on patient’s balance problem, which leads to further evaluation of patient health status in order to identify other related factors since a comprehensive fall-risk assessment would have been likely conducted providing adequate information beyond the fall occurrence. This affirms the need for provider-patient communication to serve as catapult for effective care coordination, which is effectual in any intervention strategies.

Fall prevention is increasingly drawing attention and gaining momentum among healthcare organizations (including non-managed care) since falls and fall-related injuries are easily preventable (Lach et al., 2011). Efforts that can identify and accurately analyze patient health status, including intrinsic and extrinsic risk factors, promote effective interaction between patient and provider. This study has shown the positive effect of patient communication in order to allow doctors to effectively intervene (i.e. prevent a future fall) through the provision of patient education.

Falls are the most frequently reported adverse event in hospitalised patients and carry a risk of great harm for the frail elderly. This intervention aimed to prevent high‐risk in‐patients on an acute aged care ward from falling.

Patients assessed at high falls risk were accommodated in a room staffed by volunteer companion‐observers. The volunteers engaged them in conversation, played cards, opened meals and used the call bell to summon nurses if patients attempted to move from the bed or chair without assistance. Because of occupational health and safety considerations, the volunteers did not assist patients to ambulate.

The falls rate in the acute aged care ward decreased by 44 percent (p<0.000). No patients fell in the observation room when volunteers were present. Relatives of participating in‐patients expressed appreciation of the volunteer role, in terms of increased safety and also companionship. Volunteers exercised initiative in determining their pattern of work and developing resources to support their role.

Because volunteers are not present around the clock, other strategies are needed to prevent wandering, frequently confused older in‐patients from falling during the night.

In a context where frail elderly patients need constant supervision, using volunteers is a reasonable strategy.

This intervention used an inexpensive, human resources‐based approach to significantly reduce the incidence of falls in the population at highest risk of falling. The additional benefits to patients in terms of cognitive improvement bear further investigation.

Falls are a significant burden on the Australian health care budget and can result in loss of personal independence, injury or death. A sustained high rate of inpatient falls in a 550‐bed acute care hospital has made it imperative for nurses to identify patients at highest risk, in order to implement preventive interventions. This study examined the prevalence of “intrinsic high risk” characteristics identified by the literature in people who fell during hospitalisation, to confirm the validity of these predictors in detecting risk. Over ten weeks 91 inpatients fell (total 118 falls) and were assessed for intrinsic risk factors. Most prevalent was impaired ambulatory status resulting in balance instability. Other high prevalence factors included cognitive impairment and age > 75. Commonly cited factors, such as urinary or faecal incontinence, medications and history of prior falls, were found less frequently. No significant differences in risk factors by gender were identified.

The purpose of this paper is to document the need for implementing a fall prevention strategy in an emergency department (ED). The paper also spells out the research process that led to approving an assessment tool for use in hospital outpatient services.

The fall risk assessment tool was based on the Morse Fall Scale. Gender mix and age above 65 and 80 years were assessed on six risk assessment variables using χ² analyses. A logistic regression analysis and model were used to test predictor strength and relationships among variables.

In total, 5,371 (56.5 percent) geriatric outpatients were deemed to be at fall risk during the study. Women have a higher falls incidence in young and old age categories. Being on medications for patients above 80 years exposed both genders to equal fall risks. Regression analysis explained 73-98 percent of the variance in the six-variable tool.

Canadian quality and safe healthcare accreditation standards require that hospital staff develop and adhere to fall prevention policies. Anticipated physiological falls can be prevented by healthcare interventions, particularly with older people known to bear higher risk factors. An aging population is increasing healthcare volumes and medical challenges. Precautionary measures for patients with a vulnerable cognitive and physical status are essential for quality care.