- Checking environmental issues and assessing each patient for fall risk can reduce the incidence of falls at home, in extended-care facilities, and in the hospital.
- History of recent falls: Patients with a history of recent falls are at highest risk for recurrent falls, and asking about this at the time of admission can identify these patients.
- Postural hypotension: Patients should also be evaluated for postural hypotension, as this can be a contributor to falls, especially after prolonged bed rest.
- Vitamin D levels / Supplementation: Although it is a long-term preventive measure, adequate intake of vitamin D has been shown to prevent falls (SOR B).
- Psychoactive medications should be decreased or stopped to prevent falls in hospitalized patients.
- Inappropriate footwear can also be a significant contributor to falls, and
- Balance, gait, and strength training have been shown to decrease fall risks (SOR A). While beneficial otherwise, aerobic exercises have not been shown to be effective for decreasing fall risks (SOR A).
- Instructing demented patients about fall prevention has been shown to be INEFFECTIVE due to their limited understanding (SOR C).
USPSTF Recommendations
The USPSTF recommends exercise or physical therapy to prevent falls in community-dwelling adults age 65 years and older who are at increased risk for falls.
The USPSTF recommends vitamin D supplementation to prevent falls in community-dwelling adults age 65 years and older who are at increased risk for falls.
Resources
Click to access JAGS.Falls.Guidelines.pdf
https://www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-recommendations/