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Required Core Elements

Assess one point for each core element: “yes”.

Information may be gathered from medical record, assessment and if applicable, the patient/caregiver.
Beyond protocols listed below, scoring should be based on your clinical judgement.

POINTS

Age 55+
Diagnosis (3 or more co-existing)

Includes only documented medical diagnosis

Prior history of falls within 6 months

An unintentional change in position resulting in coming to rest on the ground or at a lower level

Incontinence

Inability to make it to the bathroom or commode in timely manner Includes frenquency,urgency , and/ or nocturia.

Visual Impairment

Includes but not limited to, mascular degenertaion,diabetec retinopathies,visual field loss,age related changes,decline in visual acuity,accomodation,glaretolerance, depth perception, and night vision or not wearing prescribed glasses or having the correct prescription.

Impaired functional Mobility

May include patients who need help with IADLS or ADLS or have gait or transfer problems,arthritis, pain, fear of falling, foot problems, impaired sensation, impaired coordination or improper use of assistive devices.

Environmental hazards

May include but not limited to, poor illumination, equipment tubing, inappropriate footwear,pets, hard to reach items, floor surfaces that are uneven or cluttered, or outdoor entry and exits.

Poly Pharmacy(4 or more prescriptions-any type)

All PRESCRIPTIONS including prescriptions for OTC meds.Drugs highly associated with fall risk include but not limited to, dedatives, anti-depressants, tranquilizers, narcotics,antihypertensives, cardiac mdes, corticosteroids, anti- anxiety drugs, anticholinergic drugs, and hypoglycemic drugs.

Pain affecting level of function

Pain often affects an individual's desire or ability to move or pain can be a factor in depression or compliance with safety recommensations.

Cognitive Impairment

Could include patients with dementia, Alzheimer's or stroke patients or patients who are confused, use poor judgement, have decreased comprehension, impulsivity, memory deficits.Consider patients ability to adhere to the plan of care.

A score of 4 or more is considered at risk of falling