Authors' objectives:

This report aims to provide guidelines on the assessment and prevention of falls in older people.

Authors' recommendations: Case/risk identification - 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. - Older people reporting a fall or 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 and gait commonly used in the UK are detailed in the full guideline.) Multifactorial falls risk assessment - 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 healthcare professionals with appropriate skills and experience, normally in the setting of a specialist falls service. This assessment should be part of an individualised, multifactorial intervention. Multifactorial assessment may include the following: - identification of falls history - assessment of gait, balance and mobility, and muscle weakness - assessment of osteoporosis risk - assessment of the older persons 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. Multifactorial interventions - All older people with recurrent falls or assessed as being at increased risk of falling should be considered for an individualised multifactorial intervention. - In successful multifactorial intervention programmes the following specific components are common (against a background of the general diagnosis and management of causes and recognised risk factors): - strength and balance training - home hazard assessment and intervention - vision assessment and referral - medication review with modification/withdrawal. - Following treatment for an injurious fall, older people should be offered a multidisciplinary assessment to identify and address future risk, and individualised intervention aimed at promoting independence and improving physical and psychological function. Encouraging the participation of older people in falls prevention programmes including education and information giving - Individuals at risk of falling, and their carers, should be offered information orally and in writing about what measures they can take to prevent further falls. Professional education - All healthcare professionals dealing with patients known to be at risk of falling should develop and maintain basic professional competence in falls assessment and prevention.

Authors' methods: Clinical guideline

Project Status: Completed

URL for project: http://www.nice.org.uk/page.aspx?o=233391

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: National Institute for Clinical Excellence

Contact Address: MidCity Place, 71 High Holborn, London WC1V 6NA, UK. Tel: +44 020 7067 5800; Fax: +44 020 7067 5801

Contact Name: nice@nice.nhs.uk

Contact Email: nice@nice.nhs.uk

Copyright: National Institute for Clinical Excellence (NICE)