Community Falls Risk Assessment and Plan

Community Falls Risk Assessment and Plan

Surname: …………………………………………………..
Forename(s):……………………………………………………
Date of Birth: ______NHS No ______/ Team/Service/Locality

COMMUNITY FALLS RISK ASSESSMENT AND PLAN

Risk Factor / Yes / No
1 / History of Falls
Record how many falls in the last 12 months? ………………..
Do ANY of the following apply to the patient during the past 12 months?
  • Suffered a fragility fracture (a fragility fracture is defined as a fracture following a fall from standing height or less)
  • Attended A&E or admitted to hospital as a result of a fall
  • Seen by emergency paramedic but not taken to hospital following a fall

Suggested Actions: If patient consents a referral should be made to local Single Point of Access/Integrated Care Team where the referral can be triaged.
2 / Post Fall Coping Strategy
  • Does the patient have a method of summoning help should a fall occur at home e.g. mobile to hand or pendant alarm?
  • Is the patient able to get up from the floor independently?

Suggested Actions:
-Give advice on pendant alarms from local authority/Age UK and/or mobile phone
-Discuss coping strategies to get up from floor e.g. use of furniture to safely stand or advice to summon help, make self, comfortable and warm.
3 / Medication
  • Is the patient prescribed at risk medications related to falls e.g. anti-depressants, sedatives, opioid pain relief, diuretics?
  • Does the patient report any side effects due to medication taken? E.g. light-headedness, drowsiness
  • Is the patient concordant with medications prescribed e.g. pain relief?

Suggested Actions
-Check that the patient has had a medication review in the last 6 months. Refer for medication review if indicated in relation to falls and fracture risk.
-Check lying/standing blood pressure measurement
-Consider the impact of non-concordance on falls risk. Review with prescriber and advise accordingly.
4 / Footwear/Footcare
  • Check the condition of the patient’s foot and nails
  • Does the patient have any concerns maintaining their foot health?
  • Are there any observable or reported signs of pain and possible causes?
  • Is the person wearing appropriate footwear?

Suggested Actions
-Advise on routine foot care. Refer to podiatry for specific foot health/foot pain concerns
-Ensure suitable footwear available and worn.
5 / Continence / Hydration
  • Does the patient have any difficulties regarding urinary urgency? Consider day and night
  • Is a Urinary Tract Infection suspected?
  • Does the patient drink less than 5 cups of fluid a day?

Suggested Actions
-Consider referral to continence service for assessment if not known. Consider additional equipment/location of toilet
-Check of clinical signs & symptoms of infection. If suspected, MSU sample required to confirm. If patient unwell, consider treatment whilst waiting for sample result.
-If appropriate, encourage 6-8 cups of fluid per day & review reasons for poor fluid intake
6 / Vision/Hearing Impairment
  • Does the patient have any difficulties with blurring or misjudging distances?
  • Is the patient wearing clean & correct glasses?
  • Has the patient had their eyesight/health checked in the last 2 years?
  • Is the patient wearing their hearing aid and is working correctly?
  • Does the patient have difficulty with excess ear wax and/or a feeling of imbalance?

Suggested Actions
-Advise caution in new situations, poor lighting, and uneven surfaces.
-Advise free eye tests available every two years for 60-69 and yearly for 70 and over.
-Ensure appropriate eyewear worn and suitable
-If hearing aid not working or hearing assessment advised, refer to audiology (via GP or care co-ordinator if new problem)
-Discuss management of excess ear wax e.g. drops if symptoms persist, refer to GP/nurse
7 / Movement / Reduced Confidence
  • Observe balance in standing and when moving for signs of unsteadiness, muscle weakness and/or reduced confidence
  • Is the patient fearful of further falls/injury?
  • Are they reluctant to continue with activities in the home/go out in the community due to fear of falling?
  • Does the patient have any difficulties mobilising or with daily function related to pain?
  • If a walking aid is used, is it safe and appropriate? (height, ferrules, technique)

Suggested Actions
-Consider referral to local Single Point of Access/ Integrated Care team, suitability for strength and balance programme. Advise about safe movement.
-Walking aid – offer replacement or new provision as indicated and advice regarding safe technique and use.
8 / Environment
  • Does the patient have difficulties with any of the following: -
-Access in/out of the property e.g. door thresholds/steps
-Using the stairs in their home
-Completing daily activities e.g. bathing
  • Are there possible trip hazards around their home?

Suggested Actions
-Consider referral to local SPA/Integrated Care Team for equipment provision/therapy input.
-Advise safe movement and minimise potential hazards
Signature/Print Name
Date/Time completed

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FALLS PREVENTION & MANAGEMENT PLAN

PLAN
Consent: Does the person demonstrate an understanding of the problem / need? Yes □ No □
Does the person demonstrate an understanding (capacity) & agreement (consent) of the goals and plan? Yes □ No □
If no to either of the above, document reason(s) and action(s) taken (Including Mental Capacity Assessment):
Date/time / Identified Falls Risks / Initial
Date/
time / Goal
No / Longer Term InterventionsAgreed With Patient / Initial / Achieved Date
Date/
time / Goal No / Short Term Interventions agreed with patient / Initial / Date Goal Achieved / Initial

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