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The Critical Eldercare Fall Risk Assessment

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If you’re a primary care provider for an elderly family member, especially if you’re a long-distance caregiver, one of your greatest concerns is likely how to make sure that your loved one is safe on their own. Just like you, our skilled nursing team understands that older adults are the segment of the population at greatest risk of suffering a serious, and even life-threatening, injury from a fall.

Learn how to recognize risks in your loved one.

While every fall has a set of causes unique to each older adult, national healthcare professionals, like the National Patient Safety Foundation, have discovered a number of characteristics that are commonly found among elderly adults who are hospitalized for falls.

Cognitive impairment

Just as seniors who have trouble getting around can be at great risk of a fall, so to can seniors who aren’t at their sharpest.

Delirium, a sudden and severe confusion that can manifest in 3 ways:

  1. Hypoactive delirium where a senior is nonresponsive or lethargic
  2. Hyperactive delirium which presents with restlessness and agitation
  3. Mixed delirium sees seniors swinging back and forth between the 2 states


An older adult with depression can be more than 2 times as likely to suffer a fall than a senior who is not battling depression. If your loved one is suffering from undiagnosed depression, they may be at serious risk. The next time you visit, look for these 5 signs that may indicate you loved one is living with untreated depression:

  1. Prolonged feelings of helplessness, hopelessness, or being overwhelmed
  2. Tearfulness or, alternatively, a lack of emotion
  3. Loss of interest in life events
  4. Melancholic mood
  5. Withdrawal
Dementia or other conditions that slow cognitive processing

History of previous falls

Eldercare experts agree that an older adult’s history of prior falls is one of the best criteria for predicting the likelihood of a future falls. Research has shown that a senior who has suffered a fall can be as much as 3 times more likely to suffer fall in the subsequent year.

Impaired mobility

It’s no surprise that seniors who have problems getting around on their own are at a higher risk for falls. Any number of physical impairments can contribute to falls and fall-related injuries:

  • Muscle weakness
  • Decreased gait speed
  • Decreased stride length
  • Use of assistive devices
  • Arthritis

With the cooperation of your loved one, you can perform and in home assessment their mobility with the Timed Up and Go (TUG) test.

  1. Observe patient rise from a chair, ambulate three meters, turn, return to the chair, and sit
  2. Greater than 14 seconds predicts falls (sensitivity and specificity greater than 87%)

Special toileting needs

Any circumstance that can cause a senior to hurry, and thus be less careful of their footing, can be a risk factor for falling— such as toileting-related concerns like:

  • Incontinence
  • Urinary frequency
  • Diarrhea

Seniors with similar health issues can see an increase of 2.4 in their chances of suffering a fall.

Other contributing factors

Advanced age

1 in 3 adults over age 65 will suffer a fall ever year, and, according to the CDC, the risk goes up with age. Older adults who have hit the 75 year milestone are up to 4 times more likely to suffer a serious fall than a younger senior.


There are a number of different medicines that, either by themselves or in combination with other medicates, that can significantly increase a senior’s risk to fall, such as:

Take the first step toward prevention.

As a caregiver, it’s important to take steps to prevent injury if your loved one is at risk for a fall. Sit down with your loved one’s eldercare or primary care physician to schedule an official risk assessment and create a personalized fall prevention plan.

Bryan Reynolds
November 19, 2013
Bryan Reynolds is the Vice President of Marketing and Public Relations for Episcopal Retirement Services (ERS). Bryan is responsible for developing and implementing ERS' digital marketing strategy, and overseeing the website, social media outlets, audio and video content and online advertising. After originally attending The Ohio State University, he graduated from the College-Conservatory of Music at the University of Cincinnati, where he earned a Bachelor of fine arts focused on electronic media. Bryan loves to share his passion for technology by assisting older adults with their computer and mobile devices. He has taught several classes within ERS communities as well as at the Osher Lifelong Learning Institute run by the University of Cincinnati. He also participates on the Technology Team at ERS to help provide direction. Bryan and his wife Krista currently reside in Lebanon, Ohio with their 5 children.

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