Falls in elderly people: is the risk suitably assessed?

Abstract

Results of the annual screening of people over the age of 75 years were used to determine whether the risk of falling in this age group is adequately assessed. The study group comprised primary healthcare professionals employed within six counties throughout England and Wales. Three per cent of respondents indicated that they use formal risk assessment tools when undertaking screening of people over 75 years. Analysis of the answers provided by these respondents, and of their assessment tools used, indicates that none of the tools are suitable for identifying those people at risk of falling within the home environment. Ninety-seven per cent of respondents indicated that they did not use a formal risk assessment tool for this age group. Analysis of the data provided by these respondents identified that the information gathered did suitably identify those people at risk of falling within the home.

Home‐Screen: A Short Scale to Measure Fall Risk in the Home

“…This study sought to develop and test a short screening tool that could be used by community nurses to assess home environments and home behavior that may constitute a risk for falls. This research fills a gap in the nursing literature (Willis, 1998). The Home‐screen was designed to prompt nurses to act on these risks through referral to specialist services such as occupational therapy and targeted nursing interventions to reduce the hazard.…”

“…A short screening tool that assesses home safety and home safe behavior in community‐living older people has been developed and found to be both valid and reliable. Previously, the lack of appropriate community nursing tools in the area was a problem, and may have contributed to the high number of nurses who did not use an instrument of any kind to assess this fall risk (Willis, 1998). The Home‐screen scale could easily be incorporated in the initial assessment of a client as it is short, requires no special training, and relies upon knowledge gained through routine practice with the client in the home.…”

“…Community nurses are often the health professionals with whom older people living at home have most contact. A recent study in the United Kingdom by Willis (1998) identified that district nurses were the most likely group of professionals to screen older people (75 years and older) for the risk of falling. But what instruments do these nurses use to assess risk?…”

“…Willis surveyed health centers or individual practitioners in six counties in England and Wales and found that 97% of the respondents did not use a tool. When tools were used, however, they were found to be unsuitable for assessing risk of falling within the home environment (Willis, 1998). A similar situation exists in Australia and possibly in other countries.…”

“…(Lange, 1996;Mann et al, 1996). Although programs to increase functionality, strength, and balance have met with A recent study in the United Kingdom by Willis (1998) identified that district nurses were the most likely group varying success (Wolter & Studenski, 1996), most intrinsic factors ''are multidimensional and not readily amenable to of professionals to screen older people (75 years and older) for the risk of falling. But what instruments do these nurses change'' (Fortin, Yeaw, Campbell, & Jameson, 1998, p. 628).…”