Understanding Fall Risk Assessment Scales
Fall risk scores are derived from specialized assessment tools used by healthcare professionals. These tools, such as the Morse Fall Scale (MFS) and the Johns Hopkins Fall Risk Assessment Tool (JHFRAT), evaluate a variety of factors to quantify a patient's likelihood of falling. Each tool uses a different scoring system and assigns risk levels—low, moderate, or high—based on the total points accumulated. A score of 6, therefore, must be understood within the context of the specific scale being used. While a 6 might be low on one scale, it could potentially be different on another, making it crucial to know which assessment was conducted.
The Morse Fall Scale (MFS) Explained
The Morse Fall Scale is one of the most widely recognized and used clinical tools for assessing fall risk, particularly in hospital and long-term care settings. It evaluates six key factors to determine a cumulative risk score, which can range from 0 to 125.
- History of Falling: A score of 25 is given if the patient has a history of falling within the past three months.
- Secondary Diagnoses: A score of 15 is given if the patient has more than one medical diagnosis.
- Ambulatory Aid: Points are assigned based on whether the patient uses an aid like a cane (15) or relies on furniture (30) for support.
- IV Therapy: The presence of an IV or saline lock adds 20 points.
- Gait: This assesses the patient's walking pattern, with scores for weak (10) or impaired (20) gait.
- Mental Status: A patient who forgets their limitations scores 15 points.
On the MFS, a score of 6 is very low, as just one factor like a history of falling would result in a score of 25. Therefore, a score of 6 on the MFS would be in the 'Low Risk' category, which is typically defined as 0-24 points.
Other Assessment Tools and What a Score of 6 Could Mean
While the MFS is common, other scales use different scoring metrics. For example:
- Johns Hopkins Fall Risk Assessment Tool (JHFRAT): This scale considers multiple variables including age, medication, mobility, and a history of falls. While it doesn't use a 0-10 scale, its risk categories are also low, medium, and high.
- Hendrich II Fall Risk Model: Used in acute care hospitals, a score of 5 or more indicates a high risk of falling. A score of 6 here would be considered high.
- Falls Risk Assessment Tool (FRAT): On one version of this scale, a score of 5-11 indicates a low risk.
This variety highlights the importance of asking a healthcare provider which specific tool was used and what the score means within its framework.
What a Low Risk Score (like 6) Implies
A low fall risk score, like 6 on the MFS, does not mean a person is immune to falling. It simply suggests fewer immediate, clinically identified risk factors were present at the time of assessment. Prevention is still crucial, as even low-risk individuals can experience falls due to unforeseen circumstances or progression of age-related issues. For those with a low score, standard preventative measures are recommended to maintain safety and continue monitoring for any changes in condition.
The Dangers of Neglecting Low Risk
Even with a low score, risk factors can change rapidly due to new medications, illness, or changes in mobility. A person's confidence from a low score could also lead to overconfidence, resulting in less caution and an increased likelihood of a fall. The goal of any fall risk assessment is not just to assign a number but to encourage a proactive approach to safety. By understanding the score, individuals can focus on preventative measures that reinforce their low-risk status.
Strategies for Fall Prevention, Regardless of Score
Prevention is a continuous process that is important for everyone, especially older adults. Here are some key strategies:
- Stay Physically Active: Regular exercise, particularly balance and strength training like Tai Chi, can significantly reduce fall risk.
- Review Medications: Some medications can cause dizziness, drowsiness, or affect balance. A yearly medication review with a doctor or pharmacist is crucial.
- Get Eyes and Feet Checked: Annual eye exams ensure vision changes don't contribute to falls. Seeing a podiatrist can address foot pain or other issues that affect balance.
- Make Your Home Safer: Simple modifications like removing trip hazards, improving lighting, and installing grab bars can make a big difference.
- Increase Vitamin D: Talk to a healthcare provider about potential Vitamin D deficiency, which can contribute to muscle weakness.
Proactive Steps for Any Score
No matter the score, a comprehensive fall prevention plan involves communication and action. Speaking with a doctor about any balance issues, dizziness, or near-falls is essential. For many, a physical therapist can create a customized exercise program to improve strength and balance. Organizations like the CDC's STEADI program provide resources for both individuals and healthcare providers to prevent falls. Their materials offer a wealth of information on screening, assessment, and intervention. Taking proactive steps can help maintain independence and reduce the fear of falling.
Conclusion: Beyond the Score
A 6 fall risk score, when understood in the proper context of the assessment tool used, typically signals a low risk. However, it is never a guarantee of future safety. It is a snapshot in time. The most important takeaway is not the number itself but the opportunity it provides for preventative action. By staying informed, communicating with healthcare providers, and implementing home safety and lifestyle changes, individuals can effectively manage their risk and promote healthy aging, regardless of their initial score.
