What is the fall risk assessment called? A comprehensive guide to common tools

Over one in four older adults experiences a fall each year, underscoring the critical need for preventive measures and screening. To identify those most at risk, healthcare professionals use a structured evaluation, and understanding what is the fall risk assessment called is the first step toward proactive safety.

Quick Summary

Fall risk assessments are not a single test but a collection of standardized screening tools, each with a different name, used to evaluate an individual's likelihood of falling. Common examples include the Morse Fall Scale, the Timed Up and Go (TUG) test, and the Berg Balance Scale.

Key Points

• Not a Single Test: Fall risk assessment is a category of evaluations, not a single test. The name depends on the specific tool used by the healthcare provider.

• Common Tools: Widely used assessments include the Morse Fall Scale (for acute care), the Timed Up and Go (TUG) Test (for mobility), and the Berg Balance Scale (for balance).

• Multiple Factors: Assessments consider various factors like a history of falls, medications, balance, gait, mental status, and environmental hazards to create a complete risk profile.

• STEADI Initiative: The CDC's STEADI program is a comprehensive approach that includes a simple three-question screening to identify at-risk individuals and guide further action.

• Leads to Intervention: The assessment results guide the creation of a personalized fall prevention plan, which may include physical therapy, medication review, and home modifications.

• Promotes Independence: Proactively identifying and managing fall risks is a critical component of healthy aging, helping older adults maintain mobility and independence.

Understanding the Purpose of Fall Risk Assessments

While many people believe falls are an inevitable part of aging, they are often preventable. Fall risk assessments are standardized evaluations designed to identify an individual's specific risk factors for falling, allowing healthcare providers and caregivers to implement targeted interventions. This proactive approach is crucial for promoting safety, maintaining independence, and preventing the serious injuries that can result from falls, such as fractures or head trauma. Assessments can take place in various settings, from a doctor's office and hospital to a patient's own home, with the goal of identifying weaknesses, balance issues, and environmental hazards before an accident occurs.

Common Names for Fall Risk Assessment Tools

There is no single universal test for fall risk, but rather a toolbox of validated assessments used depending on the patient's condition and the clinical setting. These tools often focus on different aspects of mobility, strength, and cognitive function.

The Morse Fall Scale (MFS)

This is one of the most widely used fall risk assessment tools, particularly in acute care and hospital settings. The MFS is quick and simple to administer, scoring six variables to determine a patient's risk level. The factors include:

• History of falling
• Presence of a secondary diagnosis
• Use of ambulatory aids
• Intravenous (IV) therapy
• Gait
• Mental status

Scores are tallied to classify patients into low, medium, or high-risk categories, guiding staff on the level of fall prevention interventions needed.

The Timed Up and Go (TUG) Test

The TUG test is a simple and quick assessment of an individual's functional mobility and balance. The patient is timed as they rise from a chair, walk 10 feet, turn around, walk back to the chair, and sit down. A longer completion time, often 12 seconds or more for community-dwelling older adults, indicates a higher risk of falling. It provides valuable insight into gait, balance, and overall stability.

The Berg Balance Scale (BBS)

Unlike the TUG, the BBS is a more detailed assessment that measures an individual's static and dynamic balance through 14 different tasks. These tasks include standing unaided, transferring between chairs, and reaching forward while standing. Each task is scored, with a maximum total score of 56. A lower score indicates greater fall risk. The BBS takes more time but provides a more granular look at a person's balance abilities.

The Hendrich II Fall Risk Model

Specifically designed for the acute care setting, the Hendrich II model is another validated tool for identifying fall risk. It is notable for its inclusion of 'risky' medication categories as a key factor. Other variables considered include:

• Confusion/disorientation
• Depression
• Dizziness/vertigo
• Gender
• Symptomatic hypotension
• Use of anticonvulsants

CDC's STEADI Initiative

The Centers for Disease Control and Prevention (CDC) promotes a comprehensive approach to fall prevention called STEADI (Stopping Elderly Accidents, Deaths & Injuries). This initiative includes an initial screening tool with three key questions:

1. Have you fallen in the past year?
2. Do you feel unsteady when standing or walking?
3. Do you worry about falling?

A positive answer to any of these questions triggers a more comprehensive assessment. Additional clinical tests like the 30-Second Chair Stand and the Four Stage Balance Test are also part of the STEADI protocol.

Putting an Assessment into Action

Conducting a fall risk assessment is only the first step. The true value lies in using the results to create a personalized, multi-component intervention plan. This may involve a combination of strategies tailored to the individual's specific risk factors.

Common interventions based on assessment results:

• Physical Therapy: Exercises to improve strength, balance, and gait.
• Medication Review: Optimizing or adjusting medications that cause drowsiness, dizziness, or confusion.
• Home Modifications: Installing grab bars, improving lighting, removing trip hazards like loose rugs.
• Assistive Devices: Recommending and training on the proper use of canes or walkers.
• Vision Check: Correcting vision issues that impair depth perception.
• Patient Education: Discussing risk factors and prevention strategies with the individual and their family.

For more detailed, evidence-based guidance on fall prevention strategies, a valuable resource is the Centers for Disease Control and Prevention's STEADI initiative, which provides a wealth of tools and information for both healthcare providers and the public.

Comparison of Common Fall Risk Assessment Tools

Feature	Morse Fall Scale (MFS)	Timed Up and Go (TUG)	Berg Balance Scale (BBS)
Primary Setting	Acute care, hospital	Community, clinic	Clinic, therapy setting
Primary Focus	General risk factors	Functional mobility, gait	Static & dynamic balance
Equipment Needed	Assessment form	Stopwatch, chair, tape measure	Stopwatch, chair, various props
Time Required	Quick (typically <3 min)	Very quick	Longer (15-20 min)
Key Outcome	Risk score (low, med, high)	Time taken to complete	Total score out of 56

Conclusion: A Proactive Approach to Safety

Understanding what is the fall risk assessment called is an important step towards better senior care. By recognizing that different assessments exist for different purposes, individuals and caregivers can have more informed conversations with healthcare providers. The use of validated tools allows for a systematic and objective evaluation of risk, replacing guesswork with data-driven action plans. Ultimately, this approach empowers older adults to take control of their health, minimize risks, and enjoy greater independence and safety as they age.

Frequently Asked Questions

What is the most common fall risk assessment used in hospitals?

The Morse Fall Scale (MFS) is one of the most common assessments used in hospital settings. It is a quick tool that scores six key variables to determine a patient's risk level, guiding staff on the appropriate interventions.

What is the Timed Up and Go test?

The Timed Up and Go (TUG) test is a quick assessment of functional mobility. The patient is timed as they stand up, walk a short distance, turn, and sit back down. A longer time to complete the task can indicate a higher fall risk.

What factors are included in a fall risk assessment?

A comprehensive assessment considers factors such as a history of falls, current medications, balance and gait, muscle strength, vision, and any known cognitive impairments. Environmental hazards in the home may also be evaluated.

Who performs fall risk assessments?

Fall risk assessments are performed by various healthcare professionals, including nurses, primary care physicians, physical therapists, and occupational therapists.

How can I reduce my risk of falling?

Prevention strategies include engaging in regular balance and strength exercises (like Tai Chi), reviewing medications with a doctor, correcting vision problems, and making safety modifications to your home, such as installing grab bars and removing tripping hazards.

What is the STEADI initiative from the CDC?

STEADI is the CDC's comprehensive initiative for fall prevention, which stands for "Stopping Elderly Accidents, Deaths & Injuries." It offers a coordinated approach for healthcare providers to screen, assess, and intervene to reduce fall risk.

Does Medicare cover fall risk screenings?

Yes, fall risk screenings are often included as part of the Medicare Annual Wellness Visit, allowing providers to discuss prevention strategies with older patients.