What is the fall risk scale called? An overview of assessment tools

According to the Centers for Disease Control and Prevention, three million older adults are treated in emergency departments for fall-related injuries each year. For caregivers and health professionals, knowing what is the fall risk scale called is the first step in a multi-faceted approach to preventing these dangerous incidents and ensuring senior safety.

Quick Summary

Numerous tools are used by healthcare professionals to assess a person's likelihood of falling, with no single universal scale. Common examples include the Morse Fall Scale, Berg Balance Scale, and the Timed Up and Go Test, each evaluating different aspects of mobility and balance to inform fall prevention strategies.

Key Points

• No Single Scale: There is no one specific scale called "the" fall risk scale; instead, multiple validated assessment tools are used, including the Morse Fall Scale, Berg Balance Scale, and Timed Up and Go (TUG) test.

• Morse Fall Scale (MFS): One of the most common tools, especially in inpatient settings, it uses a checklist to assess factors like fall history, gait, and mental status to determine a patient's risk level.

• Performance-Based Assessments: Scales like the Berg Balance Scale and the Timed Up and Go test are performance-based, measuring an individual's balance and functional mobility through specific, timed tasks.

• Multidimensional Approach: Comprehensive fall prevention relies on using assessment scores to inform personalized interventions, addressing a variety of risk factors beyond just mobility.

• Professional Guidance: While basic screening can be done, these scales are most effectively administered and interpreted by trained healthcare professionals to create a safe and effective prevention plan.

• Regular Monitoring: Fall risk can change over time due to health shifts or environmental changes, so ongoing assessment is vital for maintaining a senior's safety.

The Importance of Comprehensive Fall Risk Assessment

For the elderly, falls represent a significant threat to health, independence, and quality of life. The question of what is the fall risk scale called is complex because healthcare professionals use a variety of assessment tools rather than just one. These scales help to objectively measure a person's risk and identify the specific factors contributing to their instability, allowing for the implementation of targeted interventions. While an initial screening may be conducted upon admission to a hospital or care facility, a comprehensive assessment often includes detailed medical history, physical examinations, and functional evaluations. By taking a holistic view, healthcare providers can develop a personalized and proactive fall prevention plan.

The Multifaceted Nature of Fall Risk

Fall risk is rarely attributable to a single cause but is instead a complex interplay of physical, environmental, and medical factors. An effective assessment must consider this multidimensional nature to be truly comprehensive. While specific assessment scales focus on different variables, all aim to uncover the underlying issues that increase a person's vulnerability to falls.

Common Risk Factors Assessed:

• History of falls: Previous falls are a strong predictor of future falls.
• Secondary diagnoses: Multiple medical conditions can increase risk.
• Medication use: Certain medications, particularly sedatives or those that cause dizziness, are a known risk factor.
• Gait and balance: Abnormalities in walking patterns or poor balance are key indicators of risk.
• Mental status: Cognitive impairment or confusion can affect judgment and awareness of limitations.
• Use of ambulatory aids: Dependence on aids like canes or walkers, or improper use, can affect stability.
• Environmental hazards: Obstacles in the living space can significantly increase fall risk.

Common Fall Risk Scales Explained

Because there is no single fall risk scale, medical professionals use different tools depending on the setting and the patient's specific needs. Below are some of the most recognized and widely used scales:

The Morse Fall Scale (MFS)

Developed by Dr. Janice Morse, the MFS is one of the most common tools used in hospitals and long-term care facilities to quickly assess a patient's risk of falling. It evaluates six variables, assigning a numerical score to each. The total score determines the patient's risk level, ranging from no risk (0-24) to moderate (25-45) and high (>45).

The Berg Balance Scale (BBS)

The BBS is a performance-based assessment tool used to objectively measure a person's static and dynamic balance. It consists of 14 specific tasks, such as standing unsupported, transferring, and turning 360 degrees. Scores range from 0 to 56, with lower scores indicating a higher risk of falling and potentially requiring walking assistance or wheelchair use. While it has been shown to have high reliability, research has noted its limitations in assessing gait and predicting falls in all populations.

The Timed Up and Go (TUG) Test

The TUG test is a simple and rapid test used to assess a person's functional mobility. It involves timing the patient as they rise from a chair, walk 10 feet, turn around, walk back, and sit down again. A result of 12 seconds or more for older adults is often associated with an increased risk of falling. The TUG is beneficial for its speed and its ability to incorporate a variety of movement components.

The Tinetti Performance Oriented Mobility Assessment (POMA)

Also known as the Tinetti Balance Test, the POMA is an easily administered test that measures an older adult's gait and balance abilities through a series of timed tasks. It has two parts: one for static balance and one for gait. The total score helps classify the individual's fall risk as high, medium, or low, making it a valuable tool for physical therapists and other clinicians.

Comparison of Fall Risk Scales

Different assessment scales serve different purposes and have their own strengths. A comparison helps clarify which tool is most appropriate for a given situation.

Feature	Morse Fall Scale (MFS)	Berg Balance Scale (BBS)	Timed Up and Go (TUG)	Tinetti POMA
Primary Focus	General clinical fall risk in inpatient settings	Static and dynamic balance	Functional mobility and balance	Balance and gait function
Administration	Checklist-based scoring by staff	Performance-based tasks	Single, timed task	Combination of performance and observation
Best Used	Acute and long-term care facilities	Initial assessment and progress tracking	Screening tool in various settings	Detailed assessment of mobility components
Equipment	Minimal; mostly observation	Stop watch, chairs, step, ruler	Stop watch, chair, 10 ft path	Stop watch, chair, 15 ft path

How Caregivers Can Use Fall Risk Information

Identifying fall risk is the first step; taking action based on the assessment results is what truly makes a difference. Caregivers, both at home and in facilities, can use the information from these scales to implement practical and preventative strategies.

• Environmental modifications: This involves removing tripping hazards, improving lighting, and installing grab bars in bathrooms and stairways to create a safer living space.
• Assistive devices: Ensure the proper use of canes, walkers, and other mobility aids, and confirm they are in good working condition.
• Medication review: Regularly review medications with a healthcare provider to minimize side effects that could increase fall risk.
• Exercise programs: Engage in exercises to improve strength, gait, and balance, as recommended by a physical therapist.
• Addressing fear of falling: For individuals with a high fear of falling (often assessed by a tool like the FES), gradual exposure to activities can help rebuild confidence.

The Role of Clinical Expertise

While understanding the various fall risk scales is valuable, they are most effective when used and interpreted by trained professionals. They can accurately administer the tests, interpret the results within the context of a patient's overall health, and tailor interventions accordingly. The Centers for Disease Control and Prevention's STEADI (Stopping Elderly Accidents, Deaths & Injuries) program provides valuable resources for healthcare professionals on how to effectively integrate fall prevention into clinical practice. Link to the CDC STEADI Program

Steps in a Professional Fall Assessment

1. Initial Screening: A quick screen using a tool like the TUG test to identify individuals who need a more in-depth assessment.
2. Detailed Physical Assessment: A healthcare provider performs a physical exam and administers more specific tests like the BBS or POMA to identify deficits in balance or gait.
3. Reviewing Medications: A thorough review of all medications, including over-the-counter drugs, is conducted to identify those that might increase fall risk.
4. Implementing Interventions: Based on the assessment, a personalized care plan is developed, incorporating a combination of environmental, medical, and physical strategies.

Conclusion

In summary, asking "What is the fall risk scale called?" reveals that multiple scales and assessment tools are used to address this critical aspect of senior care. From the Morse Fall Scale used in clinical settings to the performance-based TUG test, each provides valuable data to guide fall prevention efforts. By understanding these tools and working with healthcare professionals, caregivers and seniors can take proactive steps to reduce the risk of falls, promoting safety and maintaining independence.

Frequently Asked Questions

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

The Morse Fall Scale (MFS) is a widely used and well-known tool in acute care settings due to its ease of use and predictive validity.

Is the Timed Up and Go (TUG) test a fall risk scale?

The TUG test is a performance-based assessment that measures functional mobility and is used to screen for an increased risk of falls in older adults.

What factors are evaluated in a fall risk scale assessment?

Factors can include a history of falls, use of ambulatory aids, gait and balance, mental status, secondary diagnoses, and specific medical conditions or medications.

Who administers a fall risk scale?

These scales are typically administered by healthcare professionals, such as nurses, physical therapists, or occupational therapists, to guide care and prevention strategies.

Do I need a doctor to get a fall risk assessment?

While clinical assessments are best, a simple tool like the TUG can be performed with guidance, though professional interpretation is always recommended for a complete safety plan.

How does the Morse Fall Scale calculate risk?

It assigns a numerical score based on six variables, and the total score categorizes the patient's risk as low, moderate, or high, guiding the intensity of preventive measures.

Can fear of falling be assessed with a fall risk scale?

Yes, some specialized tools, like the Fall Efficacy Scale (FES), specifically address fear of falling, which is a key factor in fall risk among the elderly.