Falls prevention and management pathway for older people

Preventing Falls
All health and social care services for older people should provide up-to-date
information on the prevention of falls and the prevention of harm from falls.
Information should be provided in departments, clinics, waiting areas etc on how to
access local services and organisations and key falls prevention messages which support
the following:
the maintenance of health and wellbeing, e.g. exercise/physical activity opportunities
a safe home environment, e.g. aids and adaptations/care and repair services,
community alarm, fire service etc
a safer community environment, e.g. lunch clubs, support groups, Dial-a-bus and
equivalent services
the importance of regular eye tests
This information should also be provided on a one to one basis.
Level 1 conversation
All health and social care services should have a level 1 conversation with an older person
who reports a fall or an injury or functional decline caused by a fall. The key questions are
detailed in the pathway

Tips to prevent trips and falls should be made available in hard copy, along with
Up and about. Taking positive steps to avoid trips and falls

These resources are available from http://healthyhighlanders.co.uk/HPAC/

Additional information is available from
http://www.nhshighland.scot.nhs.uk/YourHealth/Falls/Pages/Welcome.aspx

Lead Reviewer: C McArthur Date of Issue: 16th Oct 2014 Version No: 1.6
Approved By:NHSH Falls Steering Group Date of Review: April 2015 Page 1 of 2
 Falls prevention and management pathway for older people

All individuals 65
years when presenting
as a consequence of a
fall, reporting a fall or
who appear unsteady Person 65
admitted to
hospital

Level 1 Conversation Yes No

1. Have you had more than one fall in the past year
2. Have you had an unexplained fall or a fall as a result of losing
consciousness/ dizziness?
In-patient falls
3. Do you or your relative/carer worry you might have a fall?
care plan
4. Do you feel unsteady or have difficulties with walking or balance?
5. If you have had a fall are you less able to do the things you used to
be able to do before the fall?

Discharge planning
No Is the answer to any of including
the above questions addressing
Yes? modifiable falls risk
at home
Yes

Single
explained fall Is the answer to Yes
e.g slip, trip etc question 2 Yes?
or no falls or
concerns Specialist assessment (Level 3) for
No
unexplained fall

Investigation and appropriate clinical

Promote health management from GP or clinic for
and wellbeing and underlying medical conditions including :
raise awareness of cardiac, metabolic, neurological or
falls prevention infection.
Refer for level 2 falls risk screening if
Level 2 Falls Risk other falls risks present.
Screening
(Multifactorial Falls Risk
Screen) and Falls Prevention Level 2 falls risk screening includes
Action Plan
1. Previous falls & fear of falling
Refer to community district/ 2. Muscle weaknesses/poor balance
integrated team 3. Transfers and daily activities
4. Nutrition
5. Osteoporosis
6. Medication
Appropriate further referral or take action as 7. Alcohol
directed by Level 2 Falls Risk Screen: 8. Eyesight and hearing
9. Footwear/foot problems
Individually tailored multifactorial 10. Cognition
specialist intervention (Level 3) 11. Continence
12. Anticipatory Care Plan
Referral to additional local community 13. Environmental Screening
services

Lead Reviewer: C McArthur Date of Issue: 16th Oct 2014 Version No: 1.6
Approved By:NHSH Falls Steering Group Date of Review: April 2015 Page 2 of 2