|
Abstract
|
How can clinicians screen for fall risk in older adults?
The world guidelines for falls prevention and management for older adults recommend that all older adults 'should be advised on falls prevention and physical activity', and that '[t] hose considered at high risk should be offered a comprehensive multifactorial falls risk assessment'.1 Yet the multifactorial risk factors for falling are numerous, and clinicians may struggle to efficiently evaluate high-risk patients.2 This article describes a 'toe-to-head' approach to the fall risk assessment, which synthesises evidence-based falls risk evaluation strategies, and is designed to meet this need in a manner aligned with the 4Ms of an age-friendly health system -- Mobility, Mentation, Medications, and What Matters...
Feet first: fall risk assessment from toe to head starting with the lower extremities
This 'toe-to-head' approach to fall risk reduction begins with the feet. An examination of the skin, nails, shoes, soles, and overall condition of the feet provides information that might otherwise be difficult to elicit, including problems in self-care, sensation, and proprioception. Potential interventions for commonly encountered problems include referral to podiatry for toenail clipping, modifications for ill-fitting shoes, and wound care for skin breakdown.5 In particular, the often hidden 'long toenail sign' -- long, untrimmed toenails -- may suggest emerging difficulties with functional independence...
Language: en |