I have fallen in the past year. People who have fallen once are likely to fall again.
I use or have been advised to use a cane or walker to get around safely. People who have been advised to use a cane or walker may already be more likely to fall.
Sometimes I feel unsteady when I am walking. Unsteadiness or needing support while walking are signs of poor balance.
I steady myself by holding onto furniture when walking at home. This is also a sign of poor balance.
I am worried about falling. People who are worried about falling are more likely to fall.
I need to push with my hands to stand up from a chair. This is a sign of weak leg muscles, a major reason for falling.
I have some trouble stepping up onto a curb. This is also a sign of weak leg muscles.
I often have to rush to the toilet. Rushing to the bathroom, especially at night, increases your chance of falling.
I have lost some feeling in my feet. Numbness in your feet can cause stumbles and lead to falls.
I take medicine that sometimes makes me feel light-headed or more tired than usual. Side effects from medicines can sometimes increase your chance of falling.
I take medicine to help me sleep or improve my mood. These medicines can sometimes increase your chance of falling.
I often feel sad or depressed. Symptoms of depression, such as not feeling well or feeling slowed down, are linked to falls.
If you would like more information, you can contact us with referral information.
According to the CDC, people with a score of 4 points or more may be at risk for falling.This checklist was developed by the Greater Los Angeles VA Geriatric Research Education Clinical Center and affilia tes and is a validated fall risk self-assessment tool (Rubenstein et al. J Safety Res; 2011: 42(6)493-499).