& Continuing Education Courses
Sponsored by: Jordan Hearing and Balance, LLC South Jordan Utah
Lynn S. Alvord PhD
Tests for Falls
There are several scales for assessing a patient’s potential for future falls. These identify if a patient has any “falls risk factors”. For example, in order to assess falls risk of hospital patients, the Morse Fall Scale uses only a nurse’s observations and chart information. A very popular current assessment scale for hospital patients is the Hendrich II, which uses not only chart information, but also a practical examination of the patient, including performance on a gait test (Get-up-and-go test), as well as presence of specific medical conditions such as a vertigo disorder. The Hendrich II is a standardized scale. Medicare requires a balance assessment of all new inpatient’s under the “Welcome to Medicare” provision.
A problem with most falls assessment scales is that they only measure a few falls risk factors. There are such a large number of risk factors that there is little overlap of these factors on the various scales, in other words, each scale measures a different set of risk factors not found on other scales. Using just one scale will miss a significant number of individuals, but assessing all possible individual risk factors would require a huge amount of time. Another approach the author (me) recommends is a “systems” based assessment, that is, a screening or assessment of disorders in the various body systems that can cause falls (musculoskeletal, vestibular, visual, etc). The Alvord Falls Screening Examination protocol assesses function in 6 body systems as well as any history of prior falls, and a balance physical examination. By assessing the body systems that can cause falls, a more complete falls risk analysis is made, thereby missing fewer individuals with less common causes of falls. The Alvord Falls Screening Examination is such a scale. See Additional information section below for details of this examination.