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Medical Tests to Assess Falls in Seniors

by Dr. Rein Tideiksaar, Fall Prevention Expert
December 14, 2012

Question: What kinds of medical tests are conducted to examine the reasons behind a senior’s fall?

Answer: The doctor’s health or medical assessment of elders who fall consists of first asking about the circumstances surrounding the fall; symptoms at the time or immediately preceding the fall (such as dizziness, loss of balance, etc.)), location of the fall (if at home, in the bathroom, bedroom, stairway, etc.?), activity at the time (walking on level ground or steps, getting up from a seated position, toileting, bathing, etc.?) and time or hour of day of the fall.

This is typically followed by a quick screen for difficulty or unsteadiness with a simple functional task (standing up from a chair, walking several feet, and returning to the chair). This is rapid estimation of an elder’s flexibility, balance, and muscle strength. Those individuals who demonstrate difficulty or unsteadiness with this task receive a more detailed fall assessment, which includes:

•    A detailed inquiry of all previous falls and their circumstances over a 3 month period. Elders and/or their caregivers may want to keep a log of all falls and their circumstances, which can help with recall.  
•    An investigation of all current medications taken, including over-the-counter medication (adverse drug reactions are a leading cause of falling).
•    A review of all current health conditions/ disorders, including an assessment of visual, neurologic (evaluation of walking and balance abilities), cardiac, and mental function.

On completion of the assessment, the doctor will identify the elder’s fall risk factors, and put together a plan of care designed to modify or treat the risk factors. If an environmental cause of falling is suspected, the doctor may ask for an occupational therapist to visit the elder’s home for a safety evaluation. If further investigation, assessment, or follow-up is necessary, the doctor may make a referral to relevant specialists. 

Lastly, for those elders with complex health conditions and risk factors, a geriatrician may be asked to become involved. A geriatrician is a medical doctor who has additional training and experience in assessing, diagnosing and treating the problems that are especially common in people as they age, such as falling.

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Rein Tideiksaar Ph.D., PA-C is the founder and president of FallPrevent, LLC, a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr Tideiksaar is a gerontologist and a geriatric physician's assistant. He has been active in the area of fall prevention for over 30 years, and has designed numerous educational and clinical fall prevention programs.

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