Table 3.

Fall-Risk Self-Assessment Screener Examined in Phase II Focus Groups

Check your risk for falling	Facts about falls
I have fallen in the last 6 months.	People who have already fallen are likely to fall again.
I worry about falling.	People who worry about falling are at risk for a serious fall.
When walking, I sometimes feel unsteady. When walking at home, I hold on to furniture to steady myself.	Unsteadiness and needing support while walking are signs of poor balance.
I use or have been advised to use a cane or walker to get around safely.	Canes or walkers can reduce the chance of falling, but only when used correctly.
When standing up from a chair, I use my hands to help push myself up. I have some trouble stepping up onto a curb.	These are signs of leg-muscle weakness—a major reason for falling.
I often have to rush to the toilet.	Rushing to the bathroom, especially at night, increases your risk of falling.
I have lost some feeling in my feet.	Numbness in the feet can cause stumbles and falls.
I take medicine that sometimes makes me feel light-headed or more tired than usual. I take medicine to help me sleep or improve my mood.	Medication side effects can sometimes increase the risk of falls and fall-related injuries.
I often feel sad or depressed.	Symptoms of depression, such as not feeling well or feeling slowed down, are associated with falls.
Because I don’t see well, I have difficulty avoiding hazards in my path, such as tree roots or electrical cords.	Poor vision is linked to falls and injuries.