Table 2.
‘Aachen Falls Prevention Scale’
| Part I | ||
|---|---|---|
| Self-questionnaire (10 questions, one point per question answered ‘yes’, 10 points max.): | ||
| Yes | no | |
| Do you have problems with hearing or vision? | ||
| Do you feel unsafe or have you been falling recently? | ||
| Are you afraid of falling? | ||
| 1. Do you take medication for sleep, cardiac problems, diuretics, or sedatives? | ||
| 2. Do you loose urine or stool involuntarily? | ||
| 3. Do you have memory problems? | ||
| 4. Do you feel lonely at times and think that your life is without value? | ||
| Do you use a walking aid on a regular basis? | ||
| 5. Do you suffer from Parkinson’s, Arthritis or Rheumatism? | ||
| 6. Are there many traps that might cause a fall in your home? | ||
| Part II | ||
| Self-Test with your partner | ||
| Stand freely, do not lean or hold on anybody, measure the time until you have to do a corrective action with your arm, upper body or lower extremity. | ||
| Standing test | ||
| Successfully completed: 20 seconds or more | ||
| Failed: less than 20 seconds | ||
| Yes | no | |
| Conclusion and self-assessment: | ||
| How would you grade your falls risk on a scale of 1 to 10 (10 … max. risk)? | ||
| If you score 5 points or worsening within the last weeks we recommend that you contact a physician for further assessment. | ||