Physiological |
Previous history of falls
Functional status
Difficulties with walking and balance
Musculoskeletal disorders (e.g. Osteoporosis)
Vestibular disorders
Vision problems
Cognitive impairments
Neurological problems (e.g. Parkinson’s disease)
Acute conditions (e.g. Orthostatic hypotension)
Chronic conditions (e.g. Diabetes)
Nutritional problems
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Care Delivery |
Brief medical history (i.e. summary of recent encounters)
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Hospital discharge information, including:
Reason for hospital admission
Major events during hospital stay
Medications affecting balance (e.g. drugs for hypertension)
Rehab and therapy notes (i.e. therapy prognosis)
Durable Medical Equipment (DME) prescribed and order status
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Concise home care orders, including:
Specific fall risk management goals
Expected outcomes of fall risk reduction interventions
Weight-bearing status (if indicated)
Assessments (e.g. Functional Gait Assessment)
HHA fall risk management procedures
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Educational |
Patient education level
Patient comprehension
Information on medications’ effects on balance
Information on condition/disease’s effects on balance
Treatment options and their fall risks
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Social |
Patient psychosocial state
Patient culture, customs, and religion
Patient values and preferences specific to fall interventions
Socioeconomic status
Language and interpretation needs
Caregiver availability
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Environmental |
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Administrative |
Patient demographics
Patient phone and address
Next of kin and caregiver contact information
Insurance and coverage information
Scheduling and appointment changes
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