Patient handout

Falls in older adults

PRODUCTION

1. Your condition

This handout is for falls in older adults. Your care team identified this based on: >=1 fall in the past 12 months — positive annual falls screen (world falls guidelines 2022).

Other reasons your team may use this plan: self-reported or observed gait/balance difficulty or unsteadiness (ags/bgs); fear of falling / activity restriction — 3rd screening question (world falls guidelines 2022); age >=65 presenting for routine visit — opportunistic annual screen (uspstf 2024).

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

Medication	Starting dose	How	When	What it does
three_question_falls_screen	—	—	—	World Falls Guidelines 2022 — annual screen: fall in past year, gait/balance problem, fear of falling; any positive → multifactorial assessment
gait_balance_performance_testing	—	—	—	TUG, gait speed, 30-s chair stand, Berg balance stratify low/intermediate/high risk (World Falls Guidelines 2022)

Plan: Multifactorial falls prevention — exercise-cornerstone bundle (World Falls Guidelines 2022)

3. When to call your provider

Contact your care team if any of the following happen:

Syncope/cardiac cause suspected → cardiology + monitored workup (AGS/BGS)
Injurious fall (fracture/head injury) → ED for imaging (AGS/BGS)
Recurrent unexplained falls despite intervention → specialist falls clinic (World Falls Guidelines 2022)

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

Fall with witnessed loss of consciousness, no prodrome/recall, or with arrhythmia/structural cardiac suspicion — syncope, not a mechanical fall (AGS/BGS)(life-threatening)
Head strike or unwitnessed fall in patient on DOAC, warfarin, or antiplatelet — risk of intracranial / delayed subdural hemorrhage (AGS/BGS)(life-threatening)
Suspected hip or long-bone fracture after a fall — inability to bear weight, deformity, shortening/external rotation (World Falls Guidelines 2022)
Prolonged lie after fall (>1 h on floor) with elevated CK, AKI, hyperkalemia, pressure injury, or hypothermia (AGS/BGS)
Two or more falls in 12 months without clear mechanical cause, or any unexplained fall (no recalled trip/slip and no witnessed precipitant) (World Falls Guidelines 2022)
Post-fall neck/back pain with neurologic deficit, urinary retention, or saddle anesthesia — spinal cord / cauda equina injury (AGS/BGS)(life-threatening)

5. Follow-up

Reassessment cadence (annual screen if low risk; 3-6 monthly if high risk or post-intervention); fracture-liaison/bone-health linkage; reinforce exercise; caregiver/home support; advance care discussion if recurrent injurious falls in frail patient (USPSTF 2024)

6. Sources

Guideline: World Falls Guidelines 2022 (Montero-Odasso) + 2024 USPSTF falls prevention + AGS/BGS