The multidisciplinary assessment of falls

The first person concerned by the risk of an elderly person falling is the attending physician. But this is not the only person to be involved in the problem of falls. Indeed, it is everyone’s business: many people are needed to prevent and manage falls.

The role of the attending physician consists, as a first step, to evaluate systematically each year how much at risk of falling is a patient. This is an assessment that can be very simple to achieve and that can take only one minute.

It consists of asking the elderly person if he/she has already fallen this year and if so, how many times. It is also necessary to make a small equilibrium test like the “Time Up and Go”.

The doctor’s other role vis-à-vis the elderly who has equilibrium disorders and who has already fallen is to find out the main risk factors in order to correct anything that can be modified to mitigate risk.

In more complex cases, the attending physician can also prescribe the patient to undergo more detailed and structured evaluations at a hospital by experts in equilibrium disorders.

Evaluation at the hospital

During this day of hospitalization for a multidisciplinary assessment of the fall, the elderly person is examined by several health professionals. There is of course the geriatrician doctor, but sometimes also other medical specialists like a neurologist, an ENT or an ophthalmologist.

Other professionals can also take part in the medical examination, such as a physiotherapist, a social worker and a dietician.

The fact that each of these health professionals has their own approach to the problem of the older person prone to falling helps to contribute to the search for risk factors.

Risk factors

This assessment of the patient prone to falling to find the primary risk factors contributing to the falling necessarily takes time. But it is important in order to learn what the risk factors of fall are in order to provide good solutions to reduce them.

Preventing a fall in high-risk people, those who have already fallen, begins with the recognition of individual risk factors. As this effort certainly takes a considerable amount of time, it cannot be scaled to reach to the entire elderly population. But that doesn’t mean that we should not take action to reduce the risk of falling the general population.

These actions may consist of facilitating access to equilibrium workshops, but it can also be a communication campaign to promote a reduced use of psychotropic drugs, for better support fighting osteoporosis, or for the Secure Housing Development to limit environmental risks.