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Check Your Risk for Falling

To find out if you’re at risk for falling, please do the following:

  • Please identify Yes/No for each statement below
  • Add up the number of points for each Yes response.
  • If you score 4 points or more, you may be at risk for falling. Discuss these results with your doctor.

Yes?No?StatementWhy it matters
Yes
2
No
o
I have fallen in the last 6 months.People who have fallen once are likely to fall again.
Yes
2
No
o
I use or have been advised to use a cane or walker to get around safely.People who have been advised to use a cane or walker may already be more likely to fall.
Yes
1
No
o
Sometimes I feel unsteady when I am walking.Unsteadiness or needing support while walking are signs of poor balance.
Yes
1
No
o
I steady myself by holding onto furniture when walking at home.This is also a sign of poor balance.
Yes
1
No
o
I am worried about falling.People who are worried about falling are more likely to fall.
Yes
1
No
o
I need to push with my hands to stand up from a chair.This is a sign of weak leg muscles, a major reason for falling.
Yes
1
No
o
I have some trouble stepping up onto a curb.This is also a sign of weak leg muscles.
Yes
1
No
o
I often have to rush to the toilet.Rushing to the bathroom, especially at night, increases your chance of falling.
Yes
1
No
o
I have lost some feeling in my feet.Numbness in your feet can cause stumbles and lead to falls.
Yes
1
No
o
I take medicine that sometimes makes me feel light-headed or more tired than usual.Side effects from medicines can sometimes increase your chance of falling.
Yes
1
No
o
I take medicine to help me sleep or improve my mood.These medicines can sometimes increase your chance of falling.
Yes
1
No
o
I often feel sad or depressed.Symptoms of depression, such as not feeling well or feeling slowed down, are linked to falls.


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