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The Impact of Falls on Older People: How to Assess the Risks and Implement Prevention Strategies




Falls increase with age, with approximately 25 per cent of those aged 65–74 falling per year, compared with more than 50 per cent of those aged over 90 years. Furthermore, injury patterns change with age. In those aged 65–70 years, the incidence of Colles’ fractures resulting from falls is approximately the same as the incidence of hip fracture. However, with increasing age, the proportion of hip fractures increases markedly. Hip fracture is potentially one of the worst outcomes from a fall. Fewer than half of those with a hip fracture regain pre-fracture level of function within 12 months. These figures highlight the ongoing challenge in terms of physical, psychological, and economic impacts of falling, both for ageing people and for practitioners involved in falls prevention programs. This chapter describes how to conduct a thorough falls risk assessment and debates the value of existing falls prevention programs.


Contents include

  • ‘The facts’
  • Risk factors for falling
  • Health promotion and falls prevention
  • Falls risk screening tools
  • Assessment
  • Falls prevention programs
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Author / Editor Biographies

BAppSc (Physiotherapy), GradDip (Physiotherapy) and PhD.
Keith Hill is a physiotherapist with more than 20 years' experience in rehabilitation and aged care. Keith has completed a PhD entitled Balance studies in older people and has published numerous papers in this area. Keith is a senior research fellow at the National Ageing Research Institute and co-director of the falls and balance clinic at the Melbourne Extended Care and Rehabilitation Service in Victoria, Australia. He was recently project manager for a successful multifactorial, multidisciplinary falls-prevention project in residential aged care.
MBBS, GradDip (Education) and FRACP.
Jennifer Schwarz has been a geriatrician since 1987. She has been working in the area of falls and balance problems in older people since 1990. She is co-director of the Falls and Balance Clinic based at the Melbourne Extended Care and Rehabilitation Service, the first such clinic in Australia.
BAppSc (Occupational Therapy), GradDip Ger, MPH.
Robyn Smith is an experienced public health researcher, and an aged care occupational therapist. She currently manages the development of allied health research for Northern Health and was formerly the director of public health at the National Ageing Research Institute (both in Melbourne, Australia). Her main research interests focus on fostering sustainable change and the application of research evidence in health and residential aged care.
RN, BA and GradDip (Arts).
Belinda Gilsenan is Project Officer at the National Ageing Research Institute and has worked as a nurse for a number of years in geriatric rehabilitation and at the same time completed a Bachelor of Arts. Her Honours thesis explored the involvement of older adult organisations in the policy-making process in Australia. Her work in the area of falls prevention has included the development of a national database of community-based falls prevention programs, which incorporates a critical appraisal of each program.

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