Skip to main content

Advertisement

Table 3 Questions to ask during PreFIT MFFP assessment falls interview

From: The design and development of a complex multifactorial falls assessment intervention for falls prevention: The Prevention of Falls Injury Trial (PreFIT)

Question Possible/probable cause of falls & onward treatment pathway
Any dizziness or giddiness? Dizziness or giddiness defined as feeling dizzy or light-headed, as if going to faint. Ask about circumstances. Check for postural hypotension (refer to manual).
Any vertigo? A sensation of spinning. May represent vestibular disease which requires medical diagnosis.
Any muscle weakness in the legs? Is one leg weaker than the other? If the person has one leg weaker than the other, this requires a full medical review. Refer to consultant-led falls service or secondary care.
Any sudden loss of consciousness? Any sudden, unexplained loss of consciousness (syncope) requires a medical review. Reasons may include anything from a vasovagal faint to a cardiac arrhythmia or other cardiac problem. Requires referral to secondary care consultant-led falls service.
Any palpitations or angina? Refer to definitions. Suggestive of cardiac disease. Ask about exercise-related chest pain. The first stage for referral is to the GP unless the pain is present at time of assessment (if so, urgent referral to secondary care for cardiac assessment.).
A trip or stumble on a hazard? Explore circumstances. Ask about home environment. Use home environment screening questions.
Any rapid position change? May indicate postural hypotension or if head movement, may indicate carotid sinus hypersensitivity. Continue with falls assessment and consider referral to consultant-led falls service/ secondary care. This may also indicate visual dependency for stability due to vestibular insufficiency (with or without vertigo).
Any visual disturbance, such as blurred vision? May indicate epileptic fit or may indicate visual problems associated with tripping on hazard. Continue with assessment also conduct vision check.
Any injuries sustained from the fall, bruising, fractures etc.? May indicate sudden drop and unable to protect themselves. Continue with falls assessment and consider other circumstances.
Any facial injuries? Similarly, indicative of sudden fall and unable to protect themselves. Continue with falls assessment and consider referral to consultant-led falls service/ secondary care.
Any tongue biting? Suggestive of epileptic fit. Ask about incontinence. Refer in the first instance to the GP who may refer to consultant-led falls service/secondary care.
Were they wearing a very tight collar around the time of the fall? Indicative of carotid sinus hypersensitivity. This will require referral to a consultant-led falls service.
Have they ever been incontinent when/after falling? May indicate epileptic-type seizure. Enquire about tongue biting. Consider referral to consultant-led falls service.
Do you worry about your balance? May indicate fear of falling. May benefit from balance retraining and reassurance. Refer to PreFIT physiotherapist.