Fall risk quick check

These are the questions doctors are asked to put to everyone 65 and older each year. A yes to any one of them is worth raising with your doctor.

1. Have you fallen in the past year?
   Yes No
2. Do you feel unsteady when you stand or walk?
   Yes No
3. Are you worried about falling?
   Yes No

Twelve statements that show what may be behind your answers. We filled in three of them from step 1. Change any that are not right.

1. I have fallen in the past year.One fall is the strongest sign of another.
   Yes No
2. I use or have been advised to use a cane or walker to get around safely.A sign that walking is already harder.
   Yes No
3. Sometimes I feel unsteady when I am walking.A sign of poor balance.
   Yes No
4. I steady myself by holding onto furniture when walking at home.A sign of poor balance.
   Yes No
5. I am worried about falling.Worry leads people to do less, which weakens legs and balance.
   Yes No
6. I need to push with my hands to stand up from a chair.A sign of weak leg muscles.
   Yes No
7. I have some trouble stepping up onto a curb.A sign of weak leg muscles.
   Yes No
8. I often have to rush to the toilet.Rushing, especially at night, leads to falls.
   Yes No
9. I have lost some feeling in my feet.Numb feet make it easier to trip or misstep.
   Yes No
10. I take medicine that sometimes makes me feel light-headed or more tired than usual.Medicine side effects can affect balance.
    Yes No
11. I take medicine to help me sleep or improve my mood.These medicines can slow reactions and affect balance.
    Yes No
12. I often feel sad or depressed.Low mood is linked to falls.
    Yes No