“It’s not the broken hip, it’s
the nursing home I don’t want.
I need to be independent,
so I take Tai Chi.”
Leonard Jones, age 74
“People who use canes are brave.
They can be more independent
and enjoy their lives.”
Shirley Warner, age 79
Four things you can do
to prevent falls:
Begin an exercise program to
improve your leg strength
Ask your doctor or pharmacist
to review your medicines
Get annual eye check-ups &
update your eyeglasses
Make your home safer by:
n Removing clutter &
n Putting railings on all stairs
& adding grab bars in
n Having good lighting,
especially on stairs
Contact your local community or senior
center for information on exercise, fall
prevention programs, or options for
improving home safety.
For more information on fall prevention,
This brochure was produced in collaboration
with the following organizations:
VA Greater Los Angeles Healthcare System,
Geriatric Research Education & Clinical Center
(GRECC), and the
Fall Prevention Center of Excellence
Centers for Disease
Control and Prevention
National Center for Injury
Prevention and Control
Falls are the main reason
why older people lose their
Check Your Risk for Falling
Your doctor may suggest:
• Having other medical tests
• Changing your medicines
• Consulting a specialist
• Seeing a physical therapist
• Attending a fall prevention
Please circle “Yes” or “No” for each statement below. Why it matters
Yes (2) No (0) I have fallen in the last 6 months. People who have fallen once are likely to fall again.
Yes (2) No (0) 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 (0) Sometimes I feel unsteady when I am walking. Unsteadiness or needing support while walking are signs of
Yes (1) No (0) I steady myself by holding onto furniture when
walking at home.
This is also a sign of poor balance.
Yes (1) No (0) I am worried about falling. People who are worried about falling are more likely to fall.
Yes (1) No (0) I need to push with my hands to stand up from
This is a sign of weak leg muscles, a major reason
Yes (1) No (0) I have some trouble stepping up onto a curb. This is also a sign of weak leg muscles.
Yes (1) No (0) I often have to rush to the toilet. Rushing to the bathroom, especially at night, increases your
chance of falling.
Yes (1) No (0) I have lost some feeling in my feet. Numbness in your feet can cause stumbles and lead to falls.
Yes (1) No (0) 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 (0) I take medicine to help me sleep or improve
These medicines can sometimes increase your chance
Yes (1) No (0) I often feel sad or depressed. Symptoms of depression, such as not feeling well or feeling
slowed down, are linked to falls.
Add up the number of points for each “yes” answer. If you scored 4 points or more, you may be at risk
for falling. Discuss this brochure with your doctor.
This checklist was developed by the Greater Los Angeles VA Geriatric Research Education Clinical Center and affiliates and is a validated fall risk
self-assessment tool (Rubenstein et al. J Safety Res; 2011:42(6)493-499). Adapted with permission of the authors.