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Nurses should routinely ask older people about falls – NICE

Practice and district nurses should routinely ask people over 65 about falls, says the National Institute for Health and Care Excellence.

Practice and district nurses should regularly ask people over 65 if they have had any falls, National Institute for Health and Care Excellence (NICE) guidance states.


Asking about an older person’s falls should be a matter of routine, says NICE Photo: iStock

Nurses should ask older people about the frequency, context and type of fall, and about whether individuals ever lose their balance or feel unsteady, according to an updated quality standard on falls in older people.

Assessment of risk

Those who have fallen once in the previous year are more likely to fall again, so if answers suggest the person is at risk, nurses should refer their patients on or advise them to see an appropriate healthcare professional.

Older people should also be asked if they have a history of falling in the past year when admitted to hospital, or during visits from social care workers.

Cameron Swift, emeritus professor from King’s College London school of medicine, who helped develop the quality standard, said: ‘We recognise that regular questions about falls may seem intrusive or repetitive, but older people often think episodes of falling or unsteadiness are unimportant, or that to raise them could threaten future independence. 

Promoting independence

‘By contrast, effective measures are now known to reduce the risk of falls, maintain independence and promote ongoing health. It’s vital, therefore, that these are offered to those who need them.’

One in three people over-65 fall at least once a year, research has found, with around 255,000 older people admitted to hospitals in England because of falls each year.

In 2015 the Chartered Society of Physiotherapy said falls cost the NHS more than £2.3 billion per year, or £4.6 million a day.

Read the NICE guidance


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