Preventing Falls in Older Adults: Operationalizing the Stopping Elderly Accidents, Deaths, and Injuries (STEADI-12) Action Tool-Handout

Handout

Pdf Summary

This document outlines a stepwise “Safe Mobility and Fall Prevention” algorithm for primary care teams, based on the STEADI framework. It is designed for follow-up after an initial fall-risk screening and emphasizes treating fall prevention as an ongoing chronic care process rather than a one-time event.

The workflow has four steps:

1. <strong>Review initial screening score</strong>  
   - <strong>Average risk (0–3):</strong> Provide education on home safety, supportive footwear, regular physical activity, and community exercise programs such as Tai Chi or EnhanceFitness; rescreen annually.  
   - <strong>Increased risk (4+):</strong> Move to detailed domain assessment.

2. <strong>Assess and prioritize modifiable risk factors</strong>  
   Focus on the highest-yield risks, which include:
   - <strong>Mobility/strength/balance problems</strong>: gait instability, difficulty rising, stair problems, poor balance tests → refer to physical therapy.
   - <strong>Medications/FRIDs</strong>: sedation, dizziness, polypharmacy, CNS-active drugs → review, reduce, switch, or optimize medications.
   - <strong>Orthostatic/cardiovascular issues</strong>: dizziness on standing, syncope, palpitations → evaluate blood pressure, hydration, and cardiovascular causes.
   - <strong>Fear of falling</strong>: reduced activity or low confidence → graded exercise, fall-prevention classes, or CBT.
   - <strong>Bladder/urgency/nocturia</strong>: rushing to toilet, nighttime toileting → treat causes and improve safe access.
   - <strong>Vision/sensory/feet issues</strong>: poor vision, neuropathy, foot pain, hearing or vestibular problems → correct or refer.
   - <strong>Home/environment hazards</strong>: poor lighting, clutter, rugs, unsafe bathroom/stairs → home safety changes and occupational therapy if needed.
   - <strong>Footwear</strong>: poor fit or traction → safer shoes and foot care.
   - <strong>Chronic conditions</strong>: integrate fall prevention into ongoing management.

3. <strong>Plan and intervene</strong>  
   Create an individualized, patient-centered action plan coordinated by the interdisciplinary team.

4. <strong>Follow up</strong>  
   Reassess falls, near-falls, adherence, barriers, and response to interventions at 3, 6, or 12 months, or sooner if health/function changes.

The tool promotes coordinated, team-based care and shared decision-making centered on the patient’s goals for safe mobility and independence.

Keywords

fall prevention

safe mobility

STEADI framework

primary care

fall-risk screening

modifiablerisk factors

physical therapy

medication review

home safety

shared decision-making