Risk Assessment for Falls

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As we grow older, gradual health changes and some medications can cause falls, but many falls can be prevented. Take this Risk Assessment to learn what to do to stay active and independent and reduce your risk of falls.

Check "Yes" if you experience this (even if only sometimes)NoYesWhat to do if you checked "Yes"
Have you had any falls in the last 6 months?  
  • Talk with your doctor(s) about your falls or concerns.


  • Show this checklist to your doctor(s) to help understand and treat your risks and protect yourself from falls.
Do you take 4 or more prescription or over-the-counter medications?  
  • Review your medications with your doctor(s) and pharmacist at each visit, and with each new prescription.


  • Ask which medications can cause drowsiness, dizziness or weakness as side effects.


  • Talk with your doctor(s) about any symptoms that could be medication side effects or interactions.
Do you have difficulty walking or standing?  
  • Tell your doctor(s) if you have any symptoms in your legs or feet, such as pain, swelling, stiffness, weakness or numbness.


  • Tell your doctor(s) about any difficulty walking and discuss treatment.


  • Ask your doctor(s) if physical therapy or other specialized treatment would help your problem.
Do you use a cane, walker or crutches or have to hold onto things when you walk?  
  • Ask your doctor(s) for training from a physical therapist to learn to use assistive devices correctly and safely.
Do you have to use your arms to be able to stand up from a chair?  
  • Ask your doctor(s) for a physical therapy referral to learn exercises to strengthen your leg muscles.


  • Exercise 2 or 3 times a week for 30 minutes at a time.
Do you ever feel unsteady on your feet, weak or dizzy?  
  • Tell your doctor(s) and ask if any specialist or treatment might help.


  • Review all your medications with your doctor(s) and/or pharmacist if you notice any of these conditions.
Has it been more than 2 years since your last eye exam?  
  • Schedule an eye exam every 2 years to protect your eyesight and balance.
Has your hearing gotten worse with age or do other people think you have a hearing problem?  
  • Schedule a hearing test every 2 years.


  • If hearing aids are recommended, learn how to use them to protect and restore your hearing, which helps improve and restore your balance.

© 2010 Healthy Advice® Networks, LLC.


Last Updated: December 15, 2010

Healthy Advice® Networks provides award-winning health-education to you when and where you need it. Healthy Advice editorial content is researched and developed by experienced medical writers who work with practicing physicians to ensure accuracy. This website is for your educational use only. Talk to your doctor before making any lifestyle or medical treatment changes.

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