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Popular Fall Risk Assessment Tools: Where STEADI Fits In

• Sara Price

As many of you already know, falls are the leading cause of both fatal and nonfatal injuries in the elderly population, and fall injuries accounted for 25,000 deaths in older adults in 2013. Fall prevention in the elderly population requires not only interdisciplinary cooperation among healthcare professionals, but also between professionals, patients, and their family members. Reliable fall risk assessment tools are imperative to decreasing that number, so we’ve provided a breakdown of the most popular fall risk assessment tools used in hospitals today and where the STEADI toolkit fits in.

Morse Fall Scale
The Morse Fall Scale was developed by Janice Morse in 1985 and assesses six key factors:

  • History of falling
  • Secondary diagnosis
  • Use of ambulatory aid
  • Intravenous therapy
  • Gait
  • Mental status

Each one of these six items is rated either “yes” or “no,” and the selection is given a point value. Depending on the sum of the items in the fall risk assessment scale, patients are categorized as high, medium, or low on the fall risk scale.

STRATIFY Scale
The STRATIFY Scale was developed in 1997 by D. Oliver et al. Along with the Morse Scale, the STRATIFY Scale is one of the two most popular and well-studied fall risk assessment tools. It addresses 5 key factors and also uses a point system:

  • History of falling
  • Whether patient is agitated
  • Whether patient is in need of frequent toileting
  • Transfer and Mobility (number score of how much aid patient requires)

Hendrich II Fall Risk Model
The Hendrich II Fall Risk Model was developed by Ann Hendrich in 2003 and assesses eight key factors:

  • Confusion, disorientation, impulsivity
  • Symptomatic depression
  • Altered elimination
  • Dizziness, vertigo
  • Male sex
  • Administration of antiepileptics (or dosage changes or cessation)
  • Administration of benzodiazepines
  • Poor performance in the “Get-Up-and-Go” test of rising from a seated position
  • Much like the Morse fall risk assessment tool, this model attributes risk points for each factor in the fall risk assessment form to determine the overall level of risk for falls.

Johns Hopkins Fall Risk Assessment Tool
The Johns Hopkins Fall Risk Assessment Tool was developed by Johns Hopkins Medicine in 2005 and assesses seven key factors:

  • Patient age
  • Prior fall history
  • Elimination
  • Medications
  • Use of patient care equipment
  • Mobility
  • Cognition

STEADI

The most recent Fall Risk Assessment Tool is STEADI (Stopping Elderly Accidents, Deaths and Injuries). STEADI was developed in 2013 by the CDC, using in-depth interviews with health care providers an algorithm adapted from the American and British Geriatric Societies’ Clinical Practices Guidelines, with the intent to improve on earlier tools like the Morse Scale and the STRATIFY Scale. STEADI is more than just a scale; it is an entire toolkit containing educational materials geared toward older adults and their families, making it more comprehensive than previous tools in recognition of the current growth in patient education.

Regardless of which fall risk assessment tools you choose to use to evaluate patients, it is important for older adults and their families to feel empowered, educated, and involved in fall prevention or fall rehabilitation plans. Griswold Home Care’s CaringTimes Blog has reliable educational resources for families regarding elderly fall prevention, chronic illnesses, disease states, and different types of care options.

©2015 Sara Price. All rights reserved.
No portion of this material may be reproduced in any form without the advance written permission of the author.

Sara Price,

Marketing Coordinator

Sara Price is the Marketing Coordinator for Griswold Home Care, a nationally recognized pioneer in the field of non-medical in-home care. For over 30 years, Griswold Home Care has helped hundreds of thousands of seniors live independently and age in place. The company refers experienced caregivers for personal care, homemaking, companionship, and other vital services to an ever-growing population of seniors and disabled adults. For more information visit www.griswoldhomecare.com.