FINDING BALANCE ALGORITHM
Fear of Falling
Fear of falling is a potential consequence of experiencing a fall; however it can also be reported by those who have never fallen. Fear of falling has been frequently cited as one of the most incapacitating psychological consequences of falls in older people because it often leads to activity restriction and increased dependence on others. Rather than reduce an older person's falls risk, a fear of falling can contribute to their risk.
Fear of falling has been shown to be negatively correlated with activity level. Fear of falling becomes problematic when it is immobilizing for the person who begins to limit their activities due to fear. When fear creates debilitating anxiety and distracts focus from or interferes with an activity then it is important to further assess.
One of the most researched and frequently used tools to assess fear of falling in older adults is the Falls Efficacy Scale which measures a person's confidence in performing certain ADLs and IADLs without falling.
The Falls Efficacy Scale – International (FES-I) has been developed by the Prevention of Falls Network Europe. There is a validated 16 item version and a 7 item version both including a social dimension.
These accurately predict falls. They are validated with those who have moderate cognitive impairment. It can also be helpful to determine if there are certain locations where the person is afraid of falling (e.g., outdoors, on stairs etc.)
As fear of falling is also related to anxiety and depression, it is important to screen for all of these factors.