The Application of a Predictive Fall Risk Index Among the Elderly

This descriptive study examined the application of a predictive fall risk index among the elderly. The research question was: To what extent do individual chronic disabilities, present on the Tinetti et al. (1986) fall risk index, prospectively identify which residents are likely to fall. Hogue\u27s ecological model of falls in late life provided a conceptual framework for the study. The convenience/purposive sample consisted of 25 elderly male residents in a midwest nursing home care unit with a rehabilitative focus. Using the Tinetti et al. (1986) fall risk index as a tool, data was collected by direct observation and chart review. The nine risk factors included in the fall risk index were mobility, morale, mental status, distant vision, hearing, postural blood pressure, back extension, medications, and activities of daily living. Incident reports were reviewed for the frequency of falls during a two-month period. Data were analyzed using chi-square with frequencies of variables. The disabilities associated with falling according to chi-square testing were mobility, mental status, back extension, hearing, and morale. The fall risk score was the number of risk index disabilities attributed to each subject. No subject with three or fewer disabilities fell. The findings of this study support the Tinetti et al. (1986) fall risk index as a predictive indicator of an elderly resident\u27s likelihood of falling in a long term care facility. If the disabilities associated with a predisposition to falling can be identified by nurses, it is possible that many of these disabilities may be remediable through coordinated interdisciplinary care. The use of the fall risk index tool in other clinical settings would be beneficial for further nursing research