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Self-Advocate Resource - Check Your Risk for Falling

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Para ver en español, haga clic aquí. Upang tingnan sa tagalog, mag-click ditto.

Anyone can fall and get hurt. But, there are some things that make it more likely that you will fall. Take a look at this list of common fall risks. Circle YES or NO to the these questions:


  1. Have you had one or more falls in the past year? YES NO
  2. Do you take 4 or more medications each day? YES NO
  3. Do you need to hold onto furniture, cane or walker to walk safely? YES NO
  4. Do you sometimes feel dizzy when getting up from a chair or bed? YES NO
  5. Do you have poor vision? YES NO
  6. Do you have a hard time hearing? YES NO
  7. Do you have a lack of feeling in your feet? YES NO
  8. Do your feet hurt? Do you wear poorly fitted shoes? YES NO
  9. Do you have loose rugs, poor lighting, or clutter in your home? YES NO
10. Do you feel you should get more exercise? YES NO
11. Do you have a fear of falling? YES NO
12. Do you sometimes have to rush to the toilet? YES NO
13. Do you drink more than one alcoholic drink per day? YES NO


The more “YES” circles you have, the more at risk you are for falls. The good news is that falls are preventable. For more information on how to prevent falls, watch the video You Can Keep from Falling or Tip Sheet: 6 Steps to Keep From Falling.

Adapted from Fall Prevention, StopFalls, Napa Valley Fall Risk Screening Tool.
Last updated on Mon, 11/21/2016 - 15:45