Medical Council of Canada

Medical expert

Falls - 32

Rationale

Falls are common with many possible contributing factors. They can be associated with serious injury. Multifactorial interventions can prevent falls and their sequelae.

Causal Conditions

(list not exhaustive)
  1. Medical conditions (e.g., vertigo, gait disturbances, syncope)
  2. Psychiatric conditions (e.g., cognitive impairment, substance abuse)
  3. Medications
  4. Environmental or behavioral risk factors (e.g., walking surface, choice of footwear)
  5. Other contributors (e.g., decreased vision, urinary urgency)

Key Objectives

Given a patient with a presenting complaint of falls, the candidate will identify contributing factors and initiate an appropriate management and prevention plan. In particular, the candidate will recognize the patient who is at risk of falling.

Enabling Objectives

Given a patient at risk of falling, the candidate will

  1. list and interpret critical clinical findings, including
    1. a description of current and previous falls;
    2. a medical history for risk factors (e.g., medical conditions, medication history, substance abuse);
    3. environmental hazards;
    4. a complete physical and functional evaluation;
  2. list and interpret relevant investigations
  3. construct an effective initial management plan, including
    1. managing acute and chronic illness with particular attention to a review of medications;
    2. suggesting specific interventions for preventing further falls (e.g., balance/gait training, muscle strengthening exercises);
    3. suggesting appropriate home safety interventions (e.g., removing environmental hazards, grab bars, emergency response systems);
    4. appropriate consultation, including with medical specialists and other health professionals (e.g., physiotherapist and occupational therapist, social worker, pharmacist).
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