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Falls among the elderly aged 65 years and older can lead to serious injuries such as hip fractures, trauma-related hospital
admissions, and even death. Falls can occur in various settings to include nursing homes, hospitals, and in the community.
Fall risk assessments, pharmacy consultation and medication review, laboratory review to include vitamin D levels, Tai
Chi exercises, and a comprehensive falls education program are primary factors to reduce fall rates. Although significant,
an appreciable change in fall rates may still not occur. According to the literature, an estimated 90 million Americans will
experience dizziness in their lifetime; dizziness can lead to loss of balance and falls. Health care professionals are often unaware
of falls in patients with undiagnosed inner ear dysfunction when there is no prior injury or report of a recent fall. Therefore, the
author, after in-depth research and consultation with fall prevention specialists, critically evaluated the need for an evidencebased
protocol to include visual, vestibular, proprioception; as well as muscular and psychological components. The expanded
protocol identifies individuals at-risk for falls as well as screen for those individuals who have not fallen and have not been
identified as a fall risk. The author discusses in detail the protocol shift that not only focuses on remediation of falls but also
fall prevention through medical diagnostics of balance and vestibular disorders, balance and vestibular rehabilitation training,
sensory-processing techniques, and psychological screening for fear of falling.
Cassandra Warner Frieson, DNP, MSN, BSN, NP-C, FNP-BC is Owner and Executive Director of Fall Injury Prevention and Rehabilitation Services LLC. She completed her Doctoral studies from the University of Alabama in Huntsville College of Nursing in Huntsville, Alabama, USA. She is a professional speaker and geriatric practitioner with clinical expertise in safety and fall prevention. Her Professional memberships include the International Nurses Association, National Association of Professional Women, American Association of Nurse Practitioners, and the American Nurses Association.