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Practice guidelines for the care of elderly patients in family medicine clinics to prevent falls in the elderly

By Chitima Boongird, M.D.

Published 18 January 2026

Practice guidelines for the care of elderly patients in family medicine clinics to prevent falls in the elderly

Guidelines for Managing Falls in the Elderly: From Screening to Holistic Care

Falling in the elderly is not a "normal" part of aging that should be overlooked. Proper risk classification and appropriate care can significantly reduce injury and mortality rates. Below is a summary of the Clinical Practice Guideline (CPG) for healthcare professionals and caregivers on managing this vulnerable group.

1. Protocol for Low-Risk Patients (Single Fall within 1 Year)

This protocol applies to patients aged 60+ with a history of only one fall in the past year and no severe injury.

The 5-Domain Assessment

  1. History Taking: Determine if the fall was related to environmental factors (indoors vs. outdoors) or physical factors.

  2. Visual Acuity (VA): Screen for vision impairments.

  3. Balance Assessment: Use the 5-Time Sit-to-Stand Test or the Timed Up and Go (TUG) test.

  4. Blood Pressure: Measure in both sitting and standing positions to check for Orthostatic Hypotension.

  5. Medication Review: Assess the risk associated with current prescriptions (e.g., sedatives, antihypertensives).

Management & Care

  • Medication: Adjust dosages or switch medications to reduce fall risks.

  • Vision: If VA is worse than 20/70 in either eye, refer to an ophthalmologist.

  • Follow-up: Schedule a follow-up visit within 6–12 months.

Patient Education

  • Provide pamphlets or links to home exercise videos for balance and strength.

  • Recommend a diet rich in Calcium and Vitamin D.

  • Provide a checklist for Home Safety & Environmental Modification.

  • Additional Screening: Check for Osteoporosis and Vitamin D levels in at-risk individuals.

2. Protocol for High-Risk Patients

This applies to patients who have fallen more than once in a year, or had a single fall resulting in physical impact (injury, fracture, bruising, reduced mobility) or developed a fear of falling.

The 9-Domain Assessment (5 + 4)

Perform the initial 5 assessments from the Low-Risk protocol, plus these 4 additional domains:

  1. Functional Status: Assess Activities of Daily Living (ADLs and IADLs).

  2. Cognitive Function: Screen using MMSE or Mini-Cog.

  3. Depression Screening: Check for signs of depressive disorders.

  4. Nutritional Status: Screen for malnutrition or BMI < 19.

Management & Referral

  • Treat the Root Cause: Manage dementia, depression, or diagnose gait abnormalities.

  • Rehabilitation Medicine: Refer for physical therapy if there are gait or balance issues.

  • Ophthalmology: Refer if significant vision problems are found.

  • Nutrition: Consult a nutritionist if malnutrition is detected.

  • Follow-up: Schedule close monitoring and provide targeted prevention strategies based on findings.

3. Holistic & Social Management

Once screened by nurses or family physicians, the patient’s social context must be addressed:

Mental Health Issues

  • If depression or dementia is detected, the medical team must collaborate to create a comprehensive treatment plan.

Patients WITHOUT Caregivers (Social Issues)

If the patient cannot perform self-care and lacks a support system:

  • Social Worker Consultation: To identify potential family resources.

  • Community Coordination: Coordinate with community service centers for home assessments and aid.

  • Long-term Monitoring: Follow up with the center to evaluate the level of assistance required and facilitate access to services.

Patients WITH Caregivers

  • Family Meeting: The doctor should host a conference to explain causes and solutions, educating the caregiver at a practical, understandable level.

  • Rehabilitation: Prescribe physical therapy both at the hospital and as a continuous home program.

  • Environment: Modify the home environment to remove hazards and adjust the patient's risky behaviors.

Follow-up: If home care becomes difficult, consult a Home Visit Team and monitor the caregiver's wellbeing periodically.

Source: https://www.rama.mahidol.ac.th/fammed/th/article/patient/28jul2020-1242

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