Fall Management: An Evidence-Based Approach to Fall Risk Assessment
Defining a Fall
There are a number of definitions of a fall. It is important that all members of a fall team are utilizing the same definition of a fall. If therapists or medical professionals are operating from different definitions of a fall then we want to we want to make sure that we are on the same page. That is going to be critically important as we move forward.
Morse and Isaacs define falls as "an untoward event which results in the patient coming to rest unintentionally on the ground or other lower surface." They also have definitions for near falls. A near fall is defined as when a person loses their balance, but they do not actually fall and do not actually sustain an injury. There is also a definition for an unwitnessed fall. For example, if you walk into a room to see a patient and they are on the floor. You do not know how they got there and nobody saw it. This is called an unwitnessed fall.
Tinetti defines a fall as "a sudden, unintentional change in position causing an individual to land at a lower level on an object the floor, or the ground other than as a consequence of sudden onset of paralysis, epileptic seizure, or overwhelming external force."
The RAI manual, which is commanly used in long-term care settings, defines a fall as "a change in position coming to rest on the ground, floor or onto the next lower surface." It may be witnessed, reported by the resident or an observer, or identified when someone is found on the floor. Per the RAI, falls are not a result of an overwhelming external force. Finally, the RAI manual has a definition for intercepted fall. An intercepted fall occurs when the resident would have fallen if he or she had not been caught by themselves or intercepted by another person. An intercepted fall is still considered a fall.
