Meals-on-Wheels Falls Risk Assessment Program
Wake Forest University School of Medicine
Falls in older adults have significant outcomes including injury, isolation due to the fear of falling, and an increase in morbidity and mortality. In this mandatory experience for third-year medical students rotating through Geriatrics, the student accompanies an assessor for the local Meals-on-Wheels (MOW) program to evaluate homebound seniors for their fall risk. The student obtains subjective and objective information including the number of falls, medications, visual acuity (using Snellen vision chart), cognition (using the Mini-Cog assessment instrument), and physical function. The student then determines the client's risk of falls as indicated by assigned readings and resources on falls prevention guidelines and the Beers List. The information obtained by the student is discussed and turned in at the wrap-up meeting with a faculty member at the end of the weeklong Geriatrics rotation.
1. To perform a falls risk assessment of a community-based older adult
2. To practice clinical skills in the geriatric competencies of medication management, cognitive and behavioral disorders, self care capacity, and falls/balance/gait disorders
3. To integrate knowledge and data from a variety of sources into a comprehensive assessment
4. To provide an effective educational intervention for clinical students in Geriatrics in the face of limited faculty time
Requires use of a Snellen card for the vision testing. Also requires students to read two journal articles:
1) Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society (2011), Summary of the Updated American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons. Journal of the American Geriatrics Society, 59(1):148–157.
2) The American Geriatrics Society 2012 Beers Criteria Update Expert Panel (2012), American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. Journal of the American Geriatrics Society, 60(4): 616–631.