Falls Specialist Service – information for providers and referrers

Why do we need the Falls Specialist Service?

Falls and the injuries that result from falls are a significant concern for many older Australians. Even in the absence of injuries, many older adults lose confidence in performing everyday activities due to fear of further falls.

This fear may cause older adults to restrict activities that are a normal part of their daily routine. This inactivity can lead to muscle weakness and the deterioration in balance and walking, which can further increase the likelihood of a fall.

Importantly, the loss of confidence and restriction of daily activities can impact on a person’s quality of life and their ability to manage independently at home.

What is the Falls Specialist Service?

The Falls Specialist Service commenced in 2001 at Sir Charles Gairdner Hospital (external site) to assist older adults living in the community to identify and reduce their risk of falls. The service has been expanded across the Perth metropolitan area through funding made available by the State and Australian Governments.

The service targets older adults over 65 who are at risk of a fall, or have already experienced a fall and would benefit from a detailed assessment of their risk of falling.

What does the service provide?

A falls specialist (physiotherapist or occupational therapist) will visit the client in their own home. They will conduct a detailed assessment to determine why the client has fallen previously and/or those risk factors that may contribute to future falls.

Assessment covers the following risk areas:

  • Medication screen: identification of high risk medication, supplement use (for example calcium, vitamin D) and reported side effects.
  • Balance, walking and muscle strength: QuickScreen© Clinical Falls Risk Assessment; Timed Up and Go Test; 4 test Balance Scale.
  • Footwear and foot health: sensory screening, and observation of biomechanical abnormalities and common untreated foot pathologies.
  • Vision: client report of known pathologies, eyewear type and performance of low contrast visual acuity as a component of the QuickScreen©.
  • Performance and confidence in daily activities (falls efficacy and Lawtons).
  • Memory and mood concerns: screening for cognitive deficits and/or depressive symptoms.
  • Bladder and bowel function.
  • Health conditions: assessment of postural blood pressure and calculation of Non BMD Fracture Risk.
  • Home hazard screen.

The falls specialist discusses the assessment findings with their client and makes specific recommendations about how they can reduce their risk of falls.

Interventions are either delivered directly by the falls specialist or indirectly via on-referral to appropriate services.

Examples of recommendations include:

  • Participation in an exercise program to improve balance, gait and muscle strength deficits - this can be delivered either as a home, group or gym program.
  • Home hazard reduction and home modifications, for example installation of grab rails, ramps or box steps.
  • Prescription of walking aids, home aids and appliance equipment to facilitate performance of daily activities.
  • Podiatry review for foot care or specific advice related to biomechanical deficits and footwear.
  • Education related to the development of a ‘personalised falls action plan’ – what to do if a fall occurs at home.
  • Behavioural modification and education about actions that may be contributing to the risk of falling.
  • Referral for medication review, for example home medication review)
  • Referral for community support assessment, for example HACC or ACAT.
  • Advise to visit an optometrist, podiatrist, GP or other health care provider (at their usual cost).

The falls specialist will liaise with the client’s GP with regards to medical or medication issues that require further assessment. Clients may be referred to a multidisciplinary falls clinic which includes assessment by a geriatrician.

How long does a visit with the falls specialist take?

Initial assessment takes at least 1 hour. Subsequent visits are around 30 to 40 minutes but vary based on purpose (for example home exercise prescription, home installations).

What does the service cost?

There is no cost associated with the falls specialist assessment. There may be costs associated with recommendations suggested by the falls specialist.

How do older adults access this service?

The Falls Specialist Service is based within day therapy units located within Departments of Geriatric Medicine (DGM) at metropolitan public hospitals. Referrals are accepted from GPs and health providers in the public or private health system across all clinical areas and settings.

Residential aged care referrals are accepted – please contact service for further information. Referrals requesting a falls assessment should be addressed to the DGM of the nearest public hospital. A Falls Specialist Program referral form (PDF 69KB) for non GP referrals is available.

Where is the service available?

See contact details (PDF 134KB) for Perth metropolitan and WA rural and regional falls services at day therapy units.

Service provider resource

See the Falls Specialist Service client information sheet (Word 302KB).

More information

Falls Specialist Coordinator:

Information on falls prevention services across WA Health can be obtained by contacting Stay On Your Feet WA®:

Produced by

Subacute, Community and Aged Care Directorate