What’s your fall risk?

I have fallen in the past 6 months.

People who have fallen once are likely to fall again.

Yes No

I use or have been advised to use a cane or walker to get around safely.

People who have been advised to use a cane or walker may already be more likely to fall.

Yes No

Sometimes I feel unsteady when I am walking.

Unsteadiness or needing support while walking are signs of poor balance.

Yes No

I steady myself by holding onto furniture when walking at home.

This is also a sign of poor balance.

Yes No

I am worried about falling.

People who are worried about falling are more likely to fall.

Yes No

I need to push with my hands to stand up from a chair.

Strengthening your leg muscles can reduce your risk of falling and being injured.

Yes No

I have some trouble stepping up onto a curb.

This is also a sign of weak leg muscles.

Yes No

I often have to rush to the toilet.

Rushing to the bathroom, especially at night, increases your chance of falling.

Yes No

I have lost some feeling in my feet.

Numbness in your feet can cause stumbles and lead to falls.

Yes No

I take medicine that sometimes makes me feel light-headed or more tired than usual.

Side effects from medicines can sometimes increase your chance of falling.

Yes No

I take medicine to help me sleep or improve my mood.

These medicines can sometimes increase your chance of falling.

Yes No

I often feel sad or depressed.

Symptoms of depression, such as not feeling well or feeling slowed down, are linked to falls.

Yes No