Blackmon Care Home Care
Fall Prevention
Name
*
First Name
Last Name
1. Risk factors for falls include*
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Parkinson's disease.
Incontinence
Previous history of falls
Delirium
2. What % adults over 65 yrs old living in the community fall each year?
*
10 %
20%
30%
50%
4. Which ethnic group is most likely to be hospitalized because of a fall?
*
African Americans
Asian Americans
Latino Americans
European Americans
Signature
*
Date
*
-
Month
-
Day
Year
Date
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