Elderly Parent Keeps Falling? The Fall Risk Assessment to Ask For

If your elderly parent keeps falling, ask their doctor for a fall risk assessment at a visit booked for that purpose. A good one follows the CDC's STEADI approach: a few screening questions, quick tests of walking, leg strength and balance, blood pressure taken lying and then standing, and a look at medicines, eyes, feet and the house. Bring a short log of recent falls and near misses, and leave with a written plan, which usually includes exercise or physical therapy.

Repeat falls usually have causes someone can find. If the latest fall was in the last few days, start with our guide to what to do after an elderly parent falls, which covers head injuries, the room-by-room home check and what Medicare pays for equipment. This article picks up when it has happened more than once.

Why repeat falls need their own appointment

The CDC's facts about older adult falls (updated September 2026) say more than one in four people 65 and older fall each year, less than half tell their doctor, and falling once doubles the chance of falling again. Most falls, the page adds, come from a combination of risk factors, which is why "be careful on the stairs, Mom" doesn't get far.

Don't count on the yearly wellness visit to cover it. Medicare.gov calls the yearly Wellness visit a conversation to build a prevention plan, not a physical, and says to schedule a separate appointment for specific concerns. Falls do come up there: the federal rule behind the benefit, 42 CFR 410.15, requires the first annual wellness visit to review fall risk and home safety, and the health questionnaire used at each one has to ask about balance and risk of falls. A screening question is a start, though, and repeat falls need more.

When you call, use the words: "She has fallen more than once and we'd like a fall risk assessment." It tells the office how much time to set aside.

Fear of falling counts too

Some parents haven't fallen much but have started living smaller: no walks, a hand on the furniture from room to room. The CDC says fear of falling can make people cut back on everyday activities, and being less active makes them weaker and more likely to fall. Worry about falling is one of the CDC's three screening questions, so it's reason enough to ask for an assessment.

What a fall risk assessment involves

The CDC's program for clinicians, STEADI (Stopping Elderly Accidents, Deaths and Injuries), has three parts: screen for fall risk, assess the risk factors that can be changed, and intervene. It's built on the American and British Geriatrics Societies' clinical guideline. Knowing the outline helps you notice what got skipped.

Step one: three questions

The STEADI pocket guide tells clinicians to ask older patients, every year:

1. Have you fallen in the past year?
2. Do you feel unsteady when standing or walking?
3. Do you worry about falling?

A yes to any of them is a positive screen, followed by "How many times?" and "Were you injured?" The guide also notes that many patients who have fallen don't bring it up. If your parent says "I'm fine," your log does the talking.

Step two: three quick physical tests

These take a few minutes with a stopwatch and a chair. The CDC sheets tell the clinician to stay next to the patient for safety, so don't try them at home alone.

The clinician is watching as well as timing. The Timed Up and Go sheet lists signs like shuffling, short strides and steadying on the walls, and says such changes may signal neurological problems that need more evaluation.

Step three: the rest of the checkup

The STEADI risk factors checklist and pocket guide cover:

• Blood pressure lying and standing. The CDC's instructions have the patient lie down for five minutes, then measure, then measure again after standing one minute and three minutes. A drop of 20 points or more in the top number, 10 or more in the bottom number, or dizziness on standing is abnormal.
• Medicines, including over-the-counter drugs and supplements.
• Vision, flagged if acuity is worse than 20/40 or there's been no eye exam in over a year.
• Feet and footwear, vitamin D intake and home hazards like throw rugs or a slippery tub.
• Other conditions: the checklist names heart rate or rhythm problems, cognitive impairment, incontinence and depression.

A blood pressure taken sitting can't show a drop on standing. If the visit ends without a lying-and-standing reading, ask for one.

The usual causes, and what can change

The CDC's list of changeable risk factors: lower body weakness, vitamin D deficiency, trouble with walking and balance, certain medicines, vision problems, foot pain or poor footwear, and home hazards. The National Institute on Aging's page on falls and fractures adds diabetes, heart disease, thyroid, nerve and blood vessel problems, age-related muscle loss, mild cognitive impairment and some dementias. It also names a sneaky one: conditions that cause a rushed trip to the bathroom, such as incontinence.

Medicines

Often the most fixable item. The CDC names tranquilizers, sedatives and antidepressants, plus some over-the-counter medicines. The STEADI checklist adds opioids and anything that causes sedation, confusion or low blood pressure, and the NIA says the more medicines a person takes, the more likely they are to fall. The pocket guide points clinicians to the Beers Criteria, the American Geriatrics Society's list of medicines that often suit older adults poorly, and to stopping, switching or lowering doses.

That's the doctor's or pharmacist's call, not yours. Bring every bottle or a complete medication list, write down any change, and don't stop or cut back anything on your own.

Blood pressure that drops on standing

The CDC brochure on postural hypotension says it can cause dizziness, blurry vision, feeling muddled or about to faint, and tends to show up when standing suddenly, in the morning, after a big meal or alcohol, or when straining on the toilet. Listed causes include some diuretics, antidepressants and blood pressure medicines, and dehydration. If the falls cluster around getting out of bed or up from dinner, say so.

Eyes, ears and feet

The NIA links even small changes in sight and hearing to more falls, and says hearing aids should fit well and be worn. The pocket guide mentions an eye doctor referral, the possible benefit of cataract surgery, and a talk about single versus multifocal lenses, so bring up bifocals on the stairs. For feet, it suggests discussing shoe fit, traction and heel height, with a podiatrist if needed.

Vitamin D

The advice here has shifted. The CDC lists vitamin D deficiency as a risk factor, and the STEADI pocket guide says to assess intake and recommend a daily supplement if someone is deficient. The U.S. Preventive Services Task Force's 2024 falls prevention recommendation leaves vitamin D out and says it is being reviewed separately. In a December 2024 draft, the Task Force recommended against vitamin D to prevent falls in postmenopausal women and men 60 and older living at home. The draft excludes people taking it for other medical reasons and people with osteoporosis, vitamin D deficiency or an absorption problem. As of late October 2026 the Task Force still lists it as being finalized, not final.

So don't start a supplement on your own because Dad keeps tripping, and don't stop one his doctor prescribed. Ask whether his level should be checked and whether a supplement fits him.

The house

For repeat falls, look for the spot where it keeps happening. Two falls in the same dark hallway is a lighting problem until proven otherwise. The full room-by-room checklist is in the after-a-fall guide linked above.

Exercise and therapy: the strongest evidence

If you remember one thing from the visit, make it the exercise referral. The USPSTF's 2024 recommendation gives exercise a "B" grade for preventing falls in adults 65 and older living at home who are at increased risk. The programs it reviewed most often trained gait, balance and everyday movements, then strength.

Physical therapy

The STEADI pocket guide says to refer people with poor gait, strength or balance to physical therapy or an evidence-based program such as Tai Chi. Medicare.gov says Part B helps pay for medically necessary outpatient physical therapy once a doctor or other provider certifies the need, including therapy to maintain function or slow decline. The usual 20% coinsurance applies after the deductible, with no yearly limit on medically necessary outpatient therapy. Medicare Advantage members should call the plan about referrals and costs.

Community programs

The National Council on Aging lists evidence-based falls prevention programs that meet the Administration for Community Living's criteria. A few that come up often:

• A Matter of Balance: an eight-week group program aimed at fear of falling, mixing goal setting, home changes and strength and balance exercise. A good fit for the parent who has stopped going out.
• Otago Exercise Program: 17 strength and balance exercises delivered by a physical therapist or PT assistant, with an eight-week clinical phase and then months of exercising on their own with check-in calls. NCOA says it reduces falls by 35 to 40 percent for frail older adults.
• Tai Chi programs, such as Tai Ji Quan: Moving for Better Balance, twice a week for 24 weeks.
• SAIL, a three-times-a-week class that can be done standing or seated.

Ask the doctor's office, or find the local Area Agency on Aging through the Eldercare Locator, to see what runs nearby.

Help at home

When home hazards are likely, the STEADI pocket guide says to refer to an occupational therapist to evaluate home safety, and the NIA says a physical or occupational therapist can help choose a cane or walker and teach your parent to use it. NCOA's list also includes two home-based programs, if one runs locally: the Home Hazards Removal Program, where an OT works through the person's habits and the house and plans fixes like grab bars, and CAPABLE, which sends an OT, a nurse and a handyman over five months. The after-a-fall guide covers how Medicare handles home visits.

Questions to ask the doctor

Keep this open on your phone. You won't need all of it.

• Can we do a full fall risk assessment today, or book a visit for it?
• What were her Timed Up and Go time, chair-stand count and balance results? Can we have them written down?
• Could you check her blood pressure lying and then standing?
• Could any of her medicines, including sleep aids and over-the-counter ones, be adding to her risk?
• Do you see a pattern in the falls we logged? Could her heart, blood sugar or nerves be involved?
• Should her vitamin D level or bone density be checked? Are an eye exam and hearing check due?
• Can you write a physical therapy referral, or suggest a class like A Matter of Balance?
• Would an occupational therapist's home visit make sense? Does she need a cane or walker fitted?
• When should we follow up? The STEADI pocket guide suggests 30 to 90 days.

Keep score between visits

Doctors ask what nobody remembers by the visit: what time, doing what, dizzy first? Keep the running fall log from the after-a-fall guide, near misses included, and add one small table for the numbers from each assessment:

Keep both where every sibling can find them. The CDC notes that head injuries can be especially serious for people on blood thinners, so if your parent takes one, put it on their emergency information sheet where paramedics will see it.

When your parent says no

Plenty of parents hear "fall assessment" as step one toward a nursing home. The CDC brochure What YOU Can Do to Prevent Falls frames it better: balance and leg-strength exercise lowers the chance of falling and helps people feel more confident.

What goes over better than a lecture: let your parent raise it with the doctor while you fill in details ("Tell her about the porch step, Dad"). Pitch the Tai Chi class, not the problem. Swap in brighter bulbs without a debate. If the resistance runs deeper, our guide to when an elderly parent refuses help covers how to shrink the ask.

If your parent lives alone, think about how they'd call for help from the floor. The NIA suggests a charged phone on them at all times and daily contact with someone. Our questions to ask before buying a medical alert system cover what fall detection can and can't do.

Frequently asked questions

Does Medicare cover a fall risk assessment?

Partly. The first annual wellness visit must include a review of fall risk and home safety, and the health questionnaire at each wellness visit asks about balance and falls. Medicare.gov suggests a separate appointment for specific health concerns, and says coinsurance and the Part B deductible may apply when extra tests or services are added to a wellness visit. Ask the office ahead of time how a fall assessment visit will be billed.

What is a normal Timed Up and Go score?

The CDC's STEADI materials say an older adult who takes 12 seconds or more to stand, walk 10 feet, turn, walk back and sit is at risk for falling. How they walk and turn matters too.

Should my parent take vitamin D to prevent falls?

Ask the doctor first. The CDC lists vitamin D deficiency as a risk factor, but a December 2024 USPSTF draft, not yet final, recommended against vitamin D to prevent falls in older adults living at home who aren't deficient or taking it for another medical reason. Don't stop a prescribed supplement without asking.

Getting the plan onto paper

An assessment leaves loose ends: a PT referral, a halved medicine, an eye appointment, scores to beat. You can hold all of it with the checklist above, the score table and a folder by the phone.

If you'd rather not build the folder from scratch, Emergency Binder Now asks you about 25 minutes of guided questions and turns the answers into a printable binder for your parent, with their medicines, doctors and pharmacy, a one-page emergency sheet for paramedics, and a list of what's still missing. See a sample binder and decide whether it saves you the trouble.

General information only, not medical advice. Questions about your parent's falls, tests, medicines or supplements belong with their doctor or pharmacist, and coverage questions with their Medicare plan.