Falls

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Useful Management Information

The Falls and Balance Service supports the assessment and diagnosis of causes and for the development of management plans of people aged 55 or older with recurrent falls or falls with high risk of injury.
A history of falls in the past year is the single most important risk factor for falls and is a predictor for further falls.
Older people reporting a fall or considered at risk of falling should be observed for balance and gait deficits. They should be considered for interventions that improve strength and balance.
Consider referral to clinical pharmacist for Home Medical Review if evidence of polypharmacy.
Telehealth appointments for initial assessment are generally not appropriate for this cohort of patients; however, telehealth review appointments can be negotiated under special circumstances.
The following links to cognitive assessment tools may be useful:
- General screening information: https://health.dementia.org.au/information/for-health-professionals/clinical-resources/cognitive-screening-and-assessment
- Montreal Cognitive Assessment (MOCA): http://dementiakt.com.au/doms/domains/cognition/moca
- GP assessment of cognition (GPCOG) tool: http://gpcog.com.au/
- Standardised mini-mental state examination (MMSE): https://www.ihpa.gov.au/sites/g/files/net636/f/publications/smmse-tool-v2.pdf
Evidence for fall prevention strategies:
- exercise
- high dose vitamin D
- psychoactive medication withdrawal (particularly antidepressants, antipsychotics and benzodiazepines)
- occupational therapy home visit
- restricted multifocal spectacle use
- expedited cataract surgery (where required)
- podiatry assessment and intervention
- multifactorial assessment with targeted interventions (including referral to physiotherapist, occupational therapist and/or dietitian as appropriate).

Minimum Referral Criteria

Category 1	Two or more falls in the previous month
Category 2	Two or more falls in previous 12 months Falls as part of an overall decline in physical, social or psychological function
Category 3	No category 3 criteria
If your patient doesn't meet the minimum referral criteria If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Relevant medical history, comorbidities and medications (including an assessment of adherence)
Number of falls in the previous 12 months
Assessment of cognitive function (MMSE, MOCA or other validated tool) in patients ≥ 65 years of age
Chronological profile of the impact of symptoms on ability to function
FBC
ELFT
MSU

If a specific test result cannot be obtained due to access, financial, religious, cultural or consent
reasons a clinical override may be requested. This reason must be clearly articulated in the body of
the referral.

Additional Referral Information

Existing psychosocial issues and supports (family, carers, home services, etc)
Copies of discharge summaries and outpatient letters relating to hospitalisations for falls, or visits to fall clinics, or home assessments for falls risk
Bone mineral densitometry report, Vitamin D assay (if performed)
Home medications review report if available

Send Referrals To

Smart Referrals

Coming Soon

Internal Referrals

Internal Referrals not accepted

Fax

1300 668 536

Post

Central Intake Unit
Robina Health Precinct
Level 4, 2 Campus Crescent
Robina QLD 4226

Enquiries

1300 668 936

Service Availability

Facilities

Robina Health Precinct

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.