The Geriatric Acute & Post-acute Care Coordination Program for Fall Prevention in the Emergency Department II

In order to determine whether a multifactorial fall prevention intervention is feasible, acceptable and may reduce recurrent falls in older adults presenting to the ED after a fall, we will randomize patients to usual care with a traditional fall evaluation by an ED clinician or an intervention. Patients in the intervention arm receive a fall risk assessment and recommendations by a physical therapist. They are also evaluated by a pharmacist and participate in a medication therapy management session with the aim to reduce fall risk increasing medication.

Inclusion criteria

• Community-dwelling adult (non-institutionalized) 65 years-old or older presenting to ED after a fall
• Fall not due to syncope or external force (i.e., struck by car or assault)
• Fall not due to serious illness (i.e., stroke, acute myocardial infarction)
• Will be discharged to home/assisted living/rehabilitation at completion of ED visit (i.e., not admitted)
• Legally authorized representative able to give informed consent if patient has cognitive impairment on Six Item Screener (score of less than four) either over the phone with witness present or in person
• Must screen or test negative for COVID-19

Exclusion criteria

• Unable to give informed consent due to intoxication or altered mental status
• Presence of injuries that prevent mobilization (i.e., pelvic or lower extremity fractures)
• Allergies to any wearable device component
• Unable or unwilling to wear Apple Watch at home (only for periodic study visits)
• Patient has advanced cancer and/or is on hospice care
• Pts coming from SNF or nursing home
• Previously enrolled in GAPcare II Aim1.b