A Systematic Review of Post-Fall Care: Developing an Integrated Continuum from Medical Assessment to Functional Rehabilitation
Abstract
Background: Falls in older adults are a frequent global health occurrence, a sign of physiologic failure, and lead to injury, functional decline, fear of falling, and death. In spite of prevention measures, postfall care is often fragmented, focusing on the management of injury and neglect of etiology.
Aim: This review aggregates current evidence to propose a standardized, patient-centered plan for comprehensive post-fall care aimed at addressing gaps in care from the time of initial response through long-term restoration of function.
Methods: A narrative review of recent literature (2025) was conducted to summarize and synthesize evidence on the components of an optimal post-fall pathway, including initial assessment, interdisciplinary study, and rehabilitation strategies.
Results: The results present an uninterrupted, five-step process: 1) Initial nurse response and triage; 2) Complete medical workup to determine etiology; 3) Interdisciplinary care planning; 4) Restoration of function through physical and occupational therapy; and 5) Secondary prevention and transition planning. This model emphasizes the key roles of all health care professionals in creating a unitary care continuum.
Conclusion: This integrated, multidisciplinary practice can transform a fall from an incident to an opportunity for holistic assessment, proactive prevention of subsequent risk, preservation of patient autonomy, and improvement in quality of life.
Full text article
References
Alharbi, S. M., al harish, T. M., Attyah Zead Alqurashi, E., Alsubaie, M. D., Alanazi, N. M., Almutairi, B. A., … Alsharari, Y. D. D. (2025). Artificial Intelligence and Robotics in Surgery: The Future of Precision Medicine. Saudi Journal of Medicine and Public Health, *2*(2), 159–170. https://doi.org/10.64483/jmph-69
Almeida, A. S., Paguia, A., & Neves, A. P. (2024). Nursing interventions to empower family caregivers to manage the risk of falling in older adults: A scoping review. International Journal of Environmental Research and Public Health, 21(3), 246. https://doi.org/10.3390/ijerph21030246
Avelino-Silva, T. J., Campora, F., Curiati, J. A., & Jacob-Filho, W. (2017). Association between delirium superimposed on dementia and mortality in hospitalized older adults: A prospective cohort study. PLoS medicine, 14(3), e1002264. https://doi.org/10.1371/journal.pmed.1002264
Bermingham, S. L. (2014). The appropriate use of neuroimaging in the diagnostic work-up of dementia: an economic literature review and cost-effectiveness analysis. Ontario health technology assessment series, 14(2), 1. https://pubmed.ncbi.nlm.nih.gov/24592297/
Barry, E., Galvin, R., Keogh, C., Horgan, F., & Fahey, T. (2014). Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis. BMC geriatrics, 14(1), 14. https://doi.org/10.1186/1471-2318-14-14
Bowie, J. (2025). Centers for Medicare and Medicaid No-Pay Policy for Fall Prevention: A Policy Analysis Project (Doctoral dissertation, Jacksonville University).
Caña-Pino, A., & Pesado-Fernández, L. (2025). Occupational Therapy Interventions for Fall Prevention in Older Adults: A Systematic Review of Multimodal Strategies. Physiologia, 5(3), 33. https://doi.org/10.3390/physiologia5030033
Dunning, E. (2009). Implementing a safe patient handling program. Nursing2020 Critical Care, 4(2), 44-50. DOI: 10.1097/01.CCN.0000347129.70704.f6
Fedorowski, A., Ricci, F., & Sutton, R. (2019). Orthostatic hypotension and cardiovascular risk. Polish Heart Journal (Kardiologia Polska), 77(11), 1020-1027. https://doi.org/10.33963/KP.15055
Gatica-Rojas, V., & Cartes-Velásquez, R. (2023). Telerehabilitation in low-resource settings to improve postural balance in older adults: a non-inferiority randomised controlled clinical trial protocol. International Journal of Environmental Research and Public Health, 20(18), 6726. https://doi.org/10.3390/ijerph20186726
Hunter, S. W. (2019). Assistive devices, falls, and cognitive aspects. Falls and Cognition in Older Persons: Fundamentals, Assessment and Therapeutic Options, 139-150. https://doi.org/10.1007/978-3-030-24233-6_8
Hazazi, Y. O. (2025). Strengthening Postpartum Depression Screening and Treatment within Primary Healthcare Centers in Riyadh 1st Cluster. Saudi Journal of Medicine and Public Health, *2*(2), 105–113. https://doi.org/10.64483/jmph-56
Liu, C. J., Chang, W. P., & Chang, M. C. (2018). Occupational therapy interventions to improve activities of daily living for community-dwelling older adults: A systematic review. The American Journal of Occupational Therapy, 72(4), 7204190060p1-7204190060p11. https://doi.org/10.5014/ajot.2018.031252
Lord, S. R., & Dayhew, J. (2001). Visual risk factors for falls in older people. Journal of the American Geriatrics Society, 49(5), 508-515. https://doi.org/10.1046/j.1532-5415.2001.49107.x
McColl, L., Strassheim, V., Linsley, M., Green, D., Dunkel, C., Trundle, H., ... & Parry, S. W. (2022). Falls efficacy scale International (FES-I) as a predictor of gait and balance abnormalities in community dwelling older people. medRxiv, 2022-09. https://doi.org/10.1101/2022.09.29.22280485
Mohammed Abu Haddash, N. A. (2025). Comprehensive Review of the Success of the Hospital-at-Home Program in Today’s Healthcare Delivery. Saudi Journal of Medicine and Public Health, *2*(2), 45–52. https://doi.org/10.64483/jmph-31
Naccarato, M., Leviner, S., Proehl, J., Barnason, S., Brim, C., Crowley, M., ... & Papa, A. (2012). Emergency Nursing Resource: orthostatic vital signs. Journal of Emergency Nursing, 38(5), 447-453. https://doi.org/10.1016/j.jen.2012.05.011
Parekh, A., Hill, K. D., & Guerbaai, R. A. (2025). Exploring Post‐Fall Management Interventions in Long‐Term Care Facilities and Hospitals for Older Adults: A Scoping Review. Journal of Clinical Nursing, 34(2), 408-421. https://doi.org/10.1111/jocn.17546
Quigley, P. A. (2020). Assessing, Managing, and Preventing Falls in Acute Care. Evidence-Based Geriatric Nursing Protocols for Best Practice, 375.
Saud Faleh Alanazi. (2024). Comparative Evaluation of the Pharmacological Mechanisms, Clinical Indications, and Risk Management Strategies of Epidural Anesthesia in Surgical and Obstetric Interventions. Saudi Journal of Medicine and Public Health, *1*(1), 47–57. https://doi.org/10.64483/jmph-36
Seppala, L. J., Petrovic, M., Ryg, J., Bahat, G., Topinkova, E., Szczerbińska, K., ... & Van der Velde, N. (2021). STOPPFall (screening tool of older persons prescriptions in older adults with high fall risk): a Delphi study by the EuGMS task and finish group on fall-risk-increasing drugs. Age and ageing, 50(4), 1189-1199. https://doi.org/10.1093/ageing/afaa249
Sheldon, R. S., Grubb II, B. P., Olshansky, B., Shen, W. K., Calkins, H., Brignole, M., ... & Kanjwal, K. (2015). 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart rhythm, 12(6), e41-e63. https://doi.org/10.1016/j.hrthm.2015.03.029
Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., ... & Lamb, S. E. (2019). Exercise for preventing falls in older people living in the community. Cochrane database of systematic reviews, (1). https://doi.org/10.1002/14651858.CD012424.pub2
Stephenson, M., Mcarthur, A., Giles, K., Lockwood, C., Aromataris, E., & Pearson, A. (2016). Prevention of falls in acute hospital settings: a multi-site audit and best practice implementation project. International Journal for Quality in Health Care, 28(1), 92-98. https://doi.org/10.1093/intqhc/mzv113
Takase, M. (2023). Falls as the result of interplay between nurses, patient and the environment: using text-mining to uncover how and why falls happen. International journal of nursing sciences, 10(1), 30-37. https://doi.org/10.1016/j.ijnss.2022.12.003
Tsiachristas, A., Langhorne, P., Burke, O., Harwood, R. H., Conroy, S. P., Kircher, T., ... & Robinson, D. (2017). Comprehensive geriatric assessment for older adults admitted to hospital. Cochrane database of systematic reviews, (9). https://doi.org/10.1002/14651858.CD006211.pub3
van Haastregt, J. C., Zijlstra, G. R., van Rossum, E., van Eijk, J. T., de Witte, L. P., & Kempen, G. I. (2007). Feasibility of a cognitive behavioural group intervention to reduce fear of falling and associated avoidance of activity in community-living older people: a process evaluation. BMC health services research, 7(1), 156. https://doi.org/10.1186/1472-6963-7-156
Wang, Z., Zhang, Y., Wu, J., & Zhang, Q. (2024). Global, regional and country-specific burden of patella, tibia or fibula, or ankle fractures and its prediction to 2035: findings from global burden of disease study 2019. BMC Public Health, 24(1), 3162. https://doi.org/10.1186/s12889-024-20675-7
Wayne, P. M., Ahn, A., Clark, J., Irwin, M. R., Kong, J., Lavretsky, H., ... & Yeh, G. Y. (2025). The Science of Tai Chi and Qigong as Whole Person Health-Part I: Rationale and State of the Science. Journal of Integrative and Complementary Medicine, 31(6), 499-520. https://doi.org/10.1089/jicm.2024.0957
Wei, F. L., Li, T., Gao, Q. Y., Huang, Y., Zhou, C. P., Wang, W., & Qian, J. X. (2022). Association between vitamin D supplementation and fall prevention. Frontiers in endocrinology, 13, 919839. https://doi.org/10.3389/fendo.2022.919839
Wenzel, L. (2023). A Gap Analysis of Falls Prevention on a Medical-Surgical Unit (Doctoral dissertation, Drexel University).
Wieczorek, P., & Chakravarthy, A. (2025). Implementing a Fall TIPS Program to Reduce Fall Rates Among Inpatient Adults (Doctoral dissertation, School of Nursing, University of Maryland at Baltimore).
World Health Organization. (2025). Step safely: Strategies for preventing and managing falls across the life-course. WHO Press. https://www.who.int/publications/i/item/978924002191-4
Yamada, M., Higuchi, T., Nishiguchi, S., Yoshimura, K., Kajiwara, Y., & Aoyama, T. (2013). Multitarget stepping program in combination with a standardized multicomponent exercise program can prevent falls in community‐dwelling older adults: a randomized, controlled trial. Journal of the American Geriatrics Society, 61(10), 1669-1675. https://doi.org/10.1111/jgs.12453
Yao, S., Zheng, P., Ji, L., Ma, Z., Wang, L., Qiao, L., ... & Wang, H. (2020). The effect of comprehensive assessment and multi-disciplinary management for the geriatric and frail patient: a multi-center, randomized, parallel controlled trial. Medicine, 99(46), e22873. DOI: 10.1097/MD.0000000000022873
Yan, J., Wang, M., & Cao, Y. (2022). Patterns of multimorbidity in association with falls among the middle-aged and older adults: results from the China Health and Retirement Longitudinal Study. BMC Public Health, 22(1), 1814. https://doi.org/10.1186/s12889-022-14124-6
Authors
Copyright (c) 2025 Sumaiah Abdullrhman Hassan Al-Saloli, Fatimah Fahad Alnasser, Fahad Hasil Alasmari, Mohammad Ayed H Alenizi, Mona Mohammed Alanazi, Eman Mohsen Yahya Zabr, Abdullah Sultan M Alsahli, Abdullah Hamoud Mohammed Almazyad, Abduaziz Rashed Zaid Bin Gannam, Nasser Faleh M Alghatani, Abdallah Saad Said Aldosery, Tahani Rashed Awad Alruwaili, Naif Saad Alsahla
This work is licensed under a Creative Commons Attribution 4.0 International License.