Balance Quiz

Following is a brief questionnaire that can help determine if you or a loved one will benefit from our Fall Prevention Program:

Yes No  
Do you hold onto furniture when walking inside your home?
 
Do you feel safer holding onto someone’s arm when walking outside your home?
 
Do you avoid or have problems with activities such as:
 
    a) picking up objects from the floor
 
    b) reaching to a high shelf
 
Do you have difficulty going up or down stairs?
 
Do you have trouble getting up from low chairs?
 
Do you need frequent rest breaks when walking?
 
Do you feel unsteady when standing or walking?
 
Are you ever afraid of falling?