An Adult at Risk is a person over 18 years who:

has care and support needs
AND may be experiencing or at risk of abuse or neglect
AND is unable to protect themselves from abuse and neglect because of their care and support needs

An adult at risk may therefore be a person who,for example:
• is an older person who is frail due to ill health, physical disability or cognitive impairment
• has a learning and/or physical disability and/or a sensory impairment
• has mental health needs including dementia or a personality disorder
• has a long-term illness/condition
• misuses substances or alcohol
• is an unpaid carer such as a family member/friend who provides personal assistance and care to adults and is subject to abuse

The 2015 NICE Quality Standards defines a fall as an unexpected loss of balance resulting in a person unintentionally coming to rest on the ground or floor, or other lower-level surface regardless of whether an injury was sustained. This also includes falling on the stairs and onto a piece of furniture with or without loss of consciousness.

A fall is distinct from a collapse which is because of an acute medical condition such as arrhythmia, transient ischaemic attack (TIA) or vertigo. Anyone can have a fall, but older people are more vulnerable and likely to fall, especially if they have a long-term health condition. Most falls do not result in serious injury, however, once a person has experienced a fall, they are more likely to have recurring falls. Some falls may cause serious injury, even death.

In addition to any physical injury, a fall can impact on a person’s self-confidence, increase social isolation, and reduce independence. It is therefore important to provide relevant 4 support and advice where possible to prevent falls occurring by taking into consideration each person’s individual risk (for example, by undertaking a falls risk assessment including environmental risk assessment and where appropriate, to ensure falls risk reduction measures are in place (see section 4 for further information).

Fall prevention strategies and interventions need to consider the fact that falls can have several causes, such as frailty, infection, confusion, and the effect of certain prescribed drugs that require many different interventions. Fall prevention is the key to safeguard people from harm.