Serving Since 1987
Serving Since 1987
Please read the following questions and answer them by checking Yes or No.
| Healthy Vision Checklist |
|---|
| Have you ever fallen before? Yes No |
| Are you 65 or over? Yes No |
| Do you experience difficulty or dizziness when getting up from a chair? Yes No |
| Are you unsteady with quick turns or on uneven ground? Yes No |
| Do you feel unsteady reaching for objects overhead or on the ground? Yes No |
| Have you noticed a decline in your vision or hearing? Yes No |
| Do you have weak muscles or stiff joints? Yes No |
| Do you have any condition that affects feeling in your feet or ankles? Yes No |
| Are you on four or more medications? Yes No |
| Do you frequently drink alcohol? Yes No |
| Do you experience difficulty sleeping? Yes No |
| Are there hazards in or around your home? Yes No |
| Have you had a recent illness or injury that has caused a lifestyle change? Yes No |
| Have you been diagnosed with any chronic neurological condition or other serious medical problems? Yes No |
The more “Yes” answers you have above, the greater your risk for a fall. But you can take control of your environment, health and lifestyle to lower that risk and stay safe. In this booklet, you will find many suggestions for becoming more health conscious and making your home safer so that you and your loved ones can stay vital, independent and on your feet!
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