You are reviewing data collected during the assessment of an older adult. Which finding would indicate an increase in the patient's risk of falling?

Fall risk assessment in older adults requires identifying both intrinsic and extrinsic factors that increase the likelihood of falling. An unsteady gait is a well-established intrinsic risk factor for falls; it directly affects balance and coordination, making it the most significant finding among the options presented. Gait instability is consistently identified in fall risk screening tools such as the Morse Fall Scale and the Timed Up and Go test. Living in a one-level home is actually a protective environmental modification because it eliminates stairway hazards, thereby reducing extrinsic fall risk. Wearing corrective lenses helps compensate for visual impairment, another known fall risk factor, so it represents a risk-reducing measure rather than an additional risk. Using a hearing aid addresses auditory deficits that can affect spatial orientation, and similarly serves as a compensatory device rather than a new risk. Students should recall that among the leading fall risk factors are impaired gait and balance, polypharmacy, cognitive impairment, lower-extremity weakness, and environmental hazards. When a nurse identifies an unsteady gait during assessment, immediate interventions such as implementing a fall prevention protocol, providing assistive devices, and educating the patient and family are warranted.