What To Do After a Fall: Four Steps For Seniors and Their Caregivers

Preventing Falls Is the Goal for Seniors and Caregivers, but Life Happens

I recently presented a webinar on ways to prevent falls for seniors and their loved ones, and an attendee asked a very important question: "What should I do if I do fall? Should I get up?" I answered with the short version during the webinar, but this question deserves a more complete answer. As an Eldercare Information Guide, I set out to do some research. I'm sharing what I learned directly with our Senior readers, but Caregivers, you'll know what to do, too.
Is Someone Nearby To Help?

When you fall, you will most likely have an idea whether there is someone around to help you. If you're at home, you'll know if you're alone or not. If you're in a public place, you'll have some idea if there are people around or whether this is an isolated area. If the fall causes an injury, you may need to summon help. If there are people around, they may be able to do the injury checks in Steps 1 and 2 below as well as alert emergency medical services (EMS). If not, you will need to summon help. Being aware of your situation will help you determine how to proceed if you fall. 
Step 1: Do Not Get Up, Check for Head Injury

After a fall, you'll always feel a little disoriented. You've changed position quickly, gotten jostled about, and have landed in an unplanned way. You're a bit embarrassed, want to reassure yourself and anyone around that you're all right, but you need to give your body time to reset. Don't get up; don't move. Give your senses some time to settle. Give your body and brain some time to start communicating again.

First, how's your head? Since head injuries can be life threatening, determine if you've hurt your head and how serious the injury is. A minor head injury is one in which you've fallen on a soft surface, like a padded carpet; there's no bleeding; you've hit your head but have fallen no farther than your own height (you didn't fall off a step stool, say); and you didn't lost consciousness or black out. For a minor head injury, you can use some first aid at home. An ice pack wrapped in a towel at the "goose egg" for about 30 minutes works for pain and make an appointment to visit the doctor within a few days to get checked out.

LaVerne Z. Coan. Open Book Communications. Article # : PC2011071301. July 13, 2011.
Step 2: Stay Down, Check for Any Other Serious Injury

Bleeding Check: Next, check for signs of bleeding, especially heavy bleeding with a pulsing flow. A bone that has broken through the skin may tear an artery or vein, causing life-threatening bleeding. If this type of bleeding occurs, apply pressure directly to the wound or just above the wound (in the case of an exposed bone), and immediately call EMS.

Other common injuries from falling are breaks or bruises to the spinal cord, a broken hip, muscle sprains, dislocations and wrist injuries. To check for these injuries, do the following:

Visual Check: You're still down where you fell. Can you see any deformities along your body, any swelling,  or unusual position of limbs? If so, call EMS. If not, proceed.

Wiggle Check: While you're down, without moving your arms and legs, wiggle your fingers, then your toes. If you can't wiggle all your digits or if it's painful to do so, there could be some kind of muscle, nerve or bone injury. Do Not Get Up. Call EMS.

Brush Check: Still down, brush your fingers along your arms and legs and make sure that you can feel that brushing all along the way. If you cannot, deeper injury is possible. Do Not Get Up. Call EMS.

Pain Check: If there is no serious head injury and you've passed the Bleeding, Visual, and Wiggle and Brush Checks, then while you're still down, start moving your body and limbs slowly, checking on the way for any strong pain. If the pain is strong, call EMS. Especially call EMS when you can't get up because of the pain.

Elderly Fall Injuries: Common Injuries from Falls in the Elderly. By Rod Brouhard, About.com Guide, Created December 21, 2010. Accessed on July 13, 2011.

Head Injury Treatment: Self-Care at Home. WebMD Medical Reference from eMedicineHealth.
Reviewed by Jonathan L Gelfand, MD on May 03, 2010. Accessed on July 13, 2011.

If You Fall or Witness a Fall, Do You Know What to Do? Public Health Agency of Canada. October 1, 2009. Accessed on July 13, 2011

What To Do When An Elderly Parent Falls. Emma Hamilton's Blog. AgedCarer: Australians Caring for their Ageing Families. Undated. Accessed on July 13, 2011.

First Aid/A Fall. Question: What questions should you ask after a person has fallen down and what should you do? Answered by Mandiye Wood, May 8, 2006. Accessed on July 13, 2011.

First Aid Treatment: Common Topics. WebMD. Accessed on July 13, 2011.
Step 3: Get Up, Slowly and Carefully

If you did not hit your head or it's a minor head bump and you've passed all the Checks in Step 2 and there is no pain at all or only minor pain, then get up slowly, preferably with someone's help.  See some suggestions for getting up after a fall at the Public Health Agency of Canada.
Step 4: Tend to Your Minor Hurts

Now that you're up and about, check for visible signs of trauma, bruises, bumps, cuts, and scrapes and tend to these. Use common sense and first aid instructions as given at your local Red Cross or at the WebMD web site.  It is a good idea for all seniors and their caregivers to have first aid training.

During the week after the fall, keep an eye out for lingering effects of the jostling your body took. Make an appointment to see a doctor if you experience:
  • Loss of consciousness
  • Strong or lingering pain
  • Dizziness
  • Nausea
  • Overall weakness
  • Headaches
  • Vision problems
1 out of 3 Elders over Age 65 Fall Each Year.
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What To Do After a Fall: The Four Steps

Step 1: Do Not Get Up; Check for Head Injury

Step 2: Stay Down; Check for Any Other Serious Injury

Step 3: If You Pass Checks in Step 1 and 2, Get Up Slowly

Step 4: Tend to Your Minor Hurts
A serious head injury is one in which you've hit your head on a hard surface, like concrete or a hard wood floor; you're bleeding from your head, nose, eyes or ears; you hit your head after falling from a height taller than you; or you've blacked out, even if only for a few seconds. If any one of these four is true of your knock on the noggin, then you have a serious head injury, and it's time to call EMS.
A fall can be unnerving and dangerous, so preventing falls is always the first goal. But if you do fall, use the 4 Steps to get you back on your feet safely and surely.
Are You Alone?
See suggestions on getting up safely and summoning help when you're alone at the Public Health Agency of Canada website.
If You Live Alone

Whether you're a Senior or not, if you live alone, you'll need to consider how to summon help if you take a tumble in your home. There are a variety of technologies that can help you communicate with a caregiver or EMS if you can't reach a landline phone. Here are some ideas:
  • Carry a simple mobile phone with you while in the house--in your pocket, on your belt, in a small waist pack. Have an easy speed dial set up to summon your family or EMS.
  • Purchase and wear an electronic Personal Medical Alert System pendant or bracelet. You can find systems that have a panic button for you to push, but some also have a "fall monitor". If the monitor descends suddenly and rapidly (detects a fall), the monitor waits for a set amount of time for the height to rise again (for you to get up). If you don't, it summons aid.
  • Install Motion Sensors in several rooms of the house. Motion detectors are part of many home alarm systems. This monitoring system works in reverse. If you don't enter the living room by a certain time, or no motion is detected when you should be up and about, this system summons help.
  • Add a family communications system to your home. Such systems, like Connected for Life from Family Health Network, use a touch-screen computer and the Internet to keep you connected to your family and friends. A simple question presented on the screen a few times a day, "Hello, are you there?" allows you to let your family know that you're up and about.
Copyright 2011 LaVerne Z. Coan. All Rights Reserved. You may download or print one copy for personal use, but please contact the author if you wish to distribute more copies to friends and relatives.  Sharing a link to this page is always permitted.
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