When an elderly person falls, the most important thing is to stay calm and assess the situation before attempting to move them. About 37% of older adults who fall end up needing medical treatment or having to limit their activity for at least a day, so taking a few minutes to check for injuries can prevent making things worse. Here’s exactly what to do, from the moment of the fall through recovery and prevention.
Check for Injuries Before Moving Them
Your first instinct will be to help the person up immediately. Resist it. Moving someone with a broken bone, especially a hip fracture, can cause severe pain and further damage. Instead, get down to their level, speak calmly, and ask them to tell you where it hurts.
Look for these red flags that mean you should call 911 rather than try to help them up yourself:
- Head injury: any bump, cut, or bruise on the head, especially if they lost consciousness even briefly
- Inability to move a limb: if they can’t move an arm or leg, or if a leg looks shortened or rotated outward
- Severe pain with any movement: particularly in the hip, back, or neck
- Confusion, dizziness, or slurred speech: these could signal a stroke or brain injury
- Shortness of breath or chest pain: these may indicate the fall was caused by a cardiac event
- Seizures, nausea, or vomiting: any of these warrant emergency evaluation
If the person hit their head and takes blood-thinning medication, they need medical attention even if they seem fine. Bleeding inside the skull can develop slowly in people on anticoagulants. UK clinical guidelines have recommended a CT scan within 8 hours for anyone on blood thinners who suffers a head injury, though doctors may take an individualized approach if the person is alert and symptom-free.
How to Safely Help Them Up
If there are no signs of serious injury and the person feels ready to get up, use the chair-assist method rather than pulling them upright. Hauling someone up by the arms risks injuring both of you.
Place a sturdy chair, or guide them toward a couch or coffee table, and walk them through these steps:
- Roll to one side: have them slowly roll onto their side
- Push up to hands and knees: from their side, they push up into a crawling position
- Crawl to the furniture: they move on hands and knees to the sturdy chair or couch
- Place hands on the furniture: with both hands gripping the seat or armrest, they put their stronger leg forward into a half-lunge
- Rise or sit: from the lunge, they push up to standing. If standing feels too difficult, they can turn and sit on the chair instead
Your role is to guide and steady, not lift. Stand close, offer a hand for balance, and let them do the work at their own pace. If they can’t get up using this method, keep them comfortable on the floor with a blanket and pillow and call for help.
Why Getting Off the Floor Quickly Matters
If an older person falls and can’t get up on their own, the time spent lying on the floor creates its own set of dangers. Researchers call this a “long lie,” and complications begin sooner than most people realize. Studies have used thresholds as short as 10 to 15 minutes to define a long lie, and by the time someone has been on the floor for two hours, physical effects are already showing up in a significant number of cases.
The longer someone stays immobile on the ground, the more serious the risks become. Dehydration, hypothermia, pressure injuries to the skin, and infections are common. In severe cases, prolonged pressure on muscles can cause rhabdomyolysis, a condition where muscle tissue breaks down and releases proteins that can damage the kidneys. Studies tracking people who lay immobile for an average of 18 hours or more found that nearly all of them developed complications. This is one of the strongest reasons for older adults who live alone to have a medical alert system or regular check-in routine.
What to Watch for in the Hours and Days After
Even if the person seems fine immediately after the fall, some injuries don’t announce themselves right away. Hip fractures sometimes cause only mild pain that worsens over the following day. Internal bleeding, particularly in the head, can take hours to produce symptoms.
For the first 24 to 48 hours, watch for new or worsening headaches, increasing confusion, difficulty walking that wasn’t present before, unusual sleepiness, or new bruising that spreads. Any of these should prompt a call to their doctor or a visit to urgent care.
It’s also worth thinking about why the fall happened. A trip over a rug is different from suddenly feeling dizzy and going down. Falls caused by lightheadedness, blurred vision, or leg weakness can point to medication side effects, blood pressure changes, or other medical issues that need attention. If the fall didn’t have an obvious environmental cause, a medical visit is a good idea even without visible injuries.
Be Ready Before Emergency Help Arrives
If you do call 911 or take the person to an emergency room, having key information ready saves time and helps responders make better decisions. The National Institute on Aging recommends keeping an updated list of all prescription medications, over-the-counter drugs, and supplements. This is especially critical for blood thinners, heart medications, and diabetes drugs, since these directly affect how emergency teams assess and treat fall injuries.
Also be ready to tell responders what happened: did the person trip, or did they feel faint? Did they lose consciousness? How long were they on the floor? Did they hit their head? These details help medical teams decide what scans or tests to order.
Exercises That Prevent Future Falls
One fall significantly increases the chances of another, partly because of physical deconditioning and partly because fear of falling leads people to move less, which weakens them further. The good news is that exercise is one of the most effective interventions available. A Cochrane review of 81 trials covering nearly 20,000 older adults found that exercise reduces the rate of falls by 23%.
Not all exercise is equally helpful, though. Balance and functional exercises, the kind where you practice standing on one leg, stepping over obstacles, or shifting your weight, reduced falls by 24%. When balance training was combined with resistance exercises like leg presses or squats, the reduction jumped to 34%. Tai Chi reduced the number of people experiencing falls by 20%.
Walking programs, dance, and pure resistance training (without a balance component) haven’t shown clear fall prevention benefits on their own. The key ingredient is challenging your balance in a controlled setting so your body gets better at recovering from the small stumbles that lead to falls. Many community centers and physical therapy offices offer group balance classes specifically designed for older adults.
Making the Home Safer
Most falls among older adults happen at home, so a room-by-room safety check can eliminate common hazards. In the bathroom, grab bars near the toilet and inside the shower are essential, not optional. Non-slip mats in the tub and on tile floors reduce one of the most dangerous surfaces in the house.
Throughout the home, remove loose rugs or secure them with double-sided tape. Keep walkways clear of cords and clutter. Make sure every room and hallway is well lit, including the path from the bedroom to the bathroom at night. Nightlights with motion sensors work well for this. Ensure frequently used items in the kitchen are stored at waist height so there’s no need to reach overhead or bend down. Stairs should have sturdy handrails on both sides, and any uneven thresholds between rooms should be addressed with small ramps or threshold strips.
One in ten falls results in an injury serious enough to send an older adult to the emergency room or restrict their daily activities. Many of these are preventable with the right combination of strength training, balance work, and a safer living environment.