If an elderly person has fallen, your first call depends on whether they’re injured. Call 911 immediately if the person hit their head, lost consciousness, can’t move a limb, has severe pain, or is on blood thinners. If they’re uninjured but simply can’t get up, you have several lower-urgency options, including your local fire department’s non-emergency line. Here’s how to assess the situation and make the right call.
When to Call 911
Some falls are medical emergencies. Falls are the most common cause of traumatic brain injuries, and 83% of hip fracture deaths in 2019 were caused by falls. Acting quickly in these cases can be lifesaving.
Call 911 if the person who fell has any of the following:
- Head impact or headache after hitting their head. Even if the person seems alert, a head strike can cause bleeding inside the skull that worsens over hours.
- Loss of consciousness, even briefly.
- Inability to move an arm or leg, or severe pain in the hip, back, or neck. This could signal a fracture or spinal injury. Do not try to move them.
- Confusion, slurred speech, or sudden weakness on one side. These are stroke symptoms, and the fall itself may have been caused by a stroke.
- Blood thinner use. If the person takes a blood-thinning medication, even a minor bump to the head can cause dangerous internal bleeding. Err on the side of calling 911.
- Visible bleeding that won’t stop with firm pressure after several minutes.
If you’re alone with someone experiencing any of these symptoms, don’t try to drive them to the ER yourself. Call 911 so paramedics can stabilize them during transport.
If They’re Not Injured but Can’t Get Up
Many falls don’t cause serious injury, but the person simply can’t get back on their feet. About 37% of older adults who fall report an injury that needs medical treatment or limits their activity for at least a day, which means the majority of falls don’t result in a major injury. Still, someone who is frail or has limited mobility may be physically unable to stand without help, even when nothing is broken.
Your best option in this situation is calling your local fire department’s non-emergency number for what’s known as a “lift assist.” Fire and EMS crews regularly respond to these calls. They’ll help the person safely off the floor, check vital signs, and confirm there’s no obvious injury. If no ambulance transport is needed, there’s often no charge, though some communities have started billing for frequent lift assists at care facilities. In cities that do charge for a treat-and-no-transport response, fees typically run around $225 to $250.
If you don’t know your fire department’s non-emergency number, calling 911 and explaining that the person is alert, uninjured, but unable to get up is perfectly acceptable. The dispatcher will categorize it as a lower-priority call.
What Not to Do While Waiting
Resist the urge to pull the person up by their arms. If there’s a hidden fracture in the hip or spine, moving them incorrectly can make the injury far worse. Instead, keep them comfortable on the floor. Place a pillow or folded blanket under their head, cover them with a blanket to prevent chilling, and stay with them. If they’re alert and not in pain, you can help them scoot to a seated position leaning against a wall or piece of sturdy furniture while you wait for help.
Urgent Care vs. the Emergency Room
If the person gets up and seems mostly fine but has moderate pain, stiffness, or swelling, they still need to be evaluated. The question is where.
An emergency room is the right choice when you suspect a hip fracture (the person can’t bear weight), a possible head injury, or any neurological symptoms like dizziness or confusion. ERs have CT scanners, which are critical for detecting brain bleeds and complex fractures.
An urgent care center can handle minor fall injuries like wrist or ankle pain, small cuts that might need stitches, or bruising you want checked out. Most urgent care locations have X-ray machines. However, they typically lack CT or MRI capability and aren’t equipped for the kind of rapid evaluation an elderly person with a head strike needs. When in doubt, choose the ER.
The Follow-Up Call That Matters Most
Even if the fall seems minor, call the person’s primary care doctor within a day or two. A single fall in an older adult is a clinical event that should trigger a full risk assessment. The CDC recommends that any adult 65 or older who presents with a fall be screened for modifiable risk factors, with a follow-up visit within 30 to 90 days.
At that visit, the doctor will typically evaluate gait, strength, and balance using timed standing and walking tests. They’ll also review medications that increase fall risk (sedatives, blood pressure drugs, and certain antidepressants are common culprits), check blood pressure in both lying and standing positions to detect drops that cause dizziness, test vision, assess footwear, and ask about hazards in the home like throw rugs and slippery bathtub floors. Vitamin D levels may also be checked, since deficiency contributes to muscle weakness and poor balance.
If balance or mobility problems are identified, your doctor can certify the need for physical therapy, which Medicare covers when a provider documents medical necessity. Physical therapy focused on gait and balance training is one of the most effective ways to prevent a second fall.
Medical Alert Devices: What to Know
If you’re considering a wearable fall detection device for a parent or loved one, understand what they can and can’t do. These devices are marketed with impressive lab-tested accuracy, often citing sensitivity rates above 94%. But real-world performance tells a different story.
A study published in the Journal of the American Geriatrics Society tracked older adults wearing a fall detection device for an average of about 80 days. Out of 84 alarms the devices triggered, 83 were false alarms. The largest share of false alarms, about 42%, happened during normal daily wear. Others were triggered by dropping the device, misusing it, or setting it down. Meanwhile, three actual falls went completely undetected. Only one real fall, in which a participant fell backward and hit her head, triggered an alert.
This doesn’t mean these devices are useless, but it does mean you shouldn’t rely on automatic fall detection as a safety net. The manual button, where the person presses to call for help, remains far more reliable. The real value of a medical alert system is giving someone who lives alone a way to summon help when they’re conscious but can’t reach a phone.
Why the First Fall Is a Warning
About 37% of falls result in an injury serious enough to need medical care or limit daily activity. But even falls that cause no physical injury carry a psychological cost. Fear of falling again often leads older adults to reduce their activity, which weakens muscles and balance further, creating a cycle that makes the next fall more likely.
The most important thing you can do after an elderly person falls isn’t just getting them off the floor. It’s making sure the fall triggers a conversation with their doctor, an honest look at the home environment, and a plan to strengthen the factors, like balance, vision, medication management, and footwear, that can be changed.