What to do if an older person falls

Supporting older adults after a fall

A fall can be damaging for anyone, but for an older person this could cause extensive injuries and mental health concerns. For this reason, taking a proactive approach to potential falls and knowing what to do if your loved one has an accident like this at home can help maintain their safety, confidence and independence. 

Here, we are breaking down everything you need to know if an older person falls, including the immediate actions to take, what to do if they suffer a head injury, how to properly assess their injuries, how and when to contact medical help, how to support them with the emotional and psychological challenges of falls, how to effectively prevent a fall from happening, and how professional home care can help.

At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about falls in older people, we can help.

What steps should I take if an older person falls?  

The difference between a person recovering well from a fall or not could be down to the steps taken immediately afterwards, so if you are caring for an older loved one, it is important to be knowledgeable on how to handle these situations. 

If an older person falls, it is important to:

• Stay calm – Speak in a calm voice to keep them relaxed, and avoid panicking. Reassure them that they will be OK, and encourage them to remain still until you can be sure there are no serious injuries. It could help to encourage them to take deep breaths. If you notice they are not breathing or unconscious, proceed straight to calling an ambulance (999 if you are in the UK). 
• Check for injuries – If they are breathing and conscious, you can check to see if there are any injuries. We will cover this in more detail below, but you should check for visible injuries like bleeding or swelling, or ask them about any pain. If you suspect they have a head injury or are bleeding excessively, again, skip straight to calling 999 if you are in the UK. 
• Decide whether or not to move them – At this stage, you must decide whether or not it is advisable to move the person. If they appear uninjured and they insist they are fine, they may attempt to get up. If you believe it is safe to do so, wait until the initial shock has worn off for them, proceed very slowly, and stop if they experience any pain. We have included more information on how to help them up safely below. If they do have an obvious injury, or you have any reason to suspect they might have an injury (such as pain or bruising) do not move them from the position they are in. Instead, call an ambulance. 
• Keep them warm  – Sometimes the shock of a fall can lead to the person’s temperature dropping, which can cause further problems, particularly if they have fallen on the ground outside. If you have determined the older person should remain where they are and wait for an ambulance, cover them with a blanket, warm clothing or something else to retain their body heat. If you are outdoors with no access to this, ask in local businesses – many will have a first aid kit with an emergency blanket. 

Seek medical advice – Whether or not they have visible injuries, it is important to have them assessed by a medical professional to check for any non-obvious or minor problems. If you think the person needs immediate medical attention, call 999 (if in the UK), take them to A&E yourself, or book a doctor’s appointment, depending on the severity of the fall. If you struggle to get a doctor’s appointment straight away, let them know about the fall so they can decide how early to see you.

What should I do if an older person hits their head?  

Falls are known to be the most common cause of traumatic brain injuries, so it is extremely important to know what to do if a person hits their head. 

If this happens to your older loved one, take action immediately and be cautious. The above recommendations for when to call an ambulance are still relevant for those who may have hit their head, however you should check for immediate signs of injury to the head, such as any bleeding, swelling, or if they have lost consciousness. If they are unconscious, disoriented, or are bleeding profusely, call 999 immediately if you are in the UK.

If they remain conscious and appear to be uninjured, try to monitor them closely for symptoms of concussion or brain injury, which usually include dizziness, confusion, a headache, nausea, or blurred vision. If there is any chance they have a neck or spinal injury, support their head and neck until help arrives, and do not move them.

Sometimes an older person might appear to be fine initially, but symptoms might be delayed, such as sleepiness, delayed confusion, or pain that becomes worse over time. Remember, some head injuries can manifest hours later, and in some cases it can take up to 72 hours after an injury for symptoms to appear. 

Even if the head injury seems minor, you should contact the person’s GP so they can rule out any hidden damage, especially if an older adult has comorbid conditions or is frail, since they are more vulnerable to complications such as brain bleeds.

How can I safely assess an older person’s injuries after a fall?

Deciding the severity of an older person’s injuries after a fall can be a challenge, and can feel like a lot of responsibility. If you are in any doubt whatsoever, do not hesitate to contact the NHS helpline on 111 for non-urgent advice, or call an ambulance on 999 if you believe the situation is an emergency. 

If you would like to know how to safely assess an older person’s injuries after a fall, follow these steps:

• Ask them questions to determine if they are alert and responsive. If they seem confused, dizzy, or are unconscious, call 999 straight away.
• Do an assessment for visible injuries like cuts, bruises, swelling or bleeding, paying close attention to areas such as the head, arms, hips and legs, in case any fractures or sprains have occurred. 
• Ask them about their level of pain, if any. They may be in shock, so it can help to ask them about specific areas of their body to draw attention to them, for example, “Do you feel any discomfort or pain in your back?” If they say yes to anything, avoid moving them as they could have a more serious injury.
• Gently test their ability to move by asking them to move their limbs. If they experience any pain, stop immediately and wait for an ambulance. Remember, this process can be physically and emotionally uncomfortable, so offering comfort, such as placing towels under their knees, can help ease the experience and show care.
• Observe their behaviour to monitor them for signs of shock or confusion, as this could indicate internal injuries are present that require medical assessment. 
• Contact the appropriate medical professional to have them checked over. Even if someone appears fine initially, soreness, fatigue or emotional distress can appear over the next 24 – 72 hours so monitoring is essential. 

Should I seek medical help? 

It is undoubtedly difficult to assess the situation after a fall and decide whether or not emergency services should be called. Some tips for making this decision include:

• If there is excessive bleeding, severe pain, a suspected broken bone, confusion or dizziness, or the person has fallen unconscious at any point, call 999 immediately 
• If you cannot get an older person off the ground without injuring them or yourself, call 999 immediately 
• If there are any of the other aforementioned symptoms, or you are in any doubt whatsoever, call the NHS helpline for advice on what to do next, on 111 
• If there are no immediate signs of injury, call the person’s GP surgery to discuss the best course of action. This is especially important if they complain of ongoing pain, weakness, or difficulty walking.
• Pendant alarms can also play a vital role in the immediate post-fall response, particularly for individuals who live alone or may struggle to reach a phone. Prompt access to help can significantly reduce the time someone spends on the floor, which is clinically important for both outcomes and recovery.

Remember, it is extremely important to seek medical advice for older adults after any fall, as there could be underlying issues or internal injuries that may not be obvious right away, but could be life-threatening. 

What are the emotional impacts of a fall, and how can I help my loved one? 

As well as the physical outcomes of a fall, there can also be significant emotional and psychological impacts for older people. Many older adults will develop a fear of falling again, which can cause further issues if they start to isolate themselves or avoid any physical activity – less activity causes them to become physically weaker, which increases their chances of having another fall. 

A fall can lead to an older person experiencing anxiety, loneliness due to isolation, depression, and a general decline in their wellbeing due to loss of confidence. Research shows that 1 in 10 falls causes an injury that could lead to the older person restricting their activities for a day or more.  

They may also feel shame and embarrassment over their fall, as they believe it will cause others to assume their abilities are declining. This may cause them to avoid telling anyone. In fact, of the 1 in 4 people who experience a fall each year, it is estimated that less than half will tell their doctor what has happened.

To help your loved one manage these potential emotions if they arise, offer regular emotional support to reassure them that falling is a common experience for people as they age, and there is nothing to be embarrassed or worried about. Reassure them that together you can take steps to avoid further falls, and encourage them to have open conversations about their feelings and what they may be worried about. 

You may find more helpful information in our guide to supporting mental health in older adults.

How can I help my older loved one prevent falls at home? 

There are useful steps you can take to help your loved one prevent falls at home which can help them regain confidence in their mobility, and put your mind at ease about how they are managing alone at home. For example: 

• Support them with physical therapy or balance exercises to improve strength, stability and coordination. This can make falls less likely, and improve their ability to stabilise before they do fall. Regular weight-bearing exercises can help to maintain muscle, and exercises like yoga or swimming can keep joints, tendons and ligaments flexible. You can read more in our guide to fitness and exercise for older adults.
• Modify the living environment to reduce risk of falls by removing any trip hazards and clutter that make moving around more difficult. For example, secure any loose rugs, keep pathways free of cables, and fix any uneven surfaces that could lead to falls. 
• Install safety devices and features to make the home more accessible, such as grab bars in the bathroom, handrails on the stairs, and non-slip mats in areas prone to moisture and slippery floors. Your loved one may also benefit from walking aids like sticks or zimmer frames to make walking feel safer. You can learn more in our guide to home adaptations for disabled older people.
• Installing personal alarms can put your mind at ease when leaving an older loved one at home, and give them more confidence by knowing they always have a way to contact someone if they fall. These usually come in the form of a strap around the neck or a wrist bracelet, with a button that enables them to easily contact help in case of an emergency. 
• Improve lighting in the home in areas that may cause trips or falls, such as stairs. If your older loved one tends to use the bathroom at night, a motion sensor light or equivalent could help them avoid falls while the main lights are off. 
• Encourage them to improve their overall health. For example, tiredness can cause falls, so getting enough sleep is important. Also, eating a healthy diet can increase energy, and it can help to avoid alcohol which can make some people unsteady on their feet. 
• In snowy or icy weather, falls outside may be more common for older people, so encourage your loved one to stay inside unless it is necessary to leave home. It may help to drop off groceries for them or help them with any other errands so they do not need to go out.   
• Consult their doctor to review their medications and manage any side effects that could be causing falls, such as dizziness or disorientation. Also, encourage them to have regular communication with their GP to monitor any health issues or changes that could increase fall risk, for example, if they have osteoporosis. 
• Encourage them to have their eyes tested, as changes in their sight could increase fall risk if they cannot see objects and trip hazards around the home. If they are reluctant to use new glasses, encourage them to get used to wearing these. You can read more about this in our guide to how often older adults should get an eye test.
• Ensure they have sturdy, non-slip footwear to give them adequate support while walking. This may be particularly important if they have foot issues such as toe deformities or hallux valgus. 
• Bring in professional home care on a regular basis to help an older loved one with tasks that might cause higher fall risk, such as housework or bathing. 

How can professional home care help prevent falls? 

Professional home carers can play a key role in preventing falls for older adults, both practically, and by helping them to remain confident in their own abilities, which can have a positive impact on their mental health. 

Home care professionals can provide personalised support and supervision, assist with personal care activities like bathing and dressing, ensure they can move around the home safely, help to transfer them in and out of chairs or beds, and assist with other activities that may present fall risks.  

As well as practical and emotional support, caregivers can provide reminders to take medications at the right time and in the right doses, to reduce any side effects that could cause fall risks (such as dizziness), and assist with regular exercises that can improve balance and strength. 

Whether occasional companionship to check in on your loved one, or daily live-in support to ensure they are always safe, there are many ways in which a professional carer can support an older person at home to improve their quality of life. 

At Home Instead, we can provide highly trained Care Professionals who are experienced in helping older adults at home. We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.

Our Care Professionals can also help record, monitor and report near misses or falls, which can be invaluable in shaping care plans in collaboration with families and GPs. In many areas, our teams are equipped with emergency lifting aids, such as Raizer chairs or similar systems, which allow carers to safely and respectfully assist someone after a fall. These tools are increasingly used in homecare settings to help reduce the time someone spends on the floor, something that’s clinically important for recovery and wellbeing.