What to do after a fall

I found my mum on the floor in the hallway. I helped her up and she seemed fine, but I was unsure: when does a fall require a hospital visit?

Falls are among the most common accidents in dementia — and the person often can't say what hurts or what happened. Knowing how to assess the situation will give you confidence.

At the moment (before helping them up)

• Don't help them up yet. Calm them down, observe: severe pain? Shortened leg or rotated outwards (suspected hip fracture)? Head injury? Blood?
• If there is intense pain, deformity, inability to bear weight on the foot, or loss of consciousness: do not move them and call the emergency number.
• If they seem fine: help them turn onto their side, get onto all fours, and then stand up using a chair for support, slowly and with a seated pause.

Monitor over the next 24-72 hours

• Did they hit their head? Watch for unusual drowsiness, vomiting, increasing headache, GREATER confusion than their usual, slurred speech — any of these: hospital. If they take anticoagulants, a bump to the head warrants medical assessment even without symptoms.
• Pains that only appear the next day, refusal to walk, or protecting an arm/leg: there might be a "hidden" fracture — get it assessed.
• In dementia, the only sign of pain might be new agitation or refusal to move.

Afterwards: prevent the next one

Every fall offers lessons: insufficient light? Rug? Loose slippers? Low blood pressure when standing up? Sedative medication? Review the house, footwear, and talk to the doctor about medication and balance physiotherapy. And record the fall in your diary — the pattern matters at appointments.

Sources: NHS (United Kingdom); NIA — National Institute on Aging (USA).