Falls are a frequent occurrence, with approximately 35% to 40% of older adults over the age of 65 experiencing one each year. When a loved one falls, the immediate reaction is often to rush to their aid and lift them up, but a calm and methodical approach is always the safest course of action. The priority is to prevent further injury to the person who has fallen and to ensure the safety of the helper. This guidance offers practical steps for evaluating the situation and safely assisting someone back to a stable position.
Immediate Assessment: Determining Safety
Before attempting any movement, conduct a rapid, yet thorough, assessment to determine if the person can be moved without causing more harm. Encourage the person to remain still for a few minutes, as residual dizziness or lightheadedness from the fall can increase the risk of a second incident. Gauge their level of consciousness by asking if they know where they are and what happened.
Ask them to describe any pain they are feeling and where it is located. Severe pain, especially in the head, neck, or back, means movement should not be attempted. Visually inspect the person for signs of injury, such as bleeding, obvious cuts, swelling, or bone deformities. If they report tingling, numbness, or inability to move their fingers or toes, suspect a possible spinal injury. A suspicion of fracture or spinal injury immediately establishes the “No-Go” decision, meaning no manual lift should be attempted.
Safe Techniques for Assisting the Lift
If the person reports no severe pain and is mentally clear, proceed with a guided lift, remembering that they should do as much of the work as possible to minimize strain on both of you. Locate a sturdy piece of furniture, such as a heavy, non-rolling chair or a robust sofa, and place it near the person’s upper body. Communication is important throughout this process, so explain each step clearly before it happens.
Guide the person to slowly roll onto their side, which is a less strenuous position than lying flat on the back. From the side-lying position, assist them in moving onto their hands and knees, taking a moment to stabilize once they are in a crawling posture. The helper should maintain proper lifting posture by keeping their back straight and bending their knees to use their leg muscles for support, avoiding strain on the back.
Next, instruct them to crawl toward the sturdy chair and place their hands firmly on the seat for support. Encourage them to shift into a kneeling lunge position, placing one foot flat on the floor while the other knee remains on the ground. This position, often called the “down on one knee” position, helps distribute the effort.
From the lunge, the person should use their arms on the chair and the strength of their legs to push themselves up to a standing position. The helper should stand behind them and provide gentle, stabilizing support at the waist, but should not attempt to pull or lift the full body weight. Once they are standing, ensure they are stable and then help them pivot and lower themselves slowly onto the chair, using their hands to feel for the seat behind them before sitting.
Post-Fall Monitoring and Comfort
Once the person is safely seated, the immediate response shifts to comfort and close observation, which is important because delayed symptoms can indicate a more serious issue. Provide a blanket, if needed, and offer a small amount of water to help them calm down and rehydrate. Take a moment to check their vital signs, including pulse, respiration rate, and blood pressure, to look for any immediate abnormalities.
Monitoring should continue for at least the next 24 to 72 hours, as symptoms like confusion, severe headache, or increasing pain can develop later. Watch for signs of delayed injury, such as new bruising, swelling, or changes in behavior or consciousness. It is a good practice to contact the person’s primary care physician for a non-emergency follow-up check, even if the fall appeared minor. A medical check-up allows a professional to assess for underlying causes, such as medication side effects or subtle changes in health, that may have contributed to the fall.
Criteria for Calling Emergency Services
In specific circumstances, calling 911 or local emergency services is required, and no attempt should be made to move the person.
Call for emergency medical assistance if:
- The person has lost consciousness, even briefly.
- They appear confused, disoriented, or are unable to communicate clearly.
- Severe pain is present, particularly in the head, neck, or back, indicating a potential fracture or spinal injury requiring professional immobilization.
- There are obvious signs of trauma, such as a compound fracture where the bone is visible, heavy bleeding, or visible head wounds.
- The person is unable to move their limbs.
- The helper cannot safely manage the lift due to the person’s size, the surrounding environment, or their own physical limitations.
While waiting for help, keep the person as still and comfortable as possible, covering them with a blanket to maintain body temperature.