Falls are frequent among older adults, causing anxiety for both the person who has fallen and the helper. The instinct to rush and lift them immediately must be resisted. The safety of the fallen individual and the helper is paramount, as improper lifting techniques can easily cause or worsen serious injuries, such as fractures or spinal trauma. A calm, methodical approach is necessary to ensure the situation is managed safely and effectively.
Prioritizing Safety: Immediate Assessment and Emergency Triage
The first action upon discovering a fall is to remain composed and assess the person’s condition without moving them. Ask about pain location and if they can gently move their limbs. Look for visible signs of severe injury, such as pooling blood, an obvious limb deformity, or a leg that appears shortened or externally rotated, which may indicate a hip fracture.
Call 911 or local emergency medical services (EMS) immediately if the person exhibits red flags. These include loss of consciousness at any point, severe pain in the head, neck, or back, or an inability to move a limb due to pain or weakness. Also call EMS if the person is confused, disoriented, or shows signs of a potential stroke or heart attack, such as sudden slurred speech or chest discomfort. If professional help is needed, keep the person still and cover them with a blanket to maintain body temperature until paramedics arrive.
If the person reports no significant pain, is alert, and can move their arms and legs slightly, you may proceed with an assisted lift. Wait a few moments first to allow the person to recover from any immediate dizziness or shock that may have contributed to the fall. Encourage deep, slow breaths and reassure them that you will guide them through the process slowly.
The Assisted Lift: Techniques for an Uninjured Person
If the assessment confirms no serious injury, the next step is a collaborative effort to get the person into a seated position using leverage. Begin by helping them gently roll onto their side, which is less stressful on the spine than lying flat. Once on their side, encourage them to push up with their arms to reach a hands-and-knees position.
Position a sturdy, non-rolling chair or sofa next to the person’s head, ensuring it is stable. The person should crawl toward the chair and place their hands flat on the seat for support. This step uses the person’s own strength to transition from the floor, minimizing strain on the helper.
From the hands-and-knees position, the person needs to bring one foot forward, placing it flat on the floor as if moving into a lunge. The helper must maintain proper body mechanics by keeping their back straight, bending their hips and knees, and using their leg muscles. The helper should avoid twisting at the waist and keep the person close to maximize leverage.
As the person pushes up with their arms and front leg, the helper provides steady support around the person’s waist or hips. Never pull on the arms or shoulders. This technique utilizes the leg muscles of both individuals for the upward movement. Once the person is standing, they should immediately pivot and sit down on the chair to regain stability and prevent a second fall.
Alternatives to Manual Lifting: When to Use Equipment
Manual lifting is not always feasible or safe, especially if the elderly person is significantly larger than the helper or if the helper has physical limitations. Specialized equipment offers a safer alternative that reduces the risk of injury for both parties.
Simple aids like a gait belt, a reinforced fabric belt worn around the waist, provide a secure handhold for the helper to assist with standing and transferring. More advanced equipment is available specifically for lifting a person from the floor. Examples include inflatable lifting cushions or battery-powered mechanical lifts, which elevate a person with minimal physical effort. These devices distribute the person’s weight and eliminate the high-strain movements associated with manual lifting.
If no specialized equipment is available, a sturdy piece of furniture, such as a sofa armrest or a robust ottoman, can be used as an intermediate transfer point. This reduces the vertical distance the person needs to move. If the person cannot assist with the lift, or if a safe lift cannot be executed with available resources, the only appropriate action is to call for professional assistance.
What to Do After the Fall and Next Steps
Once the elderly person is safely seated or lying down, monitor them closely for a minimum of 24 to 72 hours. Some injuries, particularly internal bruising or head trauma, may present delayed symptoms. Watch for signs such as increasing pain, dizziness, nausea, vomiting, or any change in cognitive function or alertness.
Even if the fall was minor and the person appears uninjured, an immediate follow-up with their primary care physician or geriatric specialist is necessary. The physician can conduct a thorough assessment to determine the cause of the fall, which is often multifactorial. This review may include checking for orthostatic hypotension or reviewing medications that might cause dizziness or impaired balance.
The medical follow-up is also an opportunity to implement fall prevention strategies. The physician may recommend a physical therapy consultation to improve strength, balance, and gait stability. A home safety assessment can also identify and reduce environmental hazards, such as removing loose rugs or installing grab bars, addressing factors that could contribute to another fall.