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Falls are unfortunately very common among the elderly. There are many causes for falling, such as tripping over an area rug or getting knocked off balance by a rambunctious pet. But there are other times when a fall takes you entirely by surprise, such as slipping as you come out of the shower. The next thing you know, you’re on the floor and can’t get up.
For seniors, falls become a very concerning problem. According to the CDC, three million elderly adults visited emergency departments in 2019 to get treatment for injuries sustained in a fall. And 34,000 adults aged 65 and older died as the result of a fall, making falls the leading cause of injury death among the senior age group.
The most common consequences of falls include fractures and brain injuries. Falls are the number-one cause of traumatic brain injury among any age group, and at least 95% of hip fractures in the elderly are caused by falls – and often by falling sideways, such as you might fall when getting out of the shower[1].
When falls occur, it’s important to know exactly how to handle the situation so that you can avoid making an injury even worse.
What Happens When You Fall?
When you begin to fall, panic instinctively kicks in. Your body tries to protect itself. Your instinct is to reach out for anything that you can catch yourself on – anything to keep from hitting the floor. That’s how you can sustain soft tissue injuries or damaged tendons or muscles. However, it’s better than a fracture.
If falling to the floor is inevitable, you will likely reach out your arms and hands to break your fall. The Mayo Clinic says that the majority of wrist fractures happen when someone tries to break a fall. And a study in BMC Geriatrics found that not only are wrist fractures most common in the elderly, they can lead to serious problems with the activities of daily living – such as eating and bathing – that are required for a person to live independently.
When your body hits the ground, further injuries depend upon where you land. For instance, landing with most of the force on your shoulder can mean a broken collarbone, shoulder, or arm. If you hit the ground solidly on your chest, you might suffer broken ribs. And if you fall onto your hip, you could wind up with a hip fracture that makes it difficult to move at all.
If you happen to hit your head, it might be severe enough that you know immediately you have been badly injured – or it might be bad enough that you lose consciousness. But sometimes you can have a severe brain injury without realizing how bad the situation is.
Actress Natasha Richardson, the wife of Liam Neeson, died of a hematoma after sustaining a head injury while skiing. She initially believed she was fine, but the bleeding in her brain progressed to a coma, and she died two days after the injury[2].
That tragic outcome is a reminder that sometimes, a fall is not “just” a fall.
What to Do After a Fall Happens
You might fall down when you’re alone.
In the immediate moments after falling, you are likely going to be disoriented. The sudden change from being upright to being on the ground can be enough to confuse even the sharpest mind. As you get your bearings, you should not move right away.
The first thing you need to do is assess the situation. Where are you hurt? You might be stunned by the fall and unable to really pinpoint where the pain is coming from. That’s why it’s so important to lie there for a moment and catch your breath.
Then, slowly begin moving. Stretch out your hands and then your arms. How does that feel? Slowly move a bit more. Perhaps you’re lying on your side – try rolling carefully to your back. If you feel pain, stop moving and assess the situation. Is the pain coming from your ribs? From your hip? Your legs?
If you believe you have suffered any sort of injury, it’s time to reach out for help. If you have a medical alert pendant, that help is right at your fingertips. You should press the button alarm and within moments, a trained agent will assist you in getting whatever help you need. At Alert1, we assess the situation with you, determine who needs to be called, and stay communicating with you until help arrives.
While you wait, do what you can to stay comfortable. It’s very important to stay warm. If you have a blanket or jacket handy, cover yourself with it. Remember that if moving makes the pain worse, it’s best to stay still.
A Note About Head Injuries
This can’t be stressed enough-- if you hit your head at any point, you need to get checked out by the doctor. Even if you feel fine, you might not be fine. Any head impact is a good reason to reach out for help right away.
Sometimes when you fall and hit your head, you might lose consciousness. This is where a medical alert system with fall detection could come in very handy. The tiny fall sensors in the device can detect that a fall has occurred. The device itself will then automatically reach out to the monitoring center. That means you don’t have to press the button to get help. If you are not responsive when an agent comes on the line, they will immediately call the proper assistance for you and stay on the line until help arrives. Even if you are unconscious after a fall, you will not be alone with Alert1’s medical alert systems and monitoring service.
If you are awake and alert after hitting your head, you should still get help. While you wait, be alert for potential changes that indicate a problem, such as changes in your vision, ringing in your ears, a significant headache, dizziness or vertigo, confusion, nausea or vomiting, or overwhelming fatigue[3]. If you notice any of these symptoms, your head injury could be more serious than you thought. When emergency services arrive, tell them about these symptoms immediately.
Getting Up After Falling Down
If you don’t feel as though you have any serious injuries, that’s great! But you still need to take your time in moving around. Sometimes, injuries don’t show up immediately. So when you do begin moving, do it very slowly.
Getting up from the floor can be difficult. You will want to roll slowly onto your hands and knees. Take your time with every phase of this movement.
If you thought you were fine but you start to feel pain when you try to get on your hands and knees, there could be an internal injury. In this situation, pain tells you when to stop to avoid further injury. An increase in pain means you need to stop and call for help.
If you can get onto your hands and knees and don’t feel more pain when doing so, look around for a sturdy object. The ideal item is a chair or sofa. You will want to slowly crawl to it and use it to assist you in getting to your feet. Here’s how[4]:
· Once you are on your hands and knees, slowly crawl to sturdy furniture.
· Get into a kneeling position. Slide the foot of your strongest leg forward until it is flat on the floor. The other knee should be firmly on the floor.
· Put both hands on the furniture.
· Slowly push up using your hands and your strongest leg.
· Turn your body as you rise, aiming to sit down on the furniture.
· Seat yourself carefully on the furniture.
· Take the time to sit and check for injuries again.
What to Do Once You’re Up
The first order of business is to rest. Sit down and take a few long moments to breathe deeply. Assess the situation again. Is there any pain or weakness? Can you move your arms and legs? Is there any tingling or loss of sensation in your limbs? Are you having any difficulty breathing? Now that you are sitting down, do you notice anything that you might have missed before, such as a sharp pain in your ankle when you move it?
When you feel as though you are able to stand, take your time with that too. Hold onto the chair, table, or any nearby sturdy object for the first few minutes. You want to be sure you’re steady on your feet before you take a step.
Now is also a good time to look for the cause of the fall. If it’s an obvious reason, such as tripping over an extension cord or slipping on smooth flooring, you now know what to fix. But if the reason isn’t obvious and you wonder how you fell down, that warrants making an appointment with the doctor. There could be an underlying medical condition that made you lose your balance.
After the Fall
In the hours and days after the fall, be alert for changes in your body. You might experience significant aching all over your body after a fall – this is often quite normal. It’s also normal to feel stiffness in your limbs while your body recovers.
Some other changes might not be normal at all, such as swelling in a particular area or difficulty with moving a joint. If the stiffness in your body turns to difficulty with moving, that’s a problem too. Sometimes injuries don’t show themselves right away, so you might find that while you initially thought you were fine, you could be in the hospital for treatment a few days later.
It’s important to look out for all kinds of pain in the days following a fall, but pay special attention to pain in your abdomen. This could indicate internal damage that has led to bleeding. While it might seem like a sore stomach has nothing to do with a fall, that’s not true – it could actually be a warning sign. Be safe by reaching out for help when you begin to feel stomach pain in the aftermath of a fall.
It’s also a good idea to watch for significant bruising. While some bruising is to be expected after a fall, bruises that darken and continue to spread over a wide area could be another indication of internal bleeding.
A medical alert device, or personal emergency response system, is great for reaching out for help right away, and you should always use it if you are injured in a fall. However, keep in mind that you can press that button at any time, including during the days after a fall. Some injuries might not show up until hours or days later, and if they do, never hesitate to press the button on a medical alert watch or pendant to get the assistance you need.