First Steps After an Elderly Person Falls
When an elderly person has fallen, the immediate reaction for many caregivers is to rush to their side and help them stand. However, attempting to lift someone without assessing the situation first can cause further harm. Prioritizing safety is the most important step for both the fallen person and the caregiver.
Assess for Injury and Ensure Safety
Before attempting any movement, you must first check for injuries. This is crucial because moving someone with a fracture, spinal, or head injury can cause permanent damage.
- Stay Calm and Reassure: Approach the person calmly, reassuring them that you are there to help and that everything will be okay. Encourage them to take slow, deep breaths to help minimize anxiety and panic. Tell them clearly and gently not to try and get up on their own yet.
- Check for Visible and Hidden Injuries: Visually inspect the person for any bleeding, bruising, or swelling, especially around the wrists, ankles, hips, and head. Ask if they are feeling any pain, and if so, where it is located and how severe it feels. Look for signs of head trauma, such as confusion, severe headache, dizziness, or vomiting. Incontinence can also be a sign of a serious issue.
- Determine if a Direct Lift is Safe: If the person can move their limbs without pain, is alert, and feels confident they can assist, you can proceed with helping them. If there is any doubt about an injury, particularly concerning the head, neck, or back, do not attempt to move them. Instead, call 911 immediately. While waiting, keep them warm with a blanket or coat and stay with them.
Call for Professional “Lift Assist”
For non-emergency situations where a senior is uninjured but unable to get up, many fire departments offer a “lift assist” service. This is a non-emergency call where professionals are dispatched to help lift a fallen person using their specialized training and equipment. This is a valuable option that prevents injury to both the senior and the caregiver.
Methods for Safely Assisting a Fallen Person
Once you have confirmed there are no serious injuries, you can assist the person using one of the following methods, depending on their mobility and available equipment. Never try to lift the person by yourself using only your arms, as this can lead to severe back injuries for you and re-injury for the senior. Remember to use good body mechanics: bend at your knees and hips, keep your back straight, and lift with your legs.
The Two-Chair Method
This technique is effective for individuals who are able to assist in their own recovery by doing most of the work themselves, with the caregiver providing stability and guidance.
- Bring two sturdy, non-rolling chairs. Ensure the chairs are stable and won't slip or tip over. Place one chair near the person's head and the other near their feet.
- Help the person roll to their side. Gently guide them to roll onto their side. From there, help them move onto their hands and knees. For individuals with sore knees, placing a towel or cushion underneath can provide extra comfort.
- Position the chair for kneeling. Move the chair closest to their head directly in front of them so they can place both hands on the seat. Remind them to keep their head up to avoid dizziness.
- Rise to a lunge position. Instruct the person to lean forward and bring their strongest leg forward into a kneeling lunge position, with their foot flat on the floor.
- Sit down slowly. Move the second chair directly behind them. With both hands firmly on the front chair, instruct them to push up with their arms and legs to stand, then carefully pivot and sit back into the chair behind them. Guide them gently by the hips for stability, but do not lift their full weight.
Using a Gait Belt
A gait belt, or transfer belt, is a tool that provides a secure grip point for the caregiver to assist with stability and guidance, not for lifting the person’s full weight.
- Wrap the gait belt snugly around the person's waist, over their clothing and above the hipbones. The belt should be tight enough to be secure, but you should still be able to fit two fingers comfortably between the belt and their body.
- Position the person so they are able to roll onto their side and get to a hands-and-knees position.
- Provide support by gripping the gait belt with an underhand grip. Bend at your knees, keep your back straight, and use your legs to assist their movement.
- Use a sturdy chair as a base, as described in the two-chair method. Guide them as they work to stand, with you providing steadying support via the gait belt.
- Gently guide them down to a chair or back to the floor if they become dizzy or cannot complete the transfer safely.
Comparison of Assisting Methods
| Feature | Two-Chair Method | Gait Belt Method | Professional 'Lift Assist' |
|---|---|---|---|
| Equipment Needed | Two sturdy, non-rolling chairs | One gait belt, one sturdy, non-rolling chair | Specialized lifting equipment (e.g., Mangar Elk) |
| Who Does the Work | Primarily the fallen person | Mostly the fallen person, with caregiver guidance | Trained emergency services personnel |
| Caregiver Strain | Minimal; focuses on guidance and stabilization | Minimal; focuses on guidance and stabilization | None |
| Best For | Mobile individuals needing stability support | Individuals needing more direct control and balance assistance | Anyone with a suspected injury or who is unable to assist themselves |
| Risk of Re-Injury | Low, as the person is largely in control | Low, as long as the caregiver does not lift | Extremely low due to professional training |
Long-Term Fall Prevention
After a fall, it is important to take steps to reduce the risk of it happening again. Preventing future falls is a long-term goal that involves a multi-faceted approach.
Home Modifications for Safety
Making changes to the home environment can significantly reduce the risk of tripping and slipping.
- Eliminate Hazards: Remove clutter, electrical cords, and loose rugs from walkways. Secure any loose floorboards or carpeting.
- Improve Lighting: Install night lights in bedrooms, hallways, and bathrooms. Ensure lighting is adequate and switches are easily accessible, perhaps even installing illuminated switches.
- Install Grab Bars and Handrails: Add grab bars in the bathroom near the toilet and shower. Install handrails on both sides of all stairways.
- Wear Proper Footwear: Encourage wearing sturdy, non-skid shoes or slippers with good traction indoors. Avoid walking in socks alone.
Health and Wellness Management
Several health-related factors contribute to the risk of falls and should be proactively managed.
- Review Medications: Consult a doctor or pharmacist to review all medications, as some can cause dizziness, drowsiness, or affect balance.
- Engage in Exercise: Regular, gentle exercises like walking, water aerobics, or tai chi can improve strength, balance, and coordination. A physical therapist can create a customized program.
- Check Vision and Hearing: Regular eye and ear exams are important, as changes in vision and hearing can significantly affect balance and awareness of surroundings.
Conclusion
Knowing how to safely assist an elderly person after a fall is critical for both their well-being and the caregiver's safety. The first and most vital step is always to assess for injury before attempting any movement. In cases of severe injury or uncertainty, calling emergency services for professional assistance is the safest option. For non-injury falls, using a step-by-step method with sturdy chairs or a gait belt allows the person to regain their footing safely with minimal risk. Finally, prioritizing long-term fall prevention through home modifications, regular health check-ups, and balance exercises is key to maintaining a senior's independence and reducing future risks. For more in-depth guidance on safe transfers, occupational therapy resources like OT Flourish can provide additional insights and techniques.
