Immediate Actions After a Fall
When you find an older person who has fallen, the first few moments are crucial for ensuring their safety and your own. Your priority is not to rush but to assess the situation calmly and methodically.
- Stay Calm and Reassure: Panic can frighten the person further. Speak in a calm, reassuring voice to let them know you are there to help.
- Assess for Injuries: Before moving them, ask where they feel pain. Look for visible signs of injury, such as bleeding, bruising, swelling, or deformities. Signs of a head injury, such as confusion, severe headache, or loss of consciousness, are red flags.
- Check the Environment: Ensure the area is safe. Remove any tripping hazards or sharp objects from around the person.
- Cover and Comfort: If they seem comfortable and uninjured, cover them with a blanket to keep them warm while you decide the next steps. Offer them a pillow for their head if it's safe to do so.
When to Call for Emergency Services (911)
It is critical to know when a fall requires immediate medical intervention. Call 911 if you observe any of the following:
- The person is unconscious, confused, or not responding.
- They complain of severe pain in their head, neck, or back.
- There is heavy or uncontrolled bleeding.
- You suspect a broken bone (a limb is at an awkward angle).
- They cannot move a limb or feel numbness.
- There are signs of a head injury, such as vomiting, dizziness, or a severe headache.
- The person complains of chest pain or difficulty breathing.
- You do not feel confident in your ability to help them get up safely.
The Safest Method: The Chair Technique
If you have assessed the situation and determined the person is not seriously injured, the chair technique is the safest way to help them off the floor.
- Bring a Sturdy Chair: Find a strong, stable chair and place it near the person's head, with the back of the chair facing them.
- Help Them Roll: Instruct the person to roll onto their side. Encourage them to use their arms to push up into a crawling position on their hands and knees.
- Position the Chair: Once they are on their hands and knees, help them move toward the chair so they can place their hands on the seat for support.
- One Leg Up: Instruct them to place their strongest foot flat on the floor in a half-kneeling position (like a lunge).
- Lift and Pivot: Standing behind them, stabilize the chair with one hand. Place your other arm around their waist for support. Instruct them to use their legs and arms to push themselves up. As they stand, pivot them slowly so their back is to the chair.
- Rest and Reassure: Guide them gently down into a seated position. Do not leave them alone immediately; give them time to rest and check for dizziness before attempting to stand again.
Safe Lifting and Transfer Techniques for Caregivers
| Aspect | Manual Lift | Assisted Lift (Chair Technique) |
|---|---|---|
| Risk of Injury | High risk for both caregiver and person being lifted. Can cause back strain, torn ligaments, or drop the person. | Low risk when performed correctly. Uses the person's own strength and stable leverage points. |
| Equipment Needed | None | A sturdy chair or other stable object (ottoman, couch). |
| Physical Strain | Places significant strain on the caregiver's back, arms, and shoulders. | |
| Empowerment | Can be disempowering for the person who has fallen. | Encourages the person to use their own muscles and feel in control of the process. |
| Best for | Never recommended. | Uninjured individuals who are able to assist themselves to some degree. |
| Safety | Unsafe and strongly discouraged by medical professionals. | Promotes a safe, controlled, and dignified transfer. |
Alternative Methods and Specialized Equipment
For those with severe knee issues, limited upper body strength, or a greater fear of falling, the chair technique may not be feasible. In these cases, specialized equipment and alternative methods are safer.
- Floor Lift: A powered or manual floor lift is a device designed to safely raise a person from the floor without straining the caregiver. This is an excellent investment for households with a high risk of falls.
- Scooting to a Step: If they are near a staircase, the person can scoot on their bottom, using their arms to assist. Once at the lowest step, they can use the step to gain some elevation and make the transfer to a chair easier.
- Inflatable Lifting Cushion: These devices, such as the Mangar Elk or Camel lift, use air to slowly inflate and lift the person from the floor. They are particularly useful for caregivers who cannot provide much physical assistance.
Post-Fall Assessment and Care
Even if the person appears fine after getting up, a fall can be a sign of an underlying issue or cause delayed injuries. It's important to take the following steps:
- Monitor for 24 Hours: Watch for any changes in mental status, new pain, or signs of delayed injury, like swelling or bruising.
- Report the Fall: Inform their doctor or healthcare provider about the fall. This is crucial for identifying potential causes, such as medication side effects or a new health condition.
- Review Medications: Some medications can cause dizziness, lightheadedness, or drowsiness, increasing fall risk. Have a doctor or pharmacist review all prescriptions and over-the-counter drugs.
Comprehensive Fall Prevention Strategies
Preventing future falls is the most important step in protecting an older person's health and independence. A comprehensive strategy addresses home safety, physical health, and medication management.
Home Safety Modifications
Making the home environment safer can significantly reduce the risk of a fall.
- Remove loose rugs and clutter from pathways.
- Improve lighting, especially in hallways, stairways, and bathrooms.
- Install grab bars in the bathroom, near the toilet and in the shower/tub.
- Ensure handrails are installed on both sides of all staircases.
- Use non-slip mats in the shower and bathtub.
Physical Health and Exercise
Maintaining strength and balance is key to preventing falls. Regular, gentle exercise can make a big difference.
- Balance Training: Exercises like Tai Chi or standing on one leg can improve stability. For more information on effective exercises, visit the National Institute on Aging.
- Strength Training: Chair stands, leg lifts, and wall push-ups can strengthen the legs and core, which are vital for maintaining balance.
- Mobility Aids: Ensure walkers, canes, or other aids are used correctly and are in good working condition.
Regular Health Screenings
- Vision and Hearing Checks: Poor vision or hearing can affect balance and awareness of surroundings. Ensure they have up-to-date prescriptions for glasses or hearing aids.
- Medication Review: As mentioned, a healthcare provider should review medications to check for side effects that increase fall risk.
Conclusion
Knowing how to help an older person off the floor safely is an essential skill for any caregiver. By calmly assessing the situation, calling for emergency help when necessary, and using safe techniques like the chair method, you can prevent further injury. The safest and most effective strategy, however, is fall prevention. By implementing home modifications, promoting regular exercise, and staying on top of health screenings, you can significantly reduce the risk of a fall and help your loved one maintain their independence and quality of life.
