After a Parent Falls: What to Do Next

If you are with your parent now, these come first:

1. 1

   Get help if they are hurt

   The National Institute on Aging says that if a person is hurt or cannot get up on their own, they should ask someone for help or call 911. Do not rush them up: getting up too quickly or the wrong way can make an injury worse.

2. 2

   Tell the doctor

   The National Institute on Aging advises telling the doctor about any fall since the last checkup, even without pain, because a fall can point to a new health problem or an issue with medications or eyesight. The CDC adds that a provider should check for signs of a brain injury after a fall, and that blood thinners raise the risk of bleeding in the brain after a head injury.

3. 3

   Look at what happened

   Write down where and when it happened, what your parent was doing, and anything they remember feeling just before. Bring those notes to the doctor.

Falls are common, and they are easy to play down. The Centers for Disease Control and Prevention (CDC) says more than one in four people 65 and older fall each year, but less than half tell their doctor. It also says that falling once doubles the chance of falling again.

A fall can change how a person lives even without an injury. The CDC notes that many people who fall become afraid of falling. The National Institute on Aging says that fear may lead people to avoid walking, shopping or seeing others, while staying active actually helps prevent falls. If your mother or father has started staying in more since the fall, mention that to the doctor too.

The CDC's STEADI fall prevention program publishes short brochures for older adults, such as "What YOU Can Do to Prevent Falls" and "Check for Safety", in English and Spanish. The CDC's prevention steps make a good list of questions for the visit:

• Can you evaluate my parent's risk of falling?
• Could any of the medicines they take cause dizziness or sleepiness? A pharmacist can also review them.
• Should they see an eye doctor? The CDC suggests an eye exam at least once a year with updated glasses.
• Should they be screened for osteoporosis, and is vitamin D worth discussing?
• Would physical therapy or a strength and balance class, such as tai chi, help them?
• Is a cane or walker needed, and is the one they have the right size?

The CDC's own fall prevention steps for the home are simple: get rid of things that could cause a trip, add grab bars inside and outside the tub or shower and next to the toilet, put railings on both sides of stairs, and add more or brighter light bulbs. Its "Check for Safety" brochure is a home checklist you can print and use on your next visit.

The National Institute on Aging adds a few habits: keep a charged cordless or mobile phone within reach, arrange daily contact with a family member or friend, and consider an emergency response system, a button worn on a necklace or bracelet that calls for help. Some smartwatches can do the same.

These changes can help, but they cannot replace a person being there. If your parent cannot get up alone, or falls at night, the question becomes who is nearby when it happens.

You do not have to decide everything this week. A few options can buy time:

Rehab after a hospital stay. Medicare covers care in a skilled nursing facility only after at least 3 days in a row as a hospital inpatient, and time under observation or in the emergency room before admission does not count. A doctor must also decide daily skilled care is needed. If your parent is in the hospital, ask the care team early whether they are an inpatient or under observation.

Home health. Medicare covers part-time or intermittent skilled services, such as therapy, for people who are homebound when a doctor orders the care. It does not cover 24-hour care at home, or personal care when that is the only care needed.

A respite stay. Some licensed assisted living communities and board and care homes take short respite stays when a room is open, which can give your parent supervision while the family works out the next step. If your parent is leaving a hospital, see going from the hospital to assisted living.

One fall does not mean a parent must leave home. But repeated falls, falls at night, being unable to get up without help, or a fall that went unnoticed for hours can be signs that living alone is getting harder. Our guide to the signs it may be time for assisted living covers other things families tend to notice.

In a licensed home, someone is there at all hours. California Advocates for Nursing Home Reform (CANHR) notes that an administrator or designated substitute must be on the premises 24 hours a day, with at least one staff member trained in CPR and first aid on duty at all times. That does not make falls impossible. Our guide to fall risk in assisted living explains what homes can and cannot do, and what to ask on a tour.

Hamssa Benrekia is a senior living placement specialist in Torrance with a background in home health, hospice and palliative care. If you decide a move is the next step, she helps families in the South Bay and Harbor area of Los Angeles County find licensed assisted living communities and board and care homes that fit the care needs and budget. To talk it through, contact Hamssa. More topics are in the California Assisted Living Placement Guide.