What to do after a fall: UK advice for older people and the people helping them

First minutes: check for injury before moving

The first rule in the NHS advice is to stay calm and take a couple of minutes to check for any pain or injuries.¹ Do not rush to stand. Whether to get up is a decision to make after that check, not before it.

If you are helping someone else, the same applies. Keep them comfortable and warm, and do not try to lift them yourself.¹ The NHS says to help them up carefully if they can.

This page is general information. It cannot tell you whether a particular person is hurt. When in doubt, the services in the next section are there to decide.

When to call 999 and when to call NHS 111

The NHS draws a line between an emergency and a call for advice. The table below puts its wording for falls, a broken hip and a head injury side by side.

One point is easy to get wrong. Blood-thinning medicine after a blow to the head sits under NHS 111 on the NHS page read for this guide, not under 999.³ Move to 999 if any of the 999 signs are present, such as loss of consciousness or a seizure.³

If you are not sure which number to use, NHS 111 is also available online.¹

How to get up safely, or help someone up

If the check finds no pain or injury and the person feels able, the NHS gives a way to get up in stages. It is only for someone who feels able to try.¹

1. Roll onto your side. Then use your arms to push yourself onto your hands and knees.¹
2. Find something stable. The NHS gives examples such as a heavy piece of furniture, the bath or the sink. Crawl to it if you need to.¹
3. Put one foot flat. Hold on and stand up slowly, using the stable object to help you.¹
4. Sit down and rest. Rest while you recover.¹

If you cannot get up, the NHS advice is to call for help. Use a phone or personal alarm if you can reach one. If not, try to attract attention by shouting for help or banging on a wall or the floor.¹

While you wait for help

• Try to keep warm, for example with a towel, coat, rug or blanket.¹
• Keep moving where you can: roll from side to side and move your arms and legs gently.¹
• Try to change position about every 30 minutes, to help prevent pressure sores.¹

The arithmetic is simple. One change every 30 minutes is 60 ÷ 30 = 2 changes an hour. No source read for this guide gives a safe length of time to stay on the floor, so this page does not give one. If you cannot get up, call for help rather than waiting.

To help someone else, keep them warm and comfortable and, if they can, help them up carefully. The NHS says not to lift them yourself.¹

Head strike, hip pain and blood thinners: red flags

A knock to the head

The NHS lists 999 signs after a head injury, including loss of consciousness without waking, not staying awake, a seizure, and a fall from a height of more than 1 metre or 5 stairs.³ Other 999 signs are problems with vision or hearing, clear fluid from the ears or nose, new weakness or numbness, and problems with walking, balance, understanding, speaking or writing.³

The NHS sends people to NHS 111 for vomiting, dizziness, being under the influence of alcohol or drugs at the time, and for anyone with a condition or medicine that thins the blood.³

After a minor head injury treated at home, the NHS says an adult should stay with the person for at least the first 24 hours. Symptoms can last for up to 2 weeks, and a GP should be seen if they last longer.³

Hip pain

A broken hip can cause pain in the hip, upper leg or groin, not being able to stand or put weight on the leg, and a leg that is at an odd angle or looks shorter, with swelling and bruising.² The NHS says to call 999 or go to A&E for severe hip pain after a fall.² Do not drive yourself; call 999 and ask for an ambulance, and bring your medicines.²

A broken hip is treated in hospital, usually with surgery on the day of arrival or the day after.² If the person is over 50 and has had a hip fracture, the NHS says a fracture liaison service can help prevent further broken bones, and you can ask the GP surgery whether there is a fracture liaison service.²

Telling your GP and asking for a falls assessment

The NHS says to see a GP if you have had a fall, or if you are worried about your balance or mobility, even if you were not hurt.¹ Age UK gives the same advice: tell your doctor you have fallen or feel unsteady, even if you feel fine.⁶

The GP will check your balance by asking you to get up and move around, and may refer you to a specialist falls service.¹ That service may look at muscle weakness, osteoporosis and eyesight, offer strength and balance work, check the home and review medicines.¹ In some areas you can refer yourself directly; ask at the surgery or your local integrated care board.¹

NICE guidance NG249, written for health professionals, says a comprehensive falls assessment is advised for someone who has fallen in the last year and could not get up alone, was injured and treated, lost consciousness, is frail or has had two or more falls.⁵ It also says professionals should explain what to do in a fall, including how to get up and when to seek help.⁵

Notes worth taking to the appointment

NICE asks professionals to find out the details of any fall.⁵ The list below is a suggestion from this page, not a published checklist. It is built from what the guidance asks about.

• When and where the fall happened, and what you were doing.
• Whether you felt dizzy, or blacked out, before or after.
• Whether you could get up on your own.
• Any injury, and whether you had treatment.
• The medicines you take, so they can be reviewed.
• How many falls you have had in the last year.

Why falls repeat and what lowers the chance

After a fall it is common to lose confidence and become cautious, which can lead to staying in more and feeling isolated. Age UK says suitable help and adjustments can make a difference.⁶

The NHS advises being active every day and doing strength and balance activities at least twice a week.¹ It also advises people at risk to make a plan for what to do in a fall, and to wear a personal alarm or carry a mobile phone.¹ Age UK describes alarms with a pendant or wrist button linked to a 24-hour response centre.⁶

Anyone can ask their local council for a free care needs assessment, which can include making the home safer.¹ Age UK also has a free helpline on 0800 678 1602, open 8am to 7pm, 365 days a year.⁶

This page covers the first response. For prevention, see falls prevention for older adults. For how risk is assessed, see falls risk assessment in the UK. For a different kind of protective equipment, see hip protectors for the elderly, and for the wider picture of airbag vests, airbag vests for the elderly.

Frequently asked questions