Part of our occasional series for anyone willing to learn — family carers, new starters, or anyone who's ever wanted to rush straight to lifting someone up before checking anything at all.

Week Zero: The Language of Care (Words We Use and Words We Avoid)
Week one: How to Use a Slide Sheet (and How Not To)
Week two: How to Use a Hoist and Sling (and How No t To)
Week Three: How to Identify Pressure Sores (and What to Avoid)
week Four: Why Washing Your Hands Properly Actually Matters
Week Five: How to Use a Sara Stedy (With Video and What to Avoid)
Week Six: Dressing and Undressing Assistance
Week Seven: How to Support Someone Through a Panic or Anxiety Episode

Before We Start

This is one of the most important things in this whole series, because the instinct to help someone up immediately after a fall is completely natural, and it is also, sometimes, exactly the wrong thing to do first. A few careful minutes of checking before any movement happens can be the difference between a bruised dignity and a genuinely serious injury made considerably worse.

This is not a substitute for first aid training, and it is never a substitute for calling 999 when the situation calls for it. What this will do is walk through the actual sequence, so you understand why each step matters and aren't tempted to skip straight to the part that feels most helpful.

The Golden Rule — Don't Rush

The single most important thing to remember is this: nobody needs to be back on their feet in the next thirty seconds. A fall that's just happened is not made worse by taking two calm minutes to check properly before moving anyone. It is very often made worse by rushing.

Step One — Stay Calm and Reassure

Before anything else, speak to them. Keep your voice steady and unhurried. "I'm here, don't worry, we're just going to check you over before we do anything." A frightened person tenses their muscles, which makes any genuine injury harder to assess and any movement more painful. Calm, first, always.

Step Two — Check Responsiveness

Is the person conscious and able to talk to you normally? If they are unresponsive, or only vaguely responsive, this is a 999 emergency immediately. Do not attempt to move them. Stay with them, keep them warm, and wait for the ambulance.

If they are conscious and talking, continue to the next checks.

Step Three — Ask About Head Injury and Loss of Consciousness

Did they hit their head? Did they black out at any point, even briefly, before or during the fall? This matters enormously, particularly for anyone on blood-thinning medication (warfarin, apixaban, rivaroxaban, and similar anticoagulants), where even a fall that looks minor carries a real risk of internal bleeding around the brain that isn't visible from outside.

If there's any suggestion of a head injury, loss of consciousness, or the person is on anticoagulants and hit their head at all, call 999 and describe this specifically. Do not assume it's fine just because they seem alright immediately afterwards. Some bleeds develop over hours.

Step Four — Ask Where It Hurts, Before Moving Anything

Ask them directly. "Does anything hurt? Where?" Let them tell you, rather than guessing or assuming. Pay particular attention to:

Hip and pelvis pain. This is one of the most common and most serious injuries in falls among older adults. A hip fracture can sometimes present as pain in the groin, thigh, or lower back rather than the hip itself, and one leg may appear shorter or turned outward compared to the other. If hip or pelvis pain is present, do not attempt to help them stand. Call 999.

Back or neck pain. Any suggestion of this means the person should not be moved at all, beyond keeping them warm and comfortable, until professional help arrives. Moving someone with a possible spinal injury incorrectly can cause serious, permanent harm.

Wrist, arm, or shoulder pain. Common from an instinctive attempt to break the fall. Painful, but rarely an emergency on its own, unless the limb looks visibly deformed or they cannot move it at all.

Step Five — Look Before You Touch

Check visually for any obvious deformity, swelling, or an unnatural angle in a limb. Check for bleeding. If there's a visible wound, control any bleeding with direct, firm pressure using whatever clean material is available before doing anything else.

Step Six — Decide, Based on What You've Found

Call 999 immediately if any of these are present: unresponsiveness, suspected head injury with loss of consciousness, suspected hip, pelvis, spine, or neck injury, visible bone deformity, uncontrolled bleeding, or if you are simply unsure. When in doubt, always call. Nobody has ever been criticised for calling an ambulance too cautiously after a fall.

If none of the above are present, and the person says they feel able to get up, you can proceed carefully to helping them up, but slowly and in stages, never in one abrupt movement.

Helping Someone Up Safely, Once You've Checked

Never attempt to lift someone under their arms and haul them upright in one motion. This is genuinely dangerous for both of you and is exactly the kind of movement that causes shoulder injuries, skin tears, and falls for the person trying to help.

Instead: help them roll onto their side, then support them into a kneeling position using a sturdy piece of furniture for support, then help them rise to standing in stages, checking in with them at each step. If at any point new pain appears, stop immediately and reassess.

If they cannot get up under their own power even with support, do not attempt to force it or lift them manually. This is when you call for help, whether that's another carer, a family member, or, if there's any doubt about safety, 999. Many ambulance services also have non-emergency lines specifically for assisted lifting of someone who is unhurt but simply cannot get up alone, which is worth knowing about in advance.

After the Fall Has Been Managed

Even once someone is safely up and seemingly unharmed, document exactly what happened. Time of the fall, what they were doing beforehand, whether they tripped on something specific or simply lost balance, what they said about how they felt, and what was checked. This detail matters enormously for the GP and for spotting patterns, because a fall is very often a symptom of something else, not simply an accident.

Condition-Specific Notes

Parkinson's disease — falls are frequently linked to freezing of gait or postural instability, and a person may need longer than usual to feel steady again afterwards. See our Parkinson's Disease Care page.

Frailty and osteoporosis — even an apparently gentle fall can cause a significant fracture in someone with reduced bone density. Always err toward caution rather than assuming a soft landing means no injury. See our Frailty and Arthritis Care page.

Stroke recovery — a fall in someone with one-sided weakness needs particular care around the affected shoulder and arm during any assisted movement, given the subluxation risk we've covered elsewhere. See our Stroke Recovery Care page.

Anticoagulant medication — repeated here because it matters this much. Any head injury in someone on blood thinners warrants a 999 call, even if they seem completely fine afterwards.

Dementia — someone with dementia may not be able to reliably tell you where it hurts, so careful visual and physical checking matters even more, and any behaviour change afterwards, increased confusion, unusual quietness, should be treated as a possible sign of an injury not yet identified.

If You Want to Learn Properly

If you're a family carer and would like a proper hands-on demonstration of safe assisted rising technique, ask us next time we're at the house. If this level of calm, careful attention in a genuinely frightening moment sounds like something you'd be good at, that's exactly what we look for in new carers. Have a look at our Careers page.

📞 01948 411222
✉️ mail@nshomecare.co.uk

North Shropshire Homecare
The Coach House, 15/17 Green End, Whitchurch, SY13 1AD

Training Tuesday: Basic First Aid for a Fall — What to Check Before Helping Someone Up