Second fall in a month and everyone keeps telling me it's just what happens at her age. Is it?

#1tomsdaughter(Joined Jan 2025 · 31 posts)September 8, 2025, 8:31 pm

Second one in five weeks. First was in the hall in early August, she got herself up, bruised her arm, made a joke about it. This one was Saturday in the kitchen and she was on the floor about twenty minutes before I got there because I was at the shops.

Nothing broken either time. She is 83. And the response from absolutely everyone, including her, has been a variation on "well, at her age". My brother said it. The neighbour said it. She says it herself, more or less proudly, as though getting up again were the achievement.

And I have this nagging feeling that two in five weeks is not the same as one, and that everybody agreeing with each other about her age is how nothing gets done. But I also do not want to be the daughter who makes a production out of a bruise. What do you actually ask for at this point? Is there a thing, or is it genuinely just what happens?

#2dee1972(Joined Apr 2025 · 24 posts)September 9, 2025, 7:18 am

It is not just what happens. The second one is the one that means something. Ask for a falls assessment and use those words.

#3ron-at-home(Joined Aug 2025 · 17 posts)September 9, 2025, 11:48 am

My contribution here is a cautionary tale about what I did instead.

After his second one I went out and spent four hundred dollars on a fall alarm and a nightlight system, felt enormously productive about it, and did not ring anybody for another two months. The alarm was not a bad purchase. It is just that it does absolutely nothing to stop him falling. It shortens how long he is on the floor afterwards, which matters, and that is the entire extent of what it does.

What I had actually done was buy myself the feeling of having acted. And because I felt I had acted, the phone call that would have led to somebody working out why he was falling did not happen until October.

Buy the alarm if you want it. Just do not let it be the thing you do instead.

#4Dr Nadia FarhatMedical moderator(Joined Nov 2024 · 54 posts)September 11, 2025, 1:22 pm

It is not just what happens at her age, and I would treat the second fall as the more important of the two.

The reason is that a fall is a symptom with a list of causes behind it rather than an accident. Families almost universally read a first fall as an event and a second as bad luck, and it is the other way round: the second is the pattern, and it is the point at which a request should stop being polite and start being firm.

On the age argument, the guideline to know about is NICE NG249, published on 29 April 2025, which states in its overview that it updates and replaces the old falls guideline CG161 from 2013. That matters practically because a great deal of the material aimed at carers still cites CG161, and if you find advice built on it, it is out of date by a full guideline generation. NG249's context chapter says that around a third of people aged 65 and over, and around half of people aged 80 and over, fall at least once a year. Two honest caveats travel with that figure. Neither NG249 nor the guideline it replaced carries an inline citation for it, so read it as the guideline's own context statement rather than a settled primary estimate: good enough to plan around, not good enough to quote as though its provenance were beyond question. And that percentage is NICE's, not the World Health Organization's, despite being attributed to WHO all over the internet. WHO's falls fact sheet covers deaths and burden, an estimated 684,000 deaths a year and 37.3 million falls severe enough to need medical attention, and contains no annual incidence share for older people at all.

So common, yes. Which is a statement about how many people fall, not a statement about whether anything can be done, and the two get run together in exactly the way your brother and your neighbour ran them together. The consequences are not trivial: NG249 records a one year mortality rate of 31 percent after a hip fracture, and around 234,800 emergency hospital admissions in England related to falls among people aged 65 and over between 2019 and 2020, about 157,370 of them, or 67 percent, among people aged 80 and over.

What to ask for, by name, is a falls assessment, and naming the guideline changes how the request is received. What that should look at is her, not her hallway: strength and balance, her blood pressure sitting and standing, her vision, her feet and footwear, and her medicines. That last one has a name too, a structured medication review, and it is the single most productive thing to request after a fall.

The order matters and most families get it exactly backwards. Strength and balance work first, and that means a referral to a programme rather than a leaflet about exercises. Then the medication review. Then the assessment of the person and the treatment of whatever is actually causing it. Then vision, feet and footwear. And the home last. The reason the home comes last is not that it does not matter, it is that families do it first, feel they have acted, and then never pursue the assessment, which is precisely the trap Ron has just described so well. Falls at home sets that order out in full, and adaptations and technology is honest about what alarms and sensors realistically do and where the ceiling is.

Three practical things for the meantime.

Every fall, including one she gets up from herself, is a same day call to her own clinician, because they hold the notes and the baseline. If they are not reachable, that is NHS 111 in the UK, the out of hours GP service in Ireland, her own doctor's office or an urgent care centre in the United States, healthdirect on 1800 022 222 in Australia, and the provincial health line on 811 in most of Canada. Straight to an ambulance, 999 or 112 in the UK and Ireland, 911 in the United States and Canada, 000 in Australia, if she cannot get up or you cannot get her up safely, if she may have hit her head or cannot remember falling, if there is severe pain or a limb that looks out of shape or she cannot bear weight, or if there is changed breathing, chest pain, one sided weakness, changed speech or she cannot be roused. Getting up tells you about the injury. It tells you nothing whatsoever about the cause. If she is on an anticoagulant and knocks her head or her body anywhere, the threshold drops considerably and that is urgent even if she seems perfectly well.

Twenty minutes on the kitchen floor is worth mentioning explicitly when you ring. Time on the floor is part of the history, not an embarrassing detail about you being at the shops.

And watch for confusion in the days after a fall, because confusion plus a fall is usually one problem rather than two. Delirium is common in this situation; the Scottish guideline SIGN 157 puts it as high as 50 percent in people who have had a hip fracture. If she becomes more muddled than she was, or muddled in a way that comes and goes, that is a same day call in its own right.

Two things I would not accept. Being told to keep an eye on things, which is not a plan. And the falls assessment turning into a conversation about a care home, which is a different conversation and should not be substituted for this one.

One deliberate absence. I am not going to give you effect sizes for falls prevention programmes, because the figures held as canonical for this site do not include them and quoting a number from memory on something this consequential is worse than quoting none. And I have not met her, examined her or seen her notes, so nothing here is a view on why she is falling. Only somebody who can assess her can tell you that, which is the whole of the point.

#5tomsdaughter(Joined Jan 2025 · 31 posts)October 6, 2025, 6:15 pm

Update, four weeks on, and thank you.

Rang the Monday after that post, used the phrase falls assessment, mentioned the second fall in five weeks and the twenty minutes on the floor. Got a call back the same day, which after a summer of being told about her age was quite a shock.

She has been seen. Blood pressure sitting and standing was apparently the interesting part and something has been changed as a result, which I am not going to detail here because it is hers and not mine. She is on a waiting list for a strength and balance group, which will be a battle to get her to, and somebody is coming about the stairs.

No falls since. Which proves nothing after four weeks, I know. But the difference between August and October is that in August everybody had an explanation and nobody had a plan.