Falls

A person who is unsteady on his feet, a little confused, or just weak is at high risk for falling. A person who has these problems is likely to fall while trying to get out of bed. Or the patient can fall off the toilet or commode, slip in the bathtub or shower, or tire out and fall as he is walking.

What the patient can do

• If you notice problems with weakness or poor balance, ask for help getting up or walking.
• If you fall, let your doctor and your caregivers know. They will want to help prevent future falls, and may need to check you for injuries.
• If you have trouble walking, ask your doctor about a home health nursing visit. Home care nurses may be able to make your home safer for you. They also have ways to help you walk more safely.

What caregivers can do

• When the patient needs to get out of bed, first sit him on the side of the bed for a minute or so. This will help if the change in position causes the patient to be dizzy or unsteady.
• If the patient is unsteady, help him when walking.
• If the patient feels light-headed, stay with the patient when he goes to the bathroom.
• Remind the patient to call for help before trying to get up.
• To help in the tub or shower, use bath mats or non-slip stickers. You can also use a shower stool or chair so the patient can sit while bathing.
• Keep electric cords off the floor. Walking paths need to be clear of clothing, throw rugs, and other items that may cause tripping or slipping.
• Tape the edges of rugs to the floor.
• Have a bedpan or urinal within easy reach.
• If possible, place a commode near the bed, or place the bed near a bathroom.
• The patient should wear shoes or non-skid slippers when walking or standing. Avoid using slippery shoes or open-heel bedroom slippers.
• Ask the doctor about a home health care visit to check your home for ways to prevent falls. Handrails, bedside commodes, grab bars, shower chairs, and other tools can help keep some patients from falling.

If the patient falls:

• Leave the patient where he has fallen until you can find out if there are serious injuries.
• If the patient is unconscious, bleeding, or has fluid draining from the mouth, ears, or nose, call the doctor or emergency services (911) right away.
• If the patient is not breathing, call 911 unless the patient is in hospice or has a Durable Power of Attorney for Health Care that states his wish not to be revived.
• If the patient can respond to you, ask if he feels any pain.
• Check the patient’s head, arms, legs, and buttocks for cuts and bruises, and look to see if the area looks strange or out of shape (possibly due to a broken bone).
• Apply ice packs and pressure to any bleeding area. (Put ice in a plastic bag and wrap bag in a towel.)
• If you cannot move the patient, make him as comfortable as possible until help comes.
• If the patient is not in pain and is not bleeding, help him back to a bed or chair. (If possible, have 2 people move the patient.)

Call the doctor if the patient:

• Notices new weakness, numbness, or change in mental status (such as if the patient is confused, doesn’t know where he is, becomes forgetful, or isn’t making sense)
• Gets weak or unsteady enough that a fall is likely
• Is not breathing
• Has bleeding, has fluid draining from the mouth, ears, or nose, or is unconscious
• Is concerned about possible injury from a fall