When Your Loved One Falls — What to Do, and Preventing the Next One

People with dementia fall more often and more dangerously. How to respond calmly and safely in the moment — and the changes that prevent the next fall.

Why are falls so common in dementia?

Dementia affects balance, gait, judgment, and vision, so falls happen more often — and the person may not recognize or report an injury.

As dementia progresses it changes how a person walks, slows their reactions, and erodes their judgment about hazards. They may misjudge a step, forget to use a walker, or stand up too quickly. Vision and depth perception decline, and some medications add dizziness or drowsiness. On top of all that, a person with dementia may not be able to tell you they're hurt — which makes your observation after a fall especially important.

Falls are the leading cause of injury in older adults, and dementia roughly doubles the risk. That's the bad news. The good news is how much of it is preventable.

What to do the moment they fall

Stay calm and don't rush to lift them — first kneel down, reassure them, and check whether they're hurt.

Your instinct is to get them up fast. Resist it. Moving someone with a serious injury — especially a possible hip fracture or head injury — can make things much worse. Get down to their level, keep your voice calm, and reassure them. Then look them over before anyone moves.

Check for pain, especially in the hip, leg, wrist, or back; an arm or leg that looks bent or shortened; bleeding; and any sign their head hit the floor. Ask where it hurts and whether they can move their limbs.

When to call 911

Call for any suspected head injury, severe pain, a deformed limb, inability to get up, loss of consciousness, or blood thinners plus a bump to the head.

• They hit their head, or you can't be sure they didn't.
• They take a blood thinner (such as warfarin, apixaban, or even daily aspirin) and hit their head — bleeding can be delayed and serious.
• Severe pain, or they can't bear weight or move a limb.
• A limb looks bent, twisted, or shortened (possible fracture).
• They lost consciousness, even briefly.
• New or worsening confusion, weakness, slurred speech, or vomiting after the fall.

How to help them up safely (if uninjured)

If you're confident they're not hurt, guide them up slowly using a sturdy chair — never haul up dead weight.

If they seem unharmed, don't lift them. Instead, help them roll onto their side, then up onto their hands and knees. Bring a stable chair close. Have them place their hands on the seat and bring one foot flat on the floor, then rise into the chair as you steady and guide — using their strength, not your back. Let them rest before standing fully.

If they can't get up but seem uninjured, keep them warm and comfortable on the floor and call a non-emergency line or a neighbor for help. Don't injure yourself trying to lift alone — two injured people helps no one.

How to prevent the next fall

Most falls are preventable with a combination of home, health, and habit changes.

• Clear the path: remove clutter, cords, and loose throw rugs; secure carpet edges.
• Light it up: bright, even lighting and night lights on the route to the bathroom.
• Add support: grab bars in the bathroom, handrails on stairs, a raised toilet seat.
• Fix the feet: supportive, non-slip footwear; no socks-only or loose slippers.
• Review medications: sedatives, sleep aids, blood-pressure drugs, and anticholinergics all raise fall risk.
• Check vision and hearing yearly, and keep glasses clean and current.
• Build strength and balance: physical therapy and simple daily movement genuinely help.
• Use mobility aids correctly, and address dizziness on standing (orthostatic hypotension) with the doctor.

The medication connection

Several common medications raise fall risk, and a review can meaningfully lower it.

Sedatives and sleep aids (including over-the-counter 'PM' products), blood-pressure medications that cause dizziness, and anticholinergic drugs that cloud thinking all make falls more likely. A 'brown-bag review' — bringing every medication and supplement to the pharmacist or doctor — is one of the highest-value things you can do. Ask directly: 'Is anything here increasing the risk of a fall, and is there a safer option?'

After a fall: watch and document

Even a minor-looking fall deserves a watchful day or two, plus a note for the doctor.

After any fall, watch for 24 to 48 hours for delayed signs of a head injury — increasing confusion, drowsiness, headache, vomiting, or weakness — and seek care if they appear. Keep a simple log of falls: when, where, what they were doing, and what might have contributed. Patterns point to fixable causes, and repeated falls warrant a medical evaluation to look for an underlying problem like infection, medication effects, or a new decline.