“Help! I’ve fallen and I can’t get up!”

This famous line from an old TV commercial is part of the American lexicon.  It is often used as part of a joke, perhaps because the TV commercial was so hokey.

But, falling is not a laughing matter.  As we get older, muscles weaken and balance decreases making it more likely that a person could fall.  Add winter weather with cold and icy conditions and the problem is exacerbated.  One-third of adults over 65 fall an average of once per year.  Fortunately, most do not result in injury, but a small percentage can be fatal if bones are broken, and complications set in.

With this in mind, caretakers (or complete strangers, for that matter) need to know exactly what to do if you see an elderly person fall.  Here are a few tips on how to appropriately respond:

DON’T try to get the person up immediately.

First, you need to check for injuries.  Calm the person by getting him or her to take some deep breaths.  To achieve a calm status more quickly, get the individual to breathe through the nose and out through the mouth.  This is called “circular breathing”.  If the individual is experiencing some shock, this should alleviate it to some extent.  While the individual is doing this, you can check him or her over for skin discoloration, swelling or other signs of injury.

When it is time, what to do next.

When the person you are assisting is composed, you are ready for the next stage of analysis.  If he or she is having problems moving or appear to be in significant pain, DO NOTHING to move them.  Call an ambulance.  If there are no obvious signs of injury you can offer to help them get off of the ground. Let the individual be in control.  You should only assist the individual without exerting pressure or pulling.  Everything should be done gradually.  The person you are helping may be hurt more than he or she — or you — realize, and the process of standing may fail.  Be prepared.  This two-minute video will give you step-by-step instructions to do this safely.  A key thing to remember is to let the fallen individual get up in his or her own time without being rushed.

Dealing with the embarrassment.

Often older people will attempt to hide an injury because they are embarrassed.  Further, they may feel that others will overreact and insist that they be more supervised or otherwise remove their independence.  It is important to reassure the individual that, even if they need a little more help, their dignity and independence will be retained.

Following up.

If your affiliation with the individual who has fallen involves a continuing relationship, try to arrange a visit to the doctor.  Some injuries may take a while to become apparent.  If the person involved is a relative or close friend, check on him or her regularly.  Falling also has a psychological impact in that it reduces confidence in previously resilient people. Falling can damage confidence and reassurance can be as important as healing.