Emergency Guide

What to Do When You Find an Elderly Parent on the Floor

You walk in and they're on the floor. Your heart stops. What you do in the next few minutes matters more than you think.

Finding a parent on the floor is one of the most frightening experiences for any family member. Whether they fell five minutes ago or five hours ago, this guide walks you through exactly what to do — step by step — so you can help them calmly and effectively.

If they are unconscious, not breathing, or bleeding heavily — call 000 immediately. Do not read the rest of this guide first. Call, then come back.

1 in 3

Over-65s fall each year (AIHW)

130,000

Fall-related hospitalisations per year in Australia

50%

Of those on floor >24hrs die within 6 months

80%

Of elderly don't wear personal alarms (UNSW)

Immediate Response: Step by Step

Stay calm. Your calmness will calm them. Follow these steps in order.

Check if they're conscious and responsive

Get down to their level. Speak clearly: “Mum, can you hear me? It's [your name].”

Responsive and alert: Good. Stay calm, ask what happened, and proceed to Step 2.
Confused or drowsy: This may indicate a head injury, dehydration, or a “long lie” (see below). Call 000.
Unconscious: Call 000 immediately. Check breathing. If not breathing, begin CPR. Do not attempt to move them.

Find out how long they've been on the floor

Ask: “When did you fall? Do you remember what happened?”

If they don't know, look for clues: is the TV on a morning program? Is the kettle cold? Are the lights from last night still on? Every hour on the floor increases medical risk dramatically.

Check for obvious injuries

Without moving them, gently check:

Head: Any bumps, cuts, or blood? Were they confused initially?
Hip: Can they move both legs? Is one leg shorter or rotated outward? (This suggests a hip fracture — do NOT try to stand them up.)
Wrists and arms: Swelling or deformity? Wrist fractures from breaking a fall are very common.
Pain anywhere: Ask them to point to where it hurts.

Decide: ambulance or help them up?

Call 000 if ANY of these apply:

They hit their head or can't remember the fall
They can't move a limb or have severe pain
They've been on the floor for more than 1 hour
They're on blood thinners (warfarin, aspirin, Xarelto)
They seem confused, dizzy, or disoriented
They have dark or tea-coloured urine (sign of muscle breakdown)

You can help them up if: The fall was recent (minutes), they have no significant pain, they can move all limbs, they feel steady, and they want to get up.

How to safely help them up

Do NOT lift them by pulling their arms. This can dislocate a shoulder or cause further injury. Instead:

Place a sturdy chair nearby.
Help them roll onto their side, then onto their hands and knees.
Guide them to grip the chair seat with both hands.
They push up to kneeling, then use the chair to stand.
Once standing, sit them in the chair for at least 10 minutes before walking.

If they can't get up this way, do not force it. Keep them warm with a blanket and call for help.

After they're up: the next 24–48 hours

Even if they seem fine, falls in elderly people can cause delayed symptoms:

Watch for increasing confusion or drowsiness (possible subdural haematoma)
Check for dark or reduced urine output (possible kidney damage from rhabdomyolysis)
Monitor for increasing pain or swelling (possible fracture)
Book a GP appointment within 48 hours for a post-fall assessment

The “Long Lie”: Why Time on the Floor Is Critical

In emergency medicine, a “long lie” means remaining on the floor for one hour or more after a fall. For older people living alone, the average time before discovery is 12 hours or more. The medical consequences escalate with every hour.

Source: AIHW, Injury in Australia: Falls; British Geriatrics Society, Long Lie guidelines.

0–1 hour

Lower Risk

Generally good outcomes if the injury itself is not severe. Bruising, pain, and shock, but recovery is likely. This is the critical detection window.

1–4 hours

Moderate Risk

Dehydration begins. Body temperature drops (hypothermia is possible even in warm houses). Pressure on skin from hard floors starts causing tissue damage. Confusion increases, especially if dehydrated.

4–12 hours

High Risk

Rhabdomyolysis becomes a serious risk. Compressed muscles begin breaking down, releasing myoglobin into the bloodstream. This protein can destroy the kidneys. Pressure ulcers begin forming. Hypothermia progresses even indoors.

12–24 hours

Critical Risk

Kidney failure from rhabdomyolysis may be irreversible. Severe dehydration causes organ stress. Pneumonia risk increases from aspiration or immobility. The fall itself may have been minor — the time on the floor is now the danger.

24+ hours

Life-Threatening

Studies show 50% of elderly people found on the floor after 24 hours die within 6 months, even if the original fall caused no significant injury. Multi-organ failure, sepsis from pressure wounds, and kidney shutdown are the primary causes.

The takeaway: Speed of detection determines outcomes far more than the severity of the fall. A minor stumble with 24 hours on the floor is more dangerous than a hard fall found within an hour. This is why any form of daily monitoring — whether a neighbour, a daily check-in call, or a personal alarm — can be the difference between a scare and a catastrophe.

What to Tell the Paramedics

When you call 000, the operator will ask specific questions. Having this information ready helps paramedics prepare the right equipment and speeds up treatment.

About the fall

• When it happened (or estimated time)
• Where they fell (bathroom, stairs, etc.)
• Did they trip, slip, or collapse?
• Did they hit their head?
• Are they conscious and responsive?

About their health

• Current medications (especially blood thinners)
• Known medical conditions
• Allergies
• GP's name and practice
• Whether they've had previous falls

Tip: Keep a one-page medical summary in a visible location in your parent's home — on the fridge is traditional. Include their name, date of birth, Medicare number, medications, conditions, allergies, GP, and emergency contacts. Paramedics look for this and it saves critical time.

The Emotional Impact — On Both of You

For Your Parent

A fall is often a turning point in an elderly person's confidence. Even if the physical injuries heal, the psychological impact can be devastating:

• Fear of falling again — leading to reduced activity and further deconditioning
• Loss of independence — fear that this will lead to “being put in a home”
• Shame — especially if they were on the floor in a vulnerable state
• Depression — particularly if recovery is slow or mobility is reduced

For You

Finding your parent on the floor is traumatic, even when the outcome is good. Common reactions include:

• Guilt — “I should have been checking more often”
• Anger — at the situation, at their stubbornness, at yourself
• Hypervigilance — the unanswered phone now triggers panic
• Decision paralysis — should they move? Get a carer? Go to residential care?

Give it a week before making big decisions. In the days after finding your parent on the floor, emotions run high. Resist the urge to immediately move them into care or make permanent changes. Let the GP do a post-fall assessment. Let recovery begin. Then have a calm conversation about what support they might need.

Preventing It From Happening Again

A fall is a warning sign, not a random event. Without intervention, someone who has fallen once has a 60–70% chance of falling again within 12 months (AIHW). Here are the evidence-based steps that reduce that risk.

Intervention	Fall Reduction	Where to Access
GP post-fall assessment	Identifies reversible causes (medications, vision, blood pressure)	Bulk-billed GP clinic
Strength & balance program	Reduces falls by up to 31%	Local council, physiotherapist
Home safety modifications	Reduces falls by 26%	Occupational therapist via My Aged Care (1800 200 422)
Medication review	Reduces falls by 39% when high-risk meds reduced	GP or pharmacist (Home Medicines Review is free under Medicare)
Vision correction	Reduces falls by 18%	Optometrist (Medicare-covered annual check)
Daily monitoring	Reduces “long lie” risk by ensuring daily contact	Telecross, neighbour, or daily check-in service

If They're Taken to Hospital

The days and weeks after hospital discharge are the highest-risk period for re-falls. Here's what to arrange before they come home:

Request an occupational therapy home assessment before discharge

Install grab rails and remove trip hazards before they return home

Arrange daily check-ins for the first 2 weeks — the re-fall risk is highest in this period

Ask the hospital physiotherapist for a home exercise program

Review medications — new medications started in hospital may increase fall risk at home

Give Them Connection. Give Yourself Peace of Mind.

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