What to actually do in the first hour after Mum has had a fall

It always starts with a phone call you do not want to answer. The neighbour, or the carer, or sometimes Mum herself, saying she had a bit of a fall earlier and didn't want to bother anyone. By that point the only useful thing left to do is the next thing. Here is the next thing.

The first thing: do not lift them up

If you are first on the scene, the instinct is to help them off the floor. Try not to, at least until you have checked a few things. Lifting someone with an unseen hip fracture can make a bad day into a much worse one. Sit on the floor with them if you can. Get them comfortable. Then look.

Things to check before anyone moves anyone:

• Head. Any bump on the head at all means call 999, or 111 at minimum, even if they seem fine.
• Hips. Ask them to gently move both legs. A leg that looks shorter than the other, or a foot turned out, is a likely hip fracture. Do not move them. Phone 999.
• Pain. Sharp pain somewhere specific, especially if they did not feel it on the way down, is worth a hospital visit.
• Memory. Are they confused, or asking the same question more than once? Concussion can be subtle, especially in older people. 111 or 999.

If everything checks out and they are calm and able, they can usually get themselves up with a chair to lean on. The Stop, Look, Hands, Knees method that the ambulance service teaches works well: get them onto hands and knees, crawl to a sturdy chair, use the chair to push themselves up backwards onto it. Slow.

When to ring 999 vs 111 vs the GP

This is the part most families get tangled up in. The rule we now use:

• 999 for any head injury, suspected broken bone, severe pain that does not let them get up, chest pain, signs of stroke, or if they have been on the floor for a long time before being found.
• 111 for "they are up and seem okay but I am not sure", or if they were able to get up but feel shaky, or if they hit their head and seem alright but you are worried. 111 will triage you.
• GP for the follow-up. Even if the fall seems fine, ring the surgery the next morning. The fall itself is rarely the issue. The reason for the fall almost always is. Low blood pressure, a medication side effect, a urinary infection, deteriorating eyesight, a dodgy rug. The GP starts the investigation.

What you should not do

A few habits to break:

• Do not let them say they are fine if they have had a fall and there is any sign of a head bump. Older people minimise. It is what they do.
• Do not skip the GP appointment "because she got up okay". Half of all older adults who have one fall have another within a year. The GP visit reduces that risk meaningfully.
• Do not move furniture and tidy the room before the ambulance arrives. The paramedics often want to see how someone fell.

How to spot a fall coming, before it happens

The most useful single fact for families: the signs of fall risk show up weeks before the fall does. They are quiet, easy to miss, and often dismissed as "just getting older". Things to watch for:

• Holding the furniture as they walk around the house, where they did not used to.
• Going upstairs one foot at a time on each step, then a pause.
• Suddenly switching from baths to showers, or stopping showers altogether.
• New bruises that they cannot remember acquiring.
• A trip or stumble that did not become a fall, especially in the same place twice.
• Dizziness on standing, or sitting on the bed for a minute before getting up.

Any one of those is a GP conversation. Two of them in the same month is the conversation, not the chat.

The thing nobody tells you about the months after

Fall risk is not the worst thing about a fall. The worst thing is the loss of confidence. Older people who have had a fall often stop doing the things that kept them mobile, which is exactly the wrong response. The hill they climbed gets steeper because they stopped walking up it.

The intervention that works is the boring one. Gentle daily activity, ideally on something they used to enjoy, with someone they like, on a predictable schedule. Falls clinics on the NHS exist for this. Ask the GP. The waiting lists are real but the programmes are good.

Why a daily check-in matters here

Most falls at home happen when nobody is around. The thing that turns a bad fall into a serious medical event is not the fall itself, it is the hours afterwards on the floor. The reason for a daily check-in, for our family, was not surveillance. It was that we wanted to know within hours, not days, if something was off.

That is what Getwello is built around. One large button, tapped each morning, that tells the family Mum is well. If she does not tap by mid-morning, we get a calm alert. We can ring. If she is fine, brilliant. If she is on the bathroom floor, we know within hours, not after the carer arrives the next day. See how the daily check-in works, or read about what to do when Dad has stopped answering the phone for the related moment that brings most families to this.