Falls in Older Adults: What to Do Today (and When to Go to the ER) — A Fresno Family Guide

By Dr. Harman Virk, DO — Board‑Certified Internal Medicine, The Modern Medicine Group (Fresno, CA) 

When your mom or grandpa falls, it’s scary—because you’re not just thinking about bruises. You’re thinking: Did they hit their head? Did they break a hip? Is this the start of something bigger?

Falls are common in adults 65+, but they’re not “just part of aging.” There are proven ways to prevent future falls and reduce injuries. 

This guide is written for Fresno-area families and caregivers who need a clear plan: what to do immediately, what warning signs mean “ER now,” and what to do in the next 7 days to prevent another fall.

• Medical disclaimer: This article is educational and not medical advice. If symptoms are severe, worsening, or you’re worried—seek urgent care.

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Quick answer: What should I do right after a senior falls?

Step 1: Pause for 30 seconds and assess (don’t rush them up)

Ask:

• “Where does it hurt?”

• “Did you hit your head?”

• “Are you dizzy, confused, or nauseated?”

• “Can you move arms/legs normally?”

If they’re in significant pain, confused, bleeding, or can’t move a limb don’t try to lift them. Call for help.

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ER red flags: When to call 911 or go immediately

Go to the ER (or call 911) if any of these are present:

Head injury or brain bleed risk

• Hit head and they take blood thinners (or you’re not sure)

• New confusion, unusual sleepiness, slurred speech

• Severe headache, vomiting, seizure

Hip fracture / serious injury signs

• They can’t stand or bear weight

• One leg looks shorter or turned outward

• Severe hip/groin pain

“This could be something dangerous” signs

• Chest pain, shortness of breath

• Fainting or near-fainting

• New weakness on one side, facial droop, sudden trouble speaking (possible stroke)

Falls can lead to fractures and hospitalization, and the risk increases with age—so these red flags matter. 

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If it seems “minor”: what to do at home (the first 2 hours)

If there are no ER red flags, here’s what families should do next:

1) Check pain and mobility

• Can they walk a few steps?

• Is pain getting worse over 15–30 minutes?

• Any new swelling, bruising, or inability to use a joint?

2) Look for delayed symptoms

Older adults may “seem fine,” then decline later. Re-check every 30–60 minutes for:

• Confusion

• Dizziness

• Increasing pain

• New weakness

3) Document what happened

Write down:

• Time of fall

• What they were doing (bathroom? standing up? stairs?)

• Any new meds or dose changes

• Any symptoms before the fall (dizzy? lightheaded? weak?)

This becomes gold for your doctor.

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The “hidden cause” checklist: why did they fall?

Most families focus on the fall itself. Doctors focus on why it happened, because that’s how you prevent the next one.

Common causes Dr. Virk mentioned (and what families often miss):

• Infection (UTIs, pneumonia) → weakness/confusion

• Medication side effects or changes (blood pressure meds, sedatives, new prescriptions)

• Low blood pressure, dehydration, low blood sugar

• COPD flare-ups or heart issues

• Balance/strength decline

Falls are extremely common (CDC says more than 1 in 4 adults 65+ fall each year), but many are preventable when you address causes like meds, vision, and home hazards. 

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What to do in the next 7 days (this is where families win)

Even if the ER says “no fracture,” your next move is crucial.

1) Book a follow-up quickly

A fall can be the start of a chain reaction: pain → less movement → weakness → higher fall risk → another fall.

A follow-up visit helps:

• review vitals and balance

• Check injuries that don’t show up right away

• review meds that can cause dizziness or falls

• decide if PT, imaging, or labs are needed

2) Bring the “brown bag” meds list

Put every pill bottle (prescriptions, OTC, supplements) in a bag. Medication review is one of the most practical fall-prevention tools because side effects and interactions are common in seniors.

3) Make the home safer the same week

Small changes reduce risk fast:

• Remove loose rugs/clutter paths

• Add night lights (hallway + bathroom)

• Install grab bars in the shower

• Use non-slip mats

• Encourage proper shoes (not socks/slippers)

Home safety + exercise + medication management are core prevention steps recommended by national aging resources. 

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Fresno resources families can actually use

If you’re caring for someone in Fresno or Madera County, these organizations can help connect you with programs and support:

• Fresno-Madera Area Agency on Aging (FMAAA) — caregiver support and aging resources.

• California Department of Aging – Falls Prevention (state guidance + connects you to local Area Agencies on Aging).

And if you’re an IHSS caregiver (or hiring one), this local hub is useful:

• https://www.themodernmedicine.com/fresno-ihss-guide

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Preventing the next fall: the “big 4” that work

Here’s what consistently reduces fall risk:

1. Strength + balance training (PT, tai chi, guided exercises)

2. Medication review (especially after hospital visits or new prescriptions)

3. Vision check + proper footwear

4. Home safety upgrades (grab bars, lighting, clutter control)

The National Institute on Aging emphasizes that many falls can be prevented through exercise, medication management, and home safety improvements. 

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Frequently Asked Questions

What should you do immediately after an elderly person falls?

Check for head injury, severe pain, confusion, bleeding, and ability to move or bear weight. If any red flags exist, seek emergency care.

When should a senior go to the ER after a fall?

If they hit their head (especially on blood thinners), can’t bear weight, show confusion, have severe pain, or have symptoms of stroke/heart issues. Falls can cause serious injury and require prompt evaluation.

Why do older adults fall even when the house is “safe”?

Often it’s medical: infection, dehydration, low blood pressure, medication changes, or a flare-up of a chronic condition—plus balance/strength decline with age.