Elderly fall and head strike¶

Falls are the leading cause of injury among older adults. When a senior falls and hits their head, subtle internal injuries can worsen over hours or days, particularly if the person takes blood thinning medications.

Do this now¶

1. Keep the person still: Do not rush to lift the person up immediately. Instruct them to stay calm and still while you check for pain, neck stiffness, or limb numbness.
2. Check for severe symptoms: Call 911 immediately if the person is unconscious, confused, vomiting, experiencing severe neck or back pain, unable to move a limb, or bleeding heavily.
3. Assess for head trauma: Look for cuts, swelling, or bruising on the scalp and face. Look closely for clear fluid or blood draining from the nose or ears.
4. Determine blood thinner status: Ask or check if the person takes anticoagulant or antiplatelet medications (such as warfarin, apixaban, rivaroxaban, or aspirin). Anyone taking blood thinners who strikes their head requires medical evaluation, even if they feel fine initially.
5. If safe to move: If there is no neck or back pain and no severe injury, help the person roll onto their side, move to a hands-and-knees position, place a sturdy chair nearby, and assist them to sit up slowly.

Delayed warning signs of intracranial bleeding¶

Symptoms of a subdural hematoma (bleeding between the brain and skull) can develop hours or even days after a head strike in older adults:

• Increasing drowsiness or difficulty waking up.
• Worsening headache or dizziness.
• Unequal pupil sizes or blurred vision.
• Slurred speech or difficulty finding words.
• New weakness or numbness on one side of the body.
• Changes in personality, memory loss, or confusion.

Fall prevention checklist¶

• Remove tripping hazards: Clear loose rugs, electrical cords, and clutter from walkways.
• Improve lighting: Install bright nightlights in hallways, stairwells, and bathrooms.
• Install grab bars: Place secure handrails along stairs and grab bars in showers and beside toilets.