14 symptoms to look for after an elderly person falls

As we get older, we become more prone to the risk of falls possibly due to increased frailty, medication or other age related conditions. Falls are one of the most common causes of injury in elderly people1, with around 30% of adults aged over 65 in England experiencing at least one fall per year.2 While many falls result in only minor bruising, some can cause serious life threatening injuries. The challenge? Symptoms don’t always appear immediately – some injuries may not present themselves for hours or even days after a fall.

This guide will help you identify both immediate and delayed symptoms to look for after an elderly person falls, so you know when to seek medical care.

Medical disclaimer: This guide is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for medical concerns. If you believe someone has a medical emergency, call emergency services immediately.

If you’re concerned about an older person having a fall accident, you can read our guide on falls prevention for elderly people. You may also find they’ll benefit from the support of a Home Care Assistant. A Home Carer can provide emotional support, as well as help with tidying and decluttering the home to reduce hazards that could cause future falls.

If your loved one has recently had a fall and you’re concerned about their wellbeing, our Convalescent Care service can help. A trained Care Assistant will visit your loved one at home to assist with an injury. They offer valuable support during recovery and are professionally trained to monitor your loved one and notice changes in their health or wellbeing.

To learn more about our services and how we can help, find your local Alina Homecare Team.

Elderly woman fallen over in the kitchen, with food scattered on the floor

What are the causes of falls in the elderly?

Anyone can have a fall, but falls in older adults are more common.3 There are a few reasons for this:

Around one third of people aged 65 and over, and over half of people aged 80 and over, will fall at least once a year.4 An increased risk of falls occurs in older individuals due to the natural ageing process. Ageing can result in muscle weakness and balance problems, vision loss, long term health conditions, or low blood pressure which can lead to dizziness.

Another consequence of ageing is the potential onset of osteoporosis. This is a health condition that weakens bones, causing them to become fragile and more likely to break. Fragility as a result of osteoporosis can lead to an increase in a person’s risk of falling, which could subsequently result in broken bones.

It’s estimated that over three million people in the UK have osteoporosis5, and it’s more commonly developed in older women than men.6 This is because of the female anatomy – ovaries produce oestrogen which helps protect bones. Following menopause, women lose bone density due to hormonal changes and the reduced production of oestrogen.7

Deficiencies such as having low levels of vitamin D in the body can also increase the chance of falls. This is because vitamin D deficiencies cause a drop in bone mineral density8 and therefore bone strength, increasing instability and the risk of a fall.

Falls can also be a consequence of various external risk factors, but most commonly arise from the following:

  • Clutter in the home causing a trip hazard; this can include loose cables or wires, or rugs and carpets that are upturned and not properly secured
  • A poorly lit room can result in dangerous surroundings for elderly individuals due to low visibility; this is because potential hazards may not be seen until it’s too late to avoid a fall
  • Uneven surfaces and changes in floor levels, such as stairs or slopes, can be more difficult to manage for an elderly person who’s unsteady on their feet
  • Slippery surfaces are potential risks, especially in areas like the kitchen and bathroom where water can be easily spilt onto floors
  • Some elderly people find that standing up quickly or getting out of a hot bath or shower can result in a bout of dizziness which may lead to a fall

Who’s at higher risk of serious fall injuries?

  • People over 80 years old (highest risk)
  • People with cognitive impairments
  • People with osteoporosis
  • People taking blood thinning medication
  • People taking multiple medications
  • People living alone or in isolation
  • People who have previously experienced a fall

How to prevent falls in older adults?

Slips and falls in the elderly are often preventable, yet research suggests that 10% of falls in people aged 75-79 result in a hospital visit, and this doubles to 20% for people aged 80 and over.9 Therefore, it’s important to try reducing the risk of falls to maintain health, confidence and independence in older people.

If your elderly loved one has had a fall injury that resulted in hospitalisation, they could benefit from our After Hospital Care. Being discharged from hospital, where they were receiving round the clock support, and readjusting to living independently at home can be unnerving. Our Home Carers can help with the transition and support your loved one to regain their confidence.

Some simple measures that you can implement for preventing a fall risk at home are:

  • Ensuring rooms and staircases are well lit
  • Implementing walking aids such as walking sticks, rollators or walking frames
  • Mopping up spills immediately to prevent slippery floors
  • Removing clutter and potential trip hazards
  • Using non-slip bath or shower mats10

Whilst they cannot rule out falls in older people, there are ways of monitoring elderly parents remotely to assist their safety and offer peace of mind for family members.

A personal alarm for the elderly can provide an instant alert should a fall occur. These are devices that can be worn around the neck or wrist and, when activated, will alert emergency services. Grab bars or pull cords can also be installed in bathrooms where falls are more likely to happen due to slippery surfaces.

Female Home Care client

How can you help someone who’s had a fall?

If you’re present when an elderly loved one has a fall, stay calm and avoid panicking. You’ll need to determine the cause and whether there are any serious injuries from a fall.

After a fall, it’s important to wait until the shock of the fall has subsided before you try to move your loved one. Check your surroundings to ensure it’s safe for you to help them without causing injury to yourself. Only move them if you’re confident it’s safe to do so without making the situation or injuries worse. Moving them too soon could worsen injuries which may extend recovery time and lead to more serious consequences. It’s always best to first consult medical professionals, such as calling the emergency services.

If your loved one hit their head or lost consciousness when they fell, they may have sustained a head injury. In this case, you should call an ambulance immediately and avoid moving them. This is also relevant if you’re concerned about a potential sprain, fracture or broken bone. It’s advised that you leave them where they fell and wait for medical assistance to arrive.

In the event of an elderly person falling and an ambulance being called, make sure they’re as comfortable as possible whilst waiting for the ambulance to arrive. Cover them with blankets to keep them warm and dry (if outside) and make sure they drink plenty of fluids to stay hydrated, if it’s safe to do so.

In the aftermath of a fall, you may find an elderly loved one lacks confidence and becomes withdrawn; this may be because they feel as though they’ve lost their independence. If they’re able, encourage them to get back to daily routines and activities as soon as possible.

Emergency warning signs: when to seek immediate emergency medical care

Whilst many falls result in minor injuries that can be monitored at home, some symptoms may indicate a serious medical emergency. If the person who’s fallen experiences any of the following symptoms, call emergency services immediately:

Head and brain injury warning signs:

  • Clear fluid or blood draining from the ears or nose
  • Increased drowsiness or difficulty staying awake
  • Loss of consciousness, even if brief
  • Repeated vomiting
  • Seizures or convulsions
  • Severe confusion or disorientation beyond what’s normal for the person
  • Severe headache that doesn’t improve with painkillers or gets progressively worse
  • Slurred speech that’s new or worsening
  • Unequal pupil size, double vision or significant vision changes

Physical injury warning signs:

  • Abdominal pain that’s severe or worsening
  • Chest pain or difficulty breathing
  • Obvious broken bones
  • Severe bleeding
  • Suspected hip fracture, such as the inability to bear weight or turn the leg outward

Behaviour changes:

  • Extreme restlessness
  • Inability to recognise familiar people or places
  • Unusual behaviour or agitation that’s out of character

If the person who’s fallen simply doesn’t seem right to you or if you feel concerned about their condition even without specific symptoms, seek medical advice. You know your loved one best and any changes – even subtle ones – could be significant warning signs.

Symptoms to look for after a fall

Symptoms to look for after a fall

While an elderly person may not initially appear to be injured after a fall, it’s important to closely monitor them afterwards for signs of serious concerns. Sometimes symptoms are delayed and will present themselves gradually over time, so it’s valuable to be aware of different symptoms to look for after a fall.

Some immediate symptoms to look for after a fall are:

  • Changes in behaviour or personality
  • Confusion or restlessness
  • Disorientation or inability to remember things
  • Drowsiness or excessive sleeping
  • Headaches
  • Loss of consciousness
  • Numbness or tingling in any part of the body
  • Slurred speech
  • Tinnitus (ringing in the ears)
  • Unusual lack of coordination
  • Vomiting or nausea

Following a fall, temporary pain may occur immediately. This pain may be short term or it could be more serious and require long term treatment. Read on to learn more about the most common injuries and symptoms to look for after a fall:

1. Broken bones

Bones weaken as we age, which means elderly people are more susceptible to broken bones after a fall. Broken bones in the arms or legs are easier to notice than internal breakages, such as the ribcage or hips. This is why it’s especially important to pay attention to any new pain that’s experienced after elderly people fall.

Pay close attention to symptoms that could indicate a broken bone; this could be pain when coughing or laughing, which may suggest a broken ribcage. Likewise, pain when moving or restricting walking could suggest a broken hip. If they experience new pain in areas where bones are likely to be broken, you should seek medical help from a trained professional to check this.

2. Bruises or blood clots

Often, when someone has a bump or fall, this can cause substantial bruising. This indicates there are broken blood vessels under the skin. Bruising can also imply more severe injuries, including sprains, strains or internal bleeding.

Due to thinner skin and fragile blood vessels beneath the surface, elderly skin is more prone to bruising. Therefore, elderly people are more likely to experience bruising after a fall. If the bruising is significant and painful and covers a large area, you should seek medical advice to determine if it requires attention.

3. Cuts or lacerations

Depending on the surroundings and the cause of a fall, an elderly person may have encountered sharp objects, such as gravel or stones, which could lead to cuts or skin lacerations. Serious cuts or lacerations may require medical intervention and stitches to stop the bleeding. If a laceration is deep enough, it could cause muscle, nerve or soft tissue damage. Prompt medical treatment can reduce the risk of infection, help reduce scarring and encourage faster healing.

4. Limited movement

After a fall or any impact with the ground, it’s normal to experience soreness and stiffness. Stiffness should usually subside quickly with stretching and moving around following a fall. However, if the pain or stiffness restricts the ability to move then it could be something serious. Serious injuries such as broken bones or spinal injuries can make it difficult to move immediately after a fall. If you notice unusual mobility limitations following an elderly fall, seek advice from a medical professional.

5. Ongoing pain

Losing balance and hitting the ground unexpectedly can result in immediate feelings of shock and pain. Sometimes, the initial pain may be minor and will subside or heal quickly. However, other times the pain can be more severe and ongoing.

If your elderly loved one experiences delayed soreness after a fall, this could be because of something more serious like a broken bone, sprain or muscular injury. Delayed pain can often occur after the shock and adrenaline of the fall have worn off.

Ignoring ongoing pain can result in the injury becoming worse over time and prolonging the healing process. It’s always recommended to seek medical attention after an elderly person falls to ensure they have no underlying injuries.

6. Sudden, sharp pain

Similar to ongoing pain, sudden and sharp pains can also be an indication that there are serious injuries. Broken bones often involve sudden, sharp pain. In some cases, even the lightest pressure or movement of an injury can cause pain.

Not all injuries or symptoms are visible. If sudden, sharp pain is experienced then it’s possible there’s a serious injury and you should seek medical attention.

7. Swelling

Swelling can often occur immediately after a fall and indicate there may be an injury. Swelling usually appears when there’s a broken bone, sprain or strain. However, you may not notice swelling straight after the fall has occurred. Instead, the swelling may increase throughout the day, so it’s an important symptom to look for after a fall.

If an elderly person has existing swollen limbs, this can make swelling after a fall difficult to notice. Swelling in seniors could be the result of water retention in the body. This is known as oedema and causes the legs and ankles to swell, but there are different kinds of exercises to reduce swollen ankles. If an elderly person experiences ankle swelling after a fall, you should consult a medical professional before attempting any exercises as there could be an underlying injury.

8. Internal injuries

Internal injuries are among the most dangerous consequences of a fall because they’re not always immediately obvious. Unlike a broken bone or visible bruise, internal damage or bleeding is hidden from view, yet potentially life threatening. Falls can cause blunt force trauma to the abdomen, resulting in torn blood vessels, ruptured organs or internal bleeding.

Internal injury signs include:

  • Chest pain, especially when taking a deep breath
  • Confusion or anxiety
  • Coughing blood
  • Difficulty breathing or shortness of breath
  • Dizziness or feeling faint
  • Feeling cold or shivering
  • Increasing weakness or fatigue
  • Loss of consciousness
  • Nausea and vomiting
  • Pale, cool or clammy skin
  • Persistent stomach pain
  • Rapid heartbeat
  • Swelling or bloating
  • Vomiting blood or blood in stools

If your loved one is taking blood thinning medication, they’re at higher risk of internal bleeding after a fall; therefore, even seemingly minor falls should be reported to a medical professional.

Body injuries

As well as the symptoms mentioned above, there are body injuries which you should be mindful of and pay close attention to. If you’re concerned about any of these in an elderly person after a fall, refer to the NHS website or seek professional medical advice.

9. Head injuries or loss of consciousness

If an elderly person hits their head during a fall or loses consciousness, you should seek medical attention immediately. Some signs of a head injury are not instantly obvious and will only present themselves later.

Signs of a head injury vary depending on the severity, but some common symptoms to look for after a fall are:

  • Blurred vision
  • Confusion or disorientation
  • Dizziness or loss of balance
  • Headaches
  • Nausea
  • Tinnitus (ringing in ears)

10. Neck injuries

Whiplash is a common neck injury from falling. This type of injury is caused by a sudden, rapid movement of the head and neck. The sudden movement can cause a sprain in the soft neck tissue, resulting in neck pain, stiffness, headaches or dizziness. In some cases, the symptoms of whiplash may only appear several hours or days after the fall. The NHS recommends taking pain medication to help with the pain of whiplash and continuing with daily activities as normal to speed up recovery.11

11. Arm injuries in the elbow, shoulder or wrist

It’s human instinct to brace ourselves for a fall – usually, this involves putting a hand or arm out to cushion the fall to the ground. This can lead to various arm injuries from falling in the elbows, shoulders or wrists. Minor injuries may heal on their own over time, while others may require medical intervention, such as a dislocation.

12. Back pain & injuries

Back pain can often occur after a fall due to the sudden impact of hitting the ground. If an elderly person has existing back injuries, this can worsen the issue. However, back pain following a fall could be due to a serious injury such as a herniated disc or compression fracture.

Older adults with osteoporosis are at higher risk of experiencing compression fractures. Symptoms can include severe back pain and difficulty standing or walking. If you suspect an elderly person has back pain following a fall, they should get plenty of rest and consult a medical professional if the pain persists.

13. Hip fractures

Hip fractures are one of the most serious consequences of elderly falls; around 76,000 hip fractures occur annually in the UK.12 They’re particularly common in elderly people and those with osteoporosis.

A broken hip is a serious injury and can take several weeks or months to recover from; it needs to be treated in hospital immediately.13 Warning signs of a hip fracture to look out for are:

  • Difficulty moving the hip and leg
  • Inability to stand or put weight on the affected leg
  • Severe pain in the hip or groin area
  • Swelling and bruising around the hip and upper leg
  • The affected leg is at an odd angle or is shorter than the unaffected leg

14. Knee & ankle injuries

Knee injuries from falling can be as minor as a bruise or sprain to a serious injury like a torn ligament or fracture. A sprain occurs when a ligament in the knee is overstretched and can usually be treat at home. A torn ligament, on the other hand, is considered a serious injury and often requires surgery to repair. Without proper treatment, a torn ligament can lead to chronic pain and further complications.

Knee pain after a fall usually signifies something serious if there’s significant swelling, severe pain or difficulty standing or walking. In this case, you should seek medical attention.

If an elderly person experiences knee or ankle swelling after a fall, you should always seek medical advice to ensure they receive the best treatment. However, the NHS does recommend using the PRICE method to help with swelling and supporting an injury for the first few days.14

  1. Protection – protect the injury by using a support or shoes that support the foot and ankle
  2. Rest – avoid putting any weight on the injury and stop exercising
  3. Ice – apply an ice pack or cold compress for 20 minutes every few hours
  4. Compression – wrap the injury with a bandage to support it
  5. Elevate – keep the injury raised as much as possible

Swelling often doesn’t appear immediately in ankle injuries and could take several hours to develop. For a mild sprain, swelling could last several days; for severe sprains, swelling normally lasts longer until the injury heals.

Delayed symptoms: why some injuries appear later

One of the most important things to understand about fall injuries is that not all symptoms appear immediately. In fact, some of the most serious injuries can take hours, days or even weeks to appear – that’s why ongoing monitoring after a fall is essential.

When someone experiences a fall, their body releases a natural stress response, known as adrenaline, which can temporarily mask pain and other symptoms. An elderly person might initially feel fine and able to move around after a fall, only to experience significant pain and stiffness several hours or days later once the adrenaline has worn off.

Some injuries may involve internal swelling and inflammation that develops progressively. A minor bump to the head may not hurt immediately, but swelling of brain tissue can develop over 24-72 hours15, leading to increasingly severe symptoms.

Some internal injuries, such as bleeding between the brain and skull, can develop slowly.16 This is especially common in elderly people and those taking blood thinning medication. A small blood vessel may bleed slowly over days or weeks, gradually building pressure in the skull.

Medical professionals recommend monitoring an elderly person for at least 7-10 days following a fall, even if they initially appear uninjured. During this time, you could keep a symptom journal to track changes and look out for:

1-24 hours after a fall:
Changes in energy levels
Difficulty with movements that were initially possible after the fall
Headaches that appear later in the day
Increasing pain or stiffness
Nausea or vomiting
Swelling that develops or worsens

2-3 days after a fall:
Bruising that appears or darkens (although this is normal, monitor the extent)
Changes in sleep patterns
Increasing difficulty with daily activities
New areas of pain or discomfort
Persistent headaches
Worsening pain, rather than improvement

4-10 days after a fall:
Any new symptoms that develop
Confusion or memory problems
Loss of appetite
Mood changes or irritability
Ongoing fatigue or weakness
Persistent or worsening headaches

Services to support elderly people at home

Knowing your elderly loved one is living alone can be unsettling. You may be worried they’re struggling by themselves, feeling lonely, or might have a fall while they’re alone. There’s also the concern they won’t communicate these feelings to anyone. However, there are ways in which you can help them and enable them to maintain their independence and routines at home.

Elderly sitting services or Elderly Care at Home can provide reassurance in these circumstances. Elderly sitting services are where a volunteer or Care Assistant visits your loved one at home to provide companionship and social interaction. Elderly Care is similar – a trained, professional Carer will provide support to your loved one at home by carrying out various tasks. These services also provide valuable peace of mind that your loved one is receiving support and there’s someone nearby in the event of a fall.

To learn more about our Home Care services and how we can help, find your local Alina Homecare Team.

Quick questions

How long after a fall can symptoms appear?

Symptoms can appear hours, days or even weeks after a fall. Immediate symptoms (within minutes to hours) are most common, but delayed symptoms are particularly concerning. Some serious injuries, especially brain bleeds, may not cause noticeable symptoms for 1-3 weeks after the fall. This is why monitoring for at least 7-10 days after any fall is crucial, particularly for elderly people on blood thinning medication. If new symptoms develop at any point, even weeks later, seek professional medical advice.

When should someone go to hospital after a fall?

Call emergency services or go to A&E immediately if the person experiences:

  • A head injury and is taking blood thinning medication
  • Abdominal pain or swelling
  • Confusion, unusual behaviour or difficulty recognising people
  • Difficulty breathing or chest pain
  • Loss of consciousness, even briefly
  • Severe bleeding that won’t stop
  • Severe headaches or repeated vomiting
  • Suspected broken bones or visible deformity
  • Weakness or numbness on one side of the body

If in doubt, contact NHS 111 for guidance on whether A&E attendance is necessary.

Can someone have a serious injury without immediate pain?

Yes, absolutely. Adrenaline released during and after a fall can mask pain for several hours, so you can’t rely on the absence of pain to rule out injury. In fact, some serious injuries develop gradually:

  • Brain bleeds may cause minimal symptoms initially
  • Concussions can occur without loss of consciousness
  • Injuries in people with dementia may not be reported due to communication difficulties
  • Internal bleeding may be painless in the early stages
How long should someone be monitored after a fall?

After a fall, the NHS recommends staying with someone for 24 hours if there has been a minor head injury to monitor for serious symptoms appearing.17 Some injuries can take several days to appear, so it’s worth monitoring the person for at least 7-10 days and noting whether symptoms are improving or worsening.

Is it normal to feel worse the day after a fall?

Yes, feeling worse 24-48 hours after a fall is common and often normal. As adrenaline wears off and inflammation develops, pain and stiffness typically increase during this period. Bruising appears and darkens, and swelling often peaks.

What to do if someone hits their head but seems fine?

Head injuries in elderly people can be particularly dangerous. Even if they seem completely fine, you should check for visible injuries, such as bleeding or swelling and monitor intensely for serious symptoms, specifically headaches, vomiting, confusion, drowsiness, vision changes or balance problems.

Refer to the NHS website for professional medical advice on head injuries and concussions18, including when to attend A&E or call emergency services.

What if the person has dementia and can’t say how they feel?

Monitoring someone with dementia after a fall requires extra vigilance because they may not be able to communicate their symptoms. Focus on:

Behavioural changes:

  • Aggressive behaviour (can indicate pain)
  • Changes in sleep patterns
  • Increased agitation or restlessness
  • More confusion that usual
  • Refusing food or activities they normally enjoy
  • Unusual quietness or withdrawal

Physical observations:

  • Check for swelling or bruising during Personal Care
  • Facial expressions (e.g. grimacing or wincing)
  • Look for asymmetry (e.g. one arm not moving as much as the other)
  • Monitor vital signs if possible (e.g. temperature, pulse)
  • Watch how they move (limping, guarding a body part, reduced mobility)

Functional changes:

  • Avoiding certain positions or movements
  • Difficulty with previously manageable movements
  • Needing more assistance than usual
Should an elderly person go to hospital after a fall?

Not every fall requires hospital admission, but seek medical support if you’re concerned about symptoms. Call emergency services if there’s a suspected serious injury, an inability to get up or if the person has sustained a head injury and is taking blood thinning medication. If unsure, call NHS 111 for medical advice. Even seemingly minor falls should be discussed with the person’s GP because the fall may indicate underlying health concerns. Additionally, a fall prevention assessment may be needed to ensure the home is safe and to prevent future falls.

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References

1. GOV.UK, “Falls: applying All Our Health”, Reviewed 20 October 2025
2. National Institute for Health & Care Excellence, “Falls”, Reviewed 20 October 2025
3. NHS, “Falls”, Reviewed 20 October 2025
4. Public Health England, “Falls and fracture consensus statement”, Reviewed 20 October 2025
5. National Institute for Health & Care Excellence, “Abaloparatide for treating osteoporosis in postmenopausal women: Draft scope”, Reviewed 20 October 2025
6. GOV.UK, “Falls: applying All Our Health”, Reviewed 20 October 2025
7. NHS, “Osteoporosis”, Reviewed 20 October 2025
5. National Institute for Health & Care Excellence, “Falls: assessment and prevention in older people and in people 50 and over at higher risk”, Reviewed 20 October 2025
9. TakingCare, “Elderly people and falls: how healthcare can better support the UK’s ageing population”, Reviewed 20 October 2025
10. Age UK, “Preventing falls”, Reviewed 20 October 2025
11. NHS, “Whiplash”, Reviewed 20 October 2025
12. Data.Gov.UK, “National Hip Fracture Database annual report 2024”, Reviewed 20 October 2025
13. NHS, “Broken hip”, Reviewed 20 October 2025
14. NHS, “Sprains and strains”, Reviewed 20 October 2025
15. Everyday Health, “What is cerebral edema? Symptoms, causes, diagnosis, treatment, and prevention”, Reviewed 20 October 2025
16. NHS, “Subdural haematoma”, Reviewed 20 October 2025
17. NHS Inform, “Minor head injury”, Reviewed 20 October 2025
18. NHS, “Head injury and concussion”, Reviewed 20 October 2025

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