What to check with the doctor after an elderly person has a fall

If you’re an older adult, falls are no laughing matter. Even if there hasn’t been an injury, it signals potential future problems that could cause falls and more serious injuries.

Proactivity is key when it comes to preventing devastating falls in elderly adults. After a fall occurs, be sure to get the proper medical assessment from a reliable source. Getting this assessment is important for many reasons. A fall can often be an indication of a new and/or severe medical issue that requires treatment. For example, an elderly individual can become weakened and then falls because of any number illnesses such as dehydration or even incontinence issues.

After a fall, many people only visit the doctor to see if they acquired any injuries. And while this is very important, it’s also essential to understand what led to the fall in order to help prevent future falls. A good evaluation wont hurt, even if you are pretty sure your elderly loved one merely stumbled and fell.

When seeing a doctor it’s important to be proactive and ask questions. Most doctors have good intentions, but studies have shown that older patients often don’t get recommended care. If you are politely assertive, you can avoid having important things overlooked.

To help you stay ahead of the game, here are some things your doctor should check after a fall. Take this list to the doctor’s appointment with you. If the doctor seems to have missed anything, don’t hesitate to ask about it. Then you can be confident your loved one is as healthy as possible and reduce the likelihood of falls in the future.

Things a doctor should check after a fall:

Any new underlying illnesses
If your loved one has been experiencing weakness, delirium or other worrying symptoms, doctors will nearly always check for this. Be sure to tell the doctor about any symptoms you’ve noticed and how quickly they have appeared.

Health issues that make elderly people more weak increase the risk of falls. Some common conditions that cause this are:

• Dehydration
• Urinary tract infection
• Anaemia- low red blood cell count
• Pneumonia
• Strokes, including mini-strokes – that don’t cause weakness on one side.
• Heart problems such as atrial fibrillation.

Blood pressure and heart rate readings

A blood pressure and heart rate reading while sitting, and another set of readings taken while standing is crucial if there are feelings of dizziness or faintness when standing up, which can lead to dangerous falls.

If your elderly loved one is on blood pressure medication, make sure to ask their doctor if they are experiencing a drop in blood pressure when standing up.

Review medications

Older adults are frequently taking medications that inadvertently increase their falls risk. However, by working with a doctor, the dosage or even need for these drugs can be reduced or eliminated altogether. Make sure the following types of medications are reviewed:

• Sedatives, tranquilizers, or sleeping medications.
• Blood pressure and diabetes medications.
• Anticholinergic medications commonly taken for allergies, overactive bladder, vertigo, nausea, and certain types of antidepressants taken to treat nerve pain.
• Any opiate pain medications.

Blood tests

After a fall, it’s wise to check an older person’s blood tests. Blood counts that are off with things like high or low sodium levels can exacerbate falls in older people.

A complete blood cell count and a check of electrolytes and kidney function can give you a good starting point. Make sure you ask the doctor to explain all blood test results, asking if they could be the cause of falls, and what the plan is to address them.

If your loved one has diabetes and uses medication to lower blood sugar, make sure you bring in a glucometer or their blood sugar log. Episodes of low blood sugar can be a risk factor for falls, but a laboratory blood test generally can’t detect moments of low blood sugar.

Balance and gait
A gait assessment means that the doctor will carefully watch how an older person is walking. However, there are also some easy balance tests that can be done.

If balance and gait seems off, there are some simple things to do, including addressing any pain or discomfort and a referral to physical therapy for a gait and balance assessment. 

Vitamin D

There is evidence to suggest that treating low vitamin D levels may help reduce the risk of falls in older adults. Additionally, low vitamin D levels can lead to weaker bones.

You should request this test for your loved one if they are mostly indoors, don’t currently take vitamin D supplements, and haven’t been checked for low vitamin D levels.

Eyesight

Has your elderly loved one had a recent eye test? Maybe they are in need of a check. Speak to the doctor about this.

Podiatry

Is your loved one in need of podiatry care? A podiatrist could potentially help reduce the risk of falls. A doctor should assess whether the patient has foot pain, foot and ankle weakness, and any reduced range of motion.

Evaluation for heart or neurological conditions

Unlike the acute illnesses that are typically looked for after a fall, these chronic conditions may be overlooked.

In some cases, a fall can occur because of a newly developed, chronic problem with the heart or blood pressure system or a neurological condition.

If these conditions concern you, ask your doctor for the possibility of these underling conditions being a cause, especially for an elderly person with reoccurring falls and when the other above issues have been addressed.