Greenville Senior AdvisorWhat should we do after an older parent falls?
Get a medical evaluation even if there is no obvious injury, ask the doctor to review medications and vision, find out why the fall happened, and make the home safer before the next one; a first fall is a strong predictor of another.
Falls in older adults often have more than one cause: medications that cause dizziness, weak legs, poor lighting, loose rugs, footwear and low blood pressure on standing. A doctor can order physical therapy to improve strength and balance.
Will Medicare pay for therapy after a fall?
Yes, Medicare covers outpatient physical therapy ordered by a doctor, and if your parent is homebound it covers home health therapy visits; after a hospital admission of at least three inpatient days, it can cover rehab in a skilled nursing facility.
DPH's data shows 13 licensed home health agencies, 17 hospice programs, 3 inpatient hospice houses and 295 licensed in-home care providers with offices in the four counties. Ask whether a home safety evaluation by an occupational therapist can be part of the plan.
How do we make a home safer after a fall?
Remove loose rugs and clutter, add grab bars in the bathroom and rails on both sides of stairs, improve lighting along the path from bed to bathroom, put frequently used items within reach, and consider a medical alert device with fall detection.
For Medicaid-eligible adults at nursing facility level of care, the Community Choices waiver includes home accessibility adaptations and personal emergency response systems.
When does a fall mean it is time for assisted living?
When falls keep happening despite changes, when a parent cannot get up or call for help alone, when falls happen at night, or when the fear of falling keeps a parent from moving around, a CRCF's around-the-clock staffing may be safer than more help at home.
Ask any CRCF how it prevents falls, how it responds when a resident falls, and how it notifies families. Serious falls resulting in hospitalization must be reported to DPH within 24 hours.
What if a parent refuses to change anything?
Respect the parent's right to decide while making the risks concrete: involve their doctor, start with small changes such as a medical alert device, and offer a trial of in-home help or adult day care rather than a move.
If a parent living alone is unable to care for themselves and refuses help to the point of serious danger, DSS Adult Protective Services (1-888-227-3487) handles self-neglect reports.
At a glance
| After a fall, do | After a fall, don't | |
|---|---|---|
| Medical | Get an evaluation and medication review | Assume no injury means no problem |
| Therapy | Ask for strength and balance therapy | Rely on rest alone |
| Home | Fix lighting, rugs, grab bars | Wait for the next fall |
| Planning | Discuss whether nights are safe | Ignore falls at night |
Sources include S.C. Code Regs. 60-84, DPH Healthcare Quality and SCDHHS pages and bulletins, CareScout, CMS and VA rate tables as cited above; see our editorial standards.
