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when to seek medical care after a head injury

Key points

  • Seek medical care immediately if there is any loss of consciousness, confusion, vomiting, severe headache, vision changes, weakness, or trouble speaking—even if they never passed out.
  • Monitor closely for 24-48 hours after any head injury, as symptoms can worsen over time. Keep a written log of changes.
  • If your loved one is on blood thinners, go to the ER even for a minor head injury—internal bleeding is a serious risk.
  • Do not give pain relievers like aspirin or ibuprofen without a doctor's approval, as they can increase bleeding risk.
  • You are the most reliable observer—trust your instincts. If something feels wrong, call 911 or go to the ER.
  • Take care of yourself during this stressful time. Ask for help from family, friends, or respite services. You cannot care for your loved one if you are exhausted or ill.

General caregiving information, not medical advice. Check medications and major care changes with your clinician.

Step-by-step

  1. If suspected neck injury or unconscious, call 911; do not move them. If conscious, help to a safe place and say: 'You had a fall. I am here. Let me check how you feel.'

  2. Call 911 immediately for red-flag symptoms: loss of consciousness, worsening confusion, repeated vomiting, sudden severe headache, weakness/numbness, vision changes, trouble speaking, seizures, or blood/clear fluid from nose/ears. Also call if these appear during home monitoring.

  3. If on blood thinners (warfarin, apixaban, clopidogrel, etc.), seek medical care even if symptoms seem mild. Tell the doctor: 'My loved one is on [medication] and had a head injury. I'm worried about bleeding.' Do not wait for symptoms.

  4. When calling 911 or at ER, give: 'My loved one has dementia. They fell at [time] from [height]. They hit [body part]. Medications: [list]. Baseline: [normal behavior]. Changes since fall: [list].'

  5. At discharge, get written instructions and ask: 'What symptoms to watch for? When to return? Who to call?' Schedule follow-up with a neurologist or geriatrician familiar with dementia.

  6. At home, create a quiet, low-stimulation environment. Check every hour for 24–48 hours; gently wake every 2–3 hours the first night to confirm they can be roused. Keep a simple log of date, time, observations, and actions. Do not give aspirin/ibuprofen without doctor approval; offer acetaminophen only if cleared.

  7. If exhausted, ask a friend, family member, or respite service to stay with your loved one so you can rest.

What not to do

  • Do not assume the injury is minor just because there was no loss of consciousness, they seem fine, or cannot tell you what happened. Internal bleeding can occur without obvious signs. Treat any bump, behavior change, or unknown event seriously.

  • Do not offer food or drink if they are drowsy, vomiting, or not fully alert. If vomiting, gently roll them onto their side to keep airway clear. Wait until consistently awake and oriented before offering small sips of water.

  • Do not manage red-flag symptoms at home with rest, ice, or OTC remedies. If a serious symptom appears, call 911. Ice helps external swelling but not internal brain injury.

  • Do not hesitate to call 911 or go to ER due to cost, COVID-19, or fear of being a bother. Acting quickly may save a life.

Practical tools

  • Head Injury Red-Flag Checklist

    Print and keep on fridge or phone. Items: loss of consciousness, confusion/worsening confusion, memory loss, blurred/double vision, nausea/vomiting (more than once), sudden severe headache, weakness/numbness, trouble speaking/writing, seizures, blood/clear fluid from nose/ears. If any present, call 911. If none, begin hourly home monitoring.

  • Caregiver's 'What to Tell the Doctor' Script

    Keep in wallet or phone: 'My loved one has dementia. They fell at [time] from [height]. They hit [head/face/back]. Medications: [list]. Baseline: [normal behavior]. Changes since fall: [list].' This minimizes stress and helps the medical team act quickly.

  • 24–48 Hour Observation Log

    Use a notebook or notes app to record date, time, observation (e.g., 'slept 2 hours, woke confused, walked with limp'), and action taken (e.g., 'offered water, helped to bathroom'). Review before follow-up to give concrete data and spot concerning trends early.

Discuss with your clinician

Ask your loved one's doctor: 'Given their dementia/TBI history, what is the safest way to manage pain after a head injury? Are there any medications we should avoid?'

Ask: 'If my loved one is on blood thinners, what is the protocol for a head injury? Should we go to the ER even for a minor bump?'

Ask: 'What are the specific signs of intracranial bleeding that I should watch for at home? How quickly can symptoms appear?'

Ask: 'Can we get a baseline brain scan (CT or MRI) now, so doctors have something to compare to in case of a future head injury?'

Ask: 'If my loved one has a seizure after a head injury, what should I do? Should I call 911 or give them medication at home?'

Ask: 'Are there any fall prevention programs or physical therapy referrals that could reduce the risk of future head injuries?'

Related guides

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