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Helping Someone Up from the Floor After a Fall

When your loved one falls and you are alone, the moment can feel overwhelming. But you are not helpless. This guide walks you through safe, step-by-step ways to assist someone with dementia up from the floor, whether they are in early, middle, or late stages. You will learn what to say, what to do, and when to call for backup. There are tools and techniques that can keep you both safer and reduce the need for emergency calls.

Key points

  • Stay calm and assess for injuries before moving anyone.
  • Use simple, one-step commands and a calm voice.
  • Guide them to roll onto all fours, then to a sturdy chair.
  • Never pull on arms or lift alone if they cannot help.
  • A transfer lift can be a lifesaver for caregivers who cannot lift.
  • Call 911 if there is any sign of injury or if you cannot get them up safely.

Why Getting Up Is Different for Someone with Dementia

A person with dementia may not be able to follow your instructions or understand what happened. After a fall, they might be confused, scared, or even combative. Their brain may not process the sequence of movements needed to stand up safely. For example, they might try to stand up too quickly, lean backward, or not know how to shift their weight forward. This is not stubbornness; it is the disease affecting their ability to plan and execute movements. In early stages, they might still be able to help you, but in middle and late stages, they may become a dead weight or resist your help entirely.

The Risk of Rushing or Pulling Incorrectly

If you try to pull someone up by their arms or under their armpits, you can injure their shoulders or your own back. The person may also panic and grab onto you, pulling you down. A fall that results in a broken hip or head injury can be devastating, especially for someone who is already frail. The goal is not to get them up as fast as possible, but to get them up safely, without causing further harm. Sometimes the safest option is to keep them comfortable on the floor while you call for help.

The Emotional Side: Your Fear and Theirs

You may feel a surge of adrenaline and guilt. You might blame yourself for not preventing the fall. Your loved one may feel embarrassed, angry, or frightened. Take a breath. Your calm voice and slow movements will help them stay calm. Tell them, 'I am here. We are going to figure this out together.' Your presence is the most important tool you have.

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

Step-by-step

  1. 1. Stay calm and assess the situation. Do not rush to lift them. First, check for obvious injuries: blood, swelling, or an awkward limb position. Ask them, 'Can you tell me where it hurts?' If they cannot speak or seem confused, assume they may be injured. If there is any sign of head injury, bleeding, or broken bone, do not move them. Call 911 immediately.

  2. 2. If they appear uninjured and are calm, talk them through the next steps using simple, one-step directions. Say, 'I am going to help you roll onto your side. Can you look at me?' Use their name and keep your voice low and steady. Avoid asking 'Do you want to get up?' because they may say no out of fear. Instead, say, 'We are going to get up together. I will help you.'

  3. 3. Help them roll onto their side facing you. Place a folded blanket or towel under their head for comfort. Then, help them get onto their hands and knees. This is called the 'all-fours' position. If they cannot do this, you can place a sturdy chair nearby for them to hold onto. Say, 'Put your hands on the floor. Now push up onto your knees.'

  4. 4. Once they are on all fours, guide them to crawl to a sturdy chair or sofa. Place the chair close to them. Say, 'Now put your hands on the seat of the chair. Keep your knees on the floor.' If they try to stand up too soon, gently say, 'Wait. Let's do this slowly. Keep your hands on the chair.'

  5. 5. From the kneeling position, help them bring one foot forward so they are in a half-kneeling position. Say, 'Put one foot flat on the floor. Now push up with your hands on the chair.' If they are too weak, you can place a folded towel under their knee for stability. Do not pull on their arms. Instead, place your hands on their hips or shoulders to guide them upward.

  6. 6. Once they are standing, let them lean against the chair or a wall for a few moments. Do not let go immediately. Say, 'Good. You did it. Let's stand here for a minute.' Check for dizziness or unsteadiness. If they seem stable, help them sit down in the chair. If they are still shaky, call for medical help.

  7. 7. If you cannot get them up safely, do not keep trying. You can injure yourself or them. Keep them comfortable on the floor with pillows and blankets. Call 911 or a neighbor for help. If you have a medical alert system, use it. It is better to wait for help than to cause a second fall or injury.

What not to do

  • Do not grab their arms or pull them up by the wrists. This can dislocate shoulders or cause fractures. Instead, guide them from the hips or shoulders.

  • Do not try to lift them alone if they are heavy or unable to help. You risk injuring your back. Use a transfer lift or call for help.

  • Do not rush them or say 'Hurry up.' This increases anxiety and confusion. Move slowly and speak calmly.

  • Do not ask 'Are you okay?' repeatedly. They may not know. Instead, say 'I am here. We will take our time.'

  • Do not leave them alone on the floor while you go for help unless you have no other option. If you must leave, put a pillow under their head and a blanket over them, and call out to them that you will be right back.

Practical tools

  • Transfer Lift (e.g., Indie Lift or Stand Lift)

    A transfer lift is like a dolly for a person. You slide it behind their back, secure a belt around their waist, and press a button to lift them to chair height. This is ideal for caregivers who cannot physically lift someone. It can be used on carpet if you place a hard board under the lift. Prices range from $600 to $3,000. Discuss with your clinician or a physical therapist which model fits your loved one's needs.

  • Sturdy Chair or Sofa

    Place a heavy, stable chair with armrests near the person before they get up. The chair should not slide or tip. Test it by pushing on it. Use it as a support for them to push up from. Avoid using a walker or rolling chair because it can slide away and cause another fall.

  • Non-Slip Floor Mat or Towel

    If the floor is wet or slippery, place a non-slip mat or a dry towel under their knees and hands. This gives them traction so they can push up without sliding. In the bathroom, always have a non-slip mat ready.

  • Pillows and Blankets for Comfort

    If they must stay on the floor while you wait for help, place pillows under their head and a blanket over them. This keeps them warm and reduces shock. Talk to them calmly to keep them oriented.

  • Medical Alert System or Phone Nearby

    Keep a phone or medical alert button within reach of the floor. If you cannot get them up, you can call for help without leaving them. Some systems have a fall detection feature that automatically alerts emergency services.

  • Phrases to Say

    Use short, clear phrases: 'Look at me.' 'Put your hands on the floor.' 'Now push up on your knees.' 'Good, you are doing great.' Avoid long explanations. Use their name. If they resist, say 'Let's try something different' and change your approach.

Discuss with your clinician

Ask your doctor or physical therapist if a transfer lift is appropriate for your loved one's weight, mobility, and stage of dementia.

Discuss whether your loved one has any conditions (e.g., osteoporosis, blood thinners) that increase the risk of injury from a fall or from being moved.

Ask about a home safety evaluation by an occupational therapist to identify fall hazards and recommend equipment.

If your loved one has frequent falls, ask about a referral to a falls prevention program or physical therapy to improve strength and balance.

Discuss whether a medical alert system with fall detection is right for your situation.

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