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After a fall: what should happen

Residents & families Aged care staff 6 min read

By Dr Josh Hatch, FRACGP

Most falls in residential care do not cause a major injury 4. What happens in the hours and days afterwards still matters, because a fall is often the first sign that something else has changed.

Numbers in the text link to the 3 sources listed at the foot of this page.

What the national guidelines expect

The 2025 guidelines for residential aged care set out the response to a fall 1.

  1. An immediate check. Staff assess whether basic life support is needed, then complete a baseline assessment, including vital signs, and look for injury 1.

  2. Neurological observations. These are done if the person hit their head, is newly confused, or if nobody saw the fall 1.

  3. Thinking about deterioration. The guidelines name anticoagulant medicines, delirium and sepsis as things that may contribute to a person getting worse after a fall 1.

  4. A fuller assessment. Every resident who falls has a comprehensive assessment, including a review of their medicines 1.

  5. Finding the cause. The cause of the fall is identified, investigated and reported, and a post-fall analysis is completed 1.

What the Quality Standards add

Under the strengthened Aged Care Quality Standards, providers must deliver effective and timely post-fall care, monitor falls and injuries, and review their reasons and consequences 43. A fall is meant to be understood, not only counted.

Hospital or not

Whether to go to hospital depends on the injury and on what the resident wants. Some situations usually need hospital: a suspected hip fracture in someone for whom surgery is an option, a head injury followed by drowsiness or new confusion, or bleeding that cannot be controlled.

Many falls do not. Bruising, a skin tear or a resident who is shaken can usually be looked after in the facility, where the person is known and the surroundings are familiar.

For a resident whose recorded goal is comfort, the question is whether hospital can offer something that cannot be provided in the facility, such as repairing a fracture to control pain. A goals of care conversation held in advance makes that decision much clearer for everyone involved on the day.

The days after

Some injuries declare themselves late. Pain that was not obvious on the day, particularly in a person with dementia who cannot describe it, may show up as reluctance to stand, guarding a limb, or a change in behaviour.

Fear of falling is common after a fall. A person who moves less because they are afraid loses strength, which makes another fall more likely. Getting back to walking, with help and with a physiotherapist where one is available, is part of recovery.

Questions a family can reasonably ask

  • Did anyone see the fall, and what was my relative doing at the time?

  • Did they hit their head, and were neurological observations done?

  • Has the GP been told, and have the medicines been reviewed?

  • Is there a pattern, such as the same time of day or the same place?

  • What has changed in the care plan as a result?

Sources cited on this page

  1. 1 Australian Commission on Safety and Quality in Health Care. Preventing Falls and Harm from Falls in Older People: Best Practice Guidelines for Australian Residential Aged Care Services. Sydney: ACSQHC; 2025. View source
  2. 4 Australian Institute of Health and Welfare, GEN Aged Care Data. Residential aged care quality indicators — January to March 2025. (2,593 services; 220,707 residents assessed for falls: 31.1% had one or more falls, 1.7% a fall with major injury; 19.8% subject to physical restraint, 15.3% through a secure area only.) Reported quarterly; later quarters are available from the same page. View source
  3. 43 Aged Care Quality and Safety Commission. Strengthened Aged Care Quality Standards (commenced 1 November 2025): Outcome 1.3 Choice, independence and quality of life; Outcome 5.5 Safety of clinical care services, Action 5.5.4. View source

See every source cited across the falls and frailty section →

Written by Dr Josh Hatch, FRACGP. General information only, reflecting his reading of the published evidence as at October 2026. It is not individual medical advice, does not create a doctor–patient relationship, and must not be used to start, stop or change any treatment. Evidence and Australian regulatory and PBS arrangements change — always confirm current advice with the treating GP, pharmacist or specialist.

This is general education, not a clinical protocol. The doctors who practise with Umbrella Aged Care are independent general practitioners, and each makes their own clinical decisions with the resident and family. Your GP’s advice for an individual may differ from what is written here. If it does, please ask them to talk it through with you.

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