Key Tips Discussed in This Blog
- Being unable to get up can turn a fall into a more serious event, particularly when an older adult remains on the floor for an extended period.
- A long lie can introduce additional health risks, with research linking prolonged time on the floor after a fall to concerns such as dehydration, hypothermia, pressure sores, and rhabdomyolysis.
- A fall response plan can reduce uncertainty, giving seniors and families a clear idea of how help can be reached if a fall occurs when no one else is nearby.
Falls are a serious health concern for older Canadians, but the consequences do not always end when the fall itself is over. For some seniors, the bigger challenge comes afterward: being unable to get up, being alone, or being unable to reach a phone or another source of help.
The Public Health Agency of Canada’s 2025 overview of falls among older adults identifies falls as the leading cause of injury-related hospitalizations and deaths among older adults in Canada. It also notes that falls can lead to disability, hospitalization, increased caregiver responsibilities, and admission to long-term care.
That makes the time between a fall and receiving assistance important. A practical fall-response plan can help reduce the time a senior spends without help and make it easier to access the right support if a fall occurs.
What Happens When a Senior Falls and Can’t Get Up?
It is easy to assume that someone who falls will simply be able to stand back up. For many older adults, that is not always possible.
Pain, injury, reduced strength, limited mobility, balance difficulties, confusion, or the position someone lands in, can all make getting up from the floor difficult or unsafe.
A 2008 BMJ prospective cohort study involving adults over age 90 illustrates how common this problem can be among very old adults. Of the participants who fell during the one-year study period, 80% were unable to get up without help after at least one fall. The study also found that 82% of recorded falls happened while the person was alone.
These figures should not be treated as estimates for all Canadian seniors. The research involved a relatively small group of people over age 90 in the United Kingdom. However, it highlights an important point: some older adults may not be physically able to get themselves up off the floor after a fall.
If a senior has fallen but appears able to move safely, our guide on how to get up safely after a fall offers practical steps to consider. If there is severe pain, a suspected injury, dizziness, loss of consciousness, or uncertainty about whether moving is safe, it may be better to remain still and seek assistance.
What Is a Long Lie?
The term “long lie” is commonly used when someone remains on the floor for an extended period after falling because they cannot get up or summon help.
There is not one universally accepted amount of time that defines a long lie in every healthcare or research setting. In the BMJ study, researchers examined falls in which participants spent an hour or more on the floor. Among those who fell, 30% experienced this at least once (Fleming et al., 2008).
Several factors can contribute to a long lie:
- Falling while alone
- Being physically unable to stand
- Having a phone or alerting device out of reach
- Not wearing an available alerting device
- Cognitive impairment or confusion
- Difficulty activating an alarm
- Hesitation about calling for assistance
The BMJ study also found that having access to a call alarm did not necessarily mean it would be used after a fall. Participants and caregivers described practical concerns, perceptions that the system was not relevant to them, and concerns related to independence (Fleming et al., 2008).
At Lifeline Canada, we see access to support differently. A medical alert system is not meant to reduce independence. Its purpose is to help protect it by giving seniors another way to reach help while continuing their normal routines.
Why Delayed Help After a Fall Can Be Dangerous
When a senior cannot get up, remaining on the floor for an extended period may pose risks beyond those of the original fall.
A 2021 scoping review of prehospital emergency management in older trauma patients identifies long lies as an important concern in older adults. The review also discusses complications including hypothermia and rhabdomyolysis, a condition involving the breakdown of damaged muscle tissue.
The original injury also matters. The review notes that relatively low-energy falls can still lead to significant injuries in older adults. Age-related physiological changes, frailty, existing medical conditions and medications can also make trauma more complicated to assess (Eichinger et al., 2021).
This does not mean every person who remains on the floor for a period of time will experience a serious complication. The effects of a fall vary considerably from one person to another.
The concern is that delayed access to help can lead to a longer period of immobility and delay in assessing injuries or symptoms that may not be obvious at first.
What Can Happen as Time Passes After a Fall?
The effects of delayed help do not follow a fixed timetable, and concerns can change as a senior remains on the floor.
| Stage After a Fall | What May Be Happening |
| Immediately after the fall | Pain, injury, dizziness, or confusion may make it difficult, unsafe, or even impossible to stand. |
| During the early period on the floor | Discomfort can increase, and the senior may begin to experience thirst, anxiety, or difficulty staying warm, particularly if they are unable to change position or summon help. |
| As time on the floor becomes prolonged | Long lies have been linked with complications such as pressure sores, dehydration, and hypothermia, while rhabdomyolysis has also been identified as a concern (Fleming et al., 2008; Eichinger et al., 2021). |
The goal is not to assign a specific risk to a certain number of minutes. Instead, it is to recognize that when a senior cannot get up, receiving help sooner can shorten the period they remain on the floor and allow injuries or other concerns to be assessed.
Common Reasons Seniors Can’t Get Up After Falling
Many of the factors that increase fall risk can also affect a person’s ability to recover from a fall.
A 2026 Canadian study examining falls across healthcare settings included more than 700,000 healthcare recipients aged 60 and older. The researchers identified several factors associated with an increased likelihood of falling, including balance impairment, health instability, cognitive impairment and limitations in activities of daily living.
These are risk factors for falling, not proof that a person will be unable to get up afterward, but they help illustrate why fall response should be considered alongside fall prevention.
Common reasons a senior may have difficulty getting up include:
- pain or injury;
- reduced leg or upper-body strength;
- balance difficulties;
- mobility limitations;
- cognitive impairment or confusion;
- fear of falling again while trying to stand; and
- an acute medical issue, such as dizziness, that may have contributed to the fall.
A previous fall can also be an important signal that it is time to review mobility, home safety and emergency planning. Our article on common causes of falls in seniors covers additional factors families may want to consider.
What Families Can Do to Prepare
Falls cannot always be prevented, but families can prepare for what happens afterward.
A fall-response plan can help seniors, caregivers, and loved ones know what to do if someone falls and cannot get up. The goal is not to make daily life more restrictive. It is to ensure that support is accessible when needed.
Fall Response Checklist
| ☐ Know how to summon help from the areas of the home used most often
☐ Keep emergency contacts current ☐ Keep important medical and medication information easy to find ☐ Review the home for trip hazards and other fall risks ☐ Use prescribed mobility aids consistently ☐ Know when a fall may require emergency medical attention ☐ Have a plan for times when the senior is home alone ☐ Consider whether a medical alert system fits the senior’s needs ☐ Review the plan if mobility, health, or living arrangements change |
Home safety is another important part of preparation. Our fall prevention tips for older adults and guide to aging in place and senior safety offer additional ways to make everyday environments safer.
Families should also encourage older adults to speak with a healthcare professional about new balance problems, dizziness, changes in mobility, recent falls, or increasing fear of falling.
How Fall Detection Can Help
Even with careful planning, there may be situations where a senior falls and cannot reach a phone or press a help button.
Automatic fall detection can add another way to initiate a response. When a compatible medical alert device detects a fall, it may automatically send an alert even if the wearer is unable to press the button themselves.
At Lifeline Canada, our fall detection options are designed to provide an additional pathway to trained response support. When an alert is received, Lifeline response can assess the situation and connect the user with the appropriate help based on the circumstances. That may include a family member, a neighbour, or the emergency services.
Automatic fall detection does have limitations. No system can detect every fall, and users should press their help button whenever they can. Fall detection also does not replace medical assessment when an injury or other health concern is suspected.
For many families, the value is in having another way to reach help. A senior can continue living independently without relying on someone to be physically present at every moment, while caregivers may have added peace of mind knowing there is another layer of support available.
Our guide to the best fall detection devices for seniors offers more information about how these systems work and what to consider when comparing options.
A Plan for What Happens Next
Fall prevention is important, but so is preparing for what happens if a fall still occurs.
Having an accessible way to summon help, a clear family response plan, and appropriate safety supports can reduce the chance that a senior remains alone and unable to get up for an extended period.
At Lifeline Canada, our goal is to help seniors maintain their independence while keeping access to support close at hand. Planning ahead can give both seniors and caregivers greater confidence about what happens next.
Frequently Asked Questions
How long is too long to lie on the floor after a fall?
There is no universal amount of time that is considered safe. If a senior cannot get up or needs assistance, help should be sought as soon as possible rather than waiting for a particular amount of time to pass.
Why might a senior be unable to get up after falling?
Pain, injury, weakness, limited mobility, balance problems, confusion, and fear can all make getting up difficult. In some cases, the condition that contributed to the fall may also make it unsafe to stand without help.
Does every fall require an ambulance?
Not necessarily. However, severe pain, a suspected head injury, loss of consciousness, serious bleeding, difficulty breathing, or other concerning symptoms may require emergency medical attention.
Can fall detection prevent a long lie?
Fall detection may help initiate a response sooner in some situations, especially when the wearer cannot press a help button. However, automatic fall detection cannot detect every fall.
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