The short answer
- The first three days are usually left to the familyGovernment guidance says the full assessment of what somebody needs longer term should normally happen once they are back in the community, so the days in between fall to you.
- Know which worry is 999 and which is a phone callA head injury, sudden confusion and a second fall each have a different number. Write them on the fridge rather than looking them up at two in the morning.
- Ask for the free help on day oneUp to about six weeks of reablement, a free care needs assessment and a referral to a falls service are all available. None of them arrives unless somebody asks.
- Book cover for the parts of the day you cannot be thereCarers on PrimeCarers charge £18 to £25 an hour with our fee included, and the shortest visit is an hour.
Care figures are what families pay on PrimeCarers, with our fee included; agencies charge £28 to £35 an hour. Benefit figures are 2026/27 rates from gov.uk. This page covers England.
The first three days
What the first 72 hours at home have to cover
Hospital discharges people once the injury has been dealt with. Under the government's hospital discharge guidance, the full assessment of somebody's longer-term needs should normally take place once they are back in a community setting rather than on a ward, so the first days at home are yours to organise.
Evening one
The first few hours back in the house
- Read the discharge letter before anyone sits down, and write the next appointment and any new tablet on the calendar.
- Walk the route from the chair to the toilet and the bed with them, once, slowly, and move whatever is in the way.
- Put a phone, a glass of water, the tablets and a light within reach of the bed.
- Eat something and drink something, even if neither of you is hungry.
Watch for
Pain that is worse than it was on the ward, or a bruise that keeps spreading.
Who to ring
The hospital ward or the A&E department they came from, on the number on the discharge letter.
Night one
The first night
- Stay in the house if the head was hit at all. NHS advice is that an adult stays with the person for at least the first 24 hours after a head injury.
- Agree how they will call you: a phone by the bed, a baby monitor, or a door left open.
- Leave a light on between the bed and the toilet, so a trip in the night is not made in the dark.
- Do not let them get up alone in the dark on the first night if they are unsteady.
Watch for
Being hard to wake, a fit, new weakness, vomiting, or clear fluid from the ears or nose. Any of those is 999.
Who to ring
999 for the list above. NHS 111 if they hit their head and take blood-thinning medicine.
Day one
The first full day at home
- Ring the GP surgery and tell them there has been a fall and an A&E visit, even if the hospital says it has sent a letter.
- Ask the GP to review the tablets, including anything for blood pressure, sleep or water retention.
- Ring the council and ask for a care needs assessment. It is free and anyone can ask for one.
- Ask the hospital or the GP whether intermediate care or reablement has been arranged, and ask for it if it has not.
Watch for
Confusion, drowsiness or agitation that was not there before the fall. Sudden confusion is a reason to go to A&E.
Who to ring
The GP surgery for the medicines and the falls service. The council for the assessment.
Days two and three
Working out what the next few weeks need
- Watch what they can and cannot do alone now: washing, dressing, the stairs, standing to cook.
- Book cover for the parts of the day you cannot be there, rather than trying to cover all of it yourself.
- Order a key safe so a carer, a neighbour or an ambulance crew can get in without breaking a door.
- Talk about a personal alarm before the subject becomes an argument later on.
Watch for
Sitting in the chair all day and refusing to move. Loss of confidence is one of the effects of a fall named in the government's falls guidance, and the strength and balance that keep somebody steady come from moving.
Who to ring
The GP for a falls service referral, or a self-referral where the local service takes them.
Clinical advice in this graphic follows the NHS pages on falls, head injury and concussion and sudden confusion. It is a general guide rather than advice about your relative. The discharge letter and the GP surgery come first if the two ever disagree.
Read the discharge letter before anyone sits down, because it says what was found, what was ruled out, what medicine has changed and what follow-up has been booked. Then ring the GP surgery in the morning and tell them there has been a fall, rather than assuming the letter has arrived and been read. Hospital discharge explained covers what should have happened before they left. If the discharge was rushed and nothing was put in place, discharge is tomorrow and there is no care is the page for that.
What to watch for
The signs that need a phone call, and which number to ring
Most of what follows a fall is bruising, stiffness and being shaken up. A small number of things need somebody medical the same hour. This is the NHS advice on falls, head injury and sudden confusion, set out by what you might see at home.
| Who to ring | Why it matters | |
|---|---|---|
| They hit their head and cannot stay awake, have a fit, are newly weak or numb, or have fluid or bleeding from an ear | 999 | These are the head injury signs the NHS says to call an ambulance for. Do not wait to see if they settle. |
| They hit their head and take medicine that thins the blood | NHS 111 | The NHS asks anyone on blood-thinning medicine to get advice after a head injury, even if they seem fine. |
| They are suddenly confused, agitated or drowsy in a way they were not before | 999, or take them to A&E | The NHS treats sudden confusion as something to assess straight away. An infection, pain or a new medicine can cause it, and each is treatable. |
| They fall again and cannot get up, or may have hurt the head, back, neck or hip | 999 | This is the NHS line on falls. Do not try to lift somebody off the floor if they are in pain or cannot help you. |
| They fall again, are not badly hurt, and cannot manage at home tonight | NHS 111 | NHS 111 can put you through to an urgent community response team, which reaches people at home within two hours where it is running. |
| New pain on standing, or they will not put weight on a leg or an arm | NHS 111 or the GP, same day | Pain that is worse than it was on the ward is worth a second look. |
| They are frightened to stand and will not move from the chair | The GP surgery, this week | Loss of confidence is a recognised effect of a fall. A falls service looks at strength, balance, eyesight and medicines together. |
They hit their head and cannot stay awake, have a fit, are newly weak or numb, or have fluid or bleeding from an ear
- Who to ring
- 999
- Why it matters
- These are the head injury signs the NHS says to call an ambulance for. Do not wait to see if they settle.
They hit their head and take medicine that thins the blood
- Who to ring
- NHS 111
- Why it matters
- The NHS asks anyone on blood-thinning medicine to get advice after a head injury, even if they seem fine.
They are suddenly confused, agitated or drowsy in a way they were not before
- Who to ring
- 999, or take them to A&E
- Why it matters
- The NHS treats sudden confusion as something to assess straight away. An infection, pain or a new medicine can cause it, and each is treatable.
They fall again and cannot get up, or may have hurt the head, back, neck or hip
- Who to ring
- 999
- Why it matters
- This is the NHS line on falls. Do not try to lift somebody off the floor if they are in pain or cannot help you.
They fall again, are not badly hurt, and cannot manage at home tonight
- Who to ring
- NHS 111
- Why it matters
- NHS 111 can put you through to an urgent community response team, which reaches people at home within two hours where it is running.
New pain on standing, or they will not put weight on a leg or an arm
- Who to ring
- NHS 111 or the GP, same day
- Why it matters
- Pain that is worse than it was on the ward is worth a second look.
They are frightened to stand and will not move from the chair
- Who to ring
- The GP surgery, this week
- Why it matters
- Loss of confidence is a recognised effect of a fall. A falls service looks at strength, balance, eyesight and medicines together.
Sources: the NHS pages on falls, head injury and sudden confusion, and NHS England on urgent community response. If the discharge letter says something different about your relative's own injury, follow the letter and ring the ward.
Write the numbers down where anybody in the house can find them: 999, 111, the GP surgery, and the ward they came from. A second fall at two in the morning is easier to handle when nobody is hunting for a phone number. What to do while you wait covers the hours between ringing for help and help arriving.
The house tonight
What to change in the house before the first night
You are not redesigning anybody's home in an evening. The aim is narrower: make tonight's journeys safer, and make it possible for somebody to reach them if one goes wrong. Twenty minutes covers most of this.
Before you go to bed
0 of 8 ticked
The route from the bed to the toilet
Getting up and down
Reaching help
Equipment and small adaptations costing under a thousand pounds each are free from the council in England where a needs assessment agrees they are needed, which covers most grab rails, raised toilet seats and walking frames. Larger work, such as a level access shower or a stairlift, can be paid for in part by a Disabled Facilities Grant, worth up to thirty thousand pounds in England and assessed on household income and savings. Both start with the council rather than a builder. The right equipment to aid the elderly goes through what helps with what, including alarms, sensors and rails.
Free help to ask for
Four things to ask for in the first week, all of them free
These run alongside each other rather than in a queue, and asking for one does not stop you arranging anything else. None of them is automatic after an A&E visit.
- 1
Intermediate care, also called reablement
Free, usually up to about six weeksA short spell of NHS and council support at home to get somebody back on their feet, which can include a physiotherapist, an occupational therapist and care workers. The NHS describes it as free for as long as it is needed, usually to a maximum of about six weeks. Ask the GP surgery or the council if it was not arranged at discharge. - 2
A care needs assessment from the council
Free, and anyone can askThe NHS says plainly that anyone can ask for a needs assessment and that it is free. A social worker or occupational therapist looks at what your relative can and cannot manage now, and writes down what would help. It also opens the door to council funding if their savings are low enough. - 3
A referral to a falls service
Through the GP, or sometimes directlyA falls service looks for the causes rather than the bruises: muscle weakness, weak bones, eyesight, and medicines that affect balance. The NHS says a GP may refer, and that in some areas you can refer yourself. Ask for a medicines review at the same time. - 4
A carer's assessment for you, and a benefits check for them
Free, separate from your relative's assessmentIf you are the one covering the nights, you are entitled to a carer's assessment of your own. Ask about Attendance Allowance at the same time: it is not means tested, it is paid at £76.70 or £114.60 a week in 2026/27, and it can be spent on a carer.
The reablement weeks are easy to lose, because the window for them is short and nobody chases you about it. Reablement: the free six weeks explains what the team does and how to ask if it was not offered, the care needs assessment covers what the council asks, and Attendance Allowance covers who qualifies, with the current rates on gov.uk. If money is the immediate worry, funding care after a hospital stay sets out what the NHS pays for and what it does not.
Paid cover and cost
What a carer costs for the first few days, and how to arrange one
Free help takes days or weeks to start, and the first nights are now. Booking a carer privately fills the gap, and does not affect anything you have asked the council or the NHS for.
£18-£25
An hour for a visit
About £20 an hour is typical. Agencies charge £28 to £35 for the same hour.
1 hour
The shortest visit
Booked in half hours after that. A morning of washing, dressing and breakfast needs an hour.
£130+
A sleeping night
A waking night, where the carer is up and about, is from about £150.
£1,050+
A week for a live-in carer
Worth pricing if somebody is needed day and night. Agencies typically charge from £1,400.
PrimeCarers rates, September 2026, our fee included.
In the first week the two visits that earn their keep are a morning call, to get somebody up, washed, dressed and fed without rushing, and an evening call to settle them for the night. Seven mornings a week is £126 to £175. If the nights are the frightening part, night care for falls and toilet trips explains what a carer does overnight, and hourly care after a hospital stay covers a first fortnight. What an hour of care costs compares this with agency pricing.
PrimeCarers is an introductory service rather than a care agency, and it holds no CQC registration. Carers on the platform are self-employed and set their own rates. Before a carer appears, their identity and right to work are checked, an enhanced DBS on the Update Service is checked, and they have an online interview. Qualifications, training and references are not checked by us: references sit on a carer's profile, and skills and training are for you to ask the carer about. Carers are covered by insurance while they work. You read the profiles, compare rates and reviews, and speak to the carers. Search carers near you or see current rates.
Questions
Questions families ask after a fall
If the head was hit, the NHS asks an adult to stay with the person for at least the first 24 hours. Call 999 if they cannot stay awake, have a fit, become newly weak or numb, have trouble speaking, walking or seeing, or have fluid or bleeding from an ear. Contact NHS 111 if they hit their head and take medicine that thins the blood. Sudden confusion that was not there before the fall means the emergency department rather than waiting until morning.
Yes, and it is most likely after a same-day visit to the emergency department, where there was no ward stay and no social work team involved. Government guidance says the full assessment of longer-term needs should normally happen once somebody is back in the community, and it asks NHS bodies and councils to involve family in discharge decisions. If nobody spoke to you, ring the council for a care needs assessment and the GP surgery about intermediate care.
There can be. Intermediate care, also called reablement, is short-term NHS and council support at home to help somebody recover, and the NHS describes it as free for as long as it is needed, usually up to about six weeks. It is normally arranged at discharge, and you can also ask the GP surgery or the council for it after a fall at home. Equipment and minor adaptations costing under a thousand pounds each are free in England where an assessment agrees they are needed.
For the first night after a head injury the NHS advice is that an adult stays with the person for at least 24 hours, so somebody should be in the house. After that it depends on what the fall has left behind: unsteadiness on the way to the toilet, pain that wakes them, or confusion at night. If you cannot stay, an overnight carer can, from about £130 for a sleeping night. Night care for falls and toilet trips explains the rest.
It depends on who is available near your relative and how quickly you can talk to them. You search by postcode, read the profiles, message two or three carers and arrange a call. Nobody is allocated to you and nothing is matched for you: you choose the carer and agree the visits directly. If you need help sooner, the emergency care page explains the faster route.
An hour every morning for a fortnight is 14 hours, which is £252 to £350 on PrimeCarers with our fee included. The same 14 hours through an agency would be £392 to £490. Visits are booked in half hours with a one-hour minimum. What an hour of care costs sets the two side by side.
Loss of confidence is a recognised effect of a fall, and staying still weakens the strength and balance that keep somebody steady. Ask the GP for a referral to a falls service, which looks at muscle strength, bone health, eyesight and any medicine that affects balance; in some areas you can refer yourself. A carer who takes the same short walk at the same time each day can be easier to accept than a daughter or a son urging them on.