At three in the morning the trip often looks fine from the hallway. Mom gets out of bed, walks to the doorway, and then she stops. She is not on the floor yet. She is standing still with one hand on the frame, or she has turned back toward the bed, or she is holding the wall and waiting. Most families only see the fall, not the stop before it. This guide is about that stop, because the stop is where you can find the problem.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
What to do in the moment
Keep your voice low and your movements slow. Stand where she can see you, but do not pull her forward by the arm, because a sudden pull can throw her weight off. Ask one plain question: are you dizzy, or does the floor look wrong? Let her answer before you say anything else. If she is steady where she stands, let her stay there until she says she is ready to move. If she looks unsteady, guide her gently back to sit on the edge of the bed and wait with her.
If she has hit her head, lost consciousness, cannot bear weight, or seems suddenly confused, stop this guide and call emergency services. Do not try to finish the walk to the bathroom first.
Find which stop she pauses at
The night route has six stops: the bed edge, the bedroom doorway, the hallway, the hallway light, the bathroom doorway, and the toilet. Think back over the last few nights and ask which stop is the pause point. It is often one of these:
The bedroom doorway, where the light from the hall changes and the floor surface may shift from carpet to hard flooring. The corner where the hallway turns toward the bathroom, because there is often no wall to hold on that bend. The bathroom threshold, where the lip of the doorway or the change in floor height catches the foot. A stretch of hallway with no hand-hold within arm's reach.
Write down which one it is. You do not need to fix every stop at once. One pause point is enough to start with.
Check the pause point, not the whole house
Stand at the pause point during daylight and then, if you can, during a dark check with someone else holding the flashlight. Look at what she would reach for. Is there something solid within arm's reach? Is the light on when she gets there, or does she cross the last few feet in the dark? Is there a cord, rug edge, low step, or pet bowl at foot level? Is the floor surface changing under her feet? Change one thing at that stop and test the walk again the next night.
What to bring to the doctor
Tell the physician exactly where the pause happens, not just that she falls at night. Describe whether she stops because of dizziness, unsteadiness, confusion, or because she is unsure of the floor. Ask which changes in the pattern should be reported right away and which can wait for the next scheduled visit. Do not try to name a medical cause yourself. That question belongs to her doctor.
What to write down after each night
Write the time, the stop where she paused, how long she stood there, whether she was dizzy or said the floor looked wrong, whether she went on or turned back, what was within reach, and whether the light was on. Keep these notes in one place, such as the drawer where you keep her appointment papers. Over a week, the pattern will show you which stop to fix first and which information to bring to the next appointment.
If you want a checklist to work from, the reading path at Start here: a reading path lists the other articles in order. If you need someone to call during the night or during the day, Local help after a fall, St. Louis lists where to start.