You hear her moving in the night. By the time you reach the hallway, she is holding the wall or standing still beside the bathroom door.
Start with tonight, not with an explanation.
If she has fallen, stay with her and use the first ten minutes after a fall. If she has not fallen, do not ask her to repeat the walk so you can study it. Help her settle in the safest way already available to you.
Then write down the first place where the walk looked different from her usual walk. That first changed stop gives her physician something specific to examine. It does not tell you the cause.
Check the six stops in order
Use the same six-stop route each time: the bed, the rise to standing, the first steps, the hallway, the bathroom entrance, and the turn to the toilet. This desk uses that fixed route so one vague report does not swallow several separate movements. You can see the full reading approach in Start here.
At the bed, note what happened before her feet touched the floor. Did she sit longer than usual? Did she call for you? Did one foot search for the floor? Write only what you saw or heard.
At the rise, note whether she stood in one movement or stopped partway. Record what her hands held and whether she sat back down. Do not turn this into a strength test.
At the first steps, note which foot moved first and whether the first step went where she appeared to intend. If she stopped, record where both feet were. Do not ask her to demonstrate it again.
In the hallway, mark the exact place where her pace, direction, posture, or hand support changed. Name the object she touched. “Left hand on the wall beside the closet” is more useful than “unsteady in hall.”
At the bathroom entrance, note whether she stopped before the threshold, stepped through without stopping, or changed how she held her support. Leave interpretation for the appointment.
At the toilet turn, note when the turn began, what she reached toward, and whether she completed the turn before starting to sit. If the route back looked different too, record it separately rather than blending both trips together.
Find the first change, not the worst-looking moment
The largest wobble may happen near the toilet. The first change may have happened beside the bed.
Read your six observations from the top. Circle the earliest stop that differed from her ordinary night walk. If nothing before the hallway looked different, write that. If you did not see the first three stops, write “not seen.” Do not fill the gap with a guess.
Use plain comparisons:
“Usually stands once. Tonight sat back down once.”
“Usually walks through the bedroom doorway. Tonight stopped there and held the frame.”
“Usually turns toward the toilet before reaching. Tonight reached first, then turned.”
Avoid words such as “weak,” “confused,” or “dizzy” unless those were her own words. Describe the movement, then put her words in quotation marks without improving them.
Write down what surrounded the change
Under the circled stop, add four short lines.
First, write what she was trying to do.
Second, write what changed.
Third, write what happened immediately afterward.
Fourth, write what help she needed, including the object or person she used.
Also note anything she reported during the trip, such as pain, spinning, faintness, urgency, numbness, or a feeling that a leg would not hold. These are observations to take to her physician, not conclusions for you to settle at home. The desk’s public clinical references are collected on the Sources page.
Include any medication, illness, or sleep change only if you know it occurred. Copy the medication name from the container or medication list. Do not rely on the color or shape of a pill, and do not change a dose on the basis of the walk note. Ask the prescribing clinician what to do.
Take one clean page to the appointment
Put the circled stop at the top of the page. Beneath it, list two or three nights in the same format. Keep separate events separate.
Bring the medication list and the names of any clinicians who already know about the falls. If you have a photo of the route, use it to show location and spacing, not to prove a diagnosis.
Ask the physician these questions in order:
“Does this change need evaluation before her next routine visit?”
“Which part of this description matters most to you?”
“What should I watch for on the next bed-to-toilet trip?”
“What should make us stop the walk and seek immediate help?”
“Should any clinician review her medications, vision, feet, walking support, blood pressure, pain, or bathroom urgency?”
“Who should receive the next note, and how should I send it?”
Write the answers beside the questions. If an instruction is unclear, read it back in your own words before you leave.
For the next night
Keep the page and a working pen where you can reach them without crossing her route. At the next trip, observe only what happens naturally. Start again at the earliest stop you can actually see.
If the first changed stop moves from one night to another, record that too. Do not force the notes into one pattern. Your job is smaller: keep the order straight, separate what you saw from what you assumed, and carry the change to the physician.
If you need help finding the right local doorway after a fall, use Local help after a fall, St. Louis. Keep the six-stop note with you when you call.