Continence, hydration, low blood pressure and dizziness

Some falls happen because a person feels they cannot wait. Continence urgency, rising quickly, low fluid intake, dehydration, dizziness and low blood pressure on standing are common triggers in adult social care.

NICE recommends considering diet, fluid intake and weight loss, urinary continence, and cardiovascular examination including lying and standing blood pressure in a falls assessment. NHS Inform also identifies postural hypotension, dizziness and dehydration as factors that increase risk.

What frontline staff should watch for

• Urgency and rushing: when someone tries to reach the toilet without waiting for help.
• Repeated night-time getting up: especially if the route, lighting or call bell setup is inadequate.
• Poor fluid intake: dry mouth, reduced drinking, hot weather, illness or long periods without support to drink.
• Dizziness or feeling faint: on standing from bed or chair, after bathing, or after long periods sitting or lying down.
• Found on the floor without a clear explanation: escalate rather than make assumptions.
• New weakness after illness: the person may need more time, closer supervision or a revised plan before transfers or toilet trips.

Manager focus: night-time patterns

When someone rushes, feels faint or is drinking poorly, falls prevention starts with noticing the pattern and not dismissing it.