If You Fall at Home Alone and Can't Get Up

When you live on your own, the frightening part of a fall is often not the fall -- it is the time on the floor before anyone knows. Here is what the evidence says, and how to shorten that wait.

Download Free Learn More

In a study of adults in their 90s, 80% could not get up unaided after a fall and 30% were on the floor for an hour or more (Fleming & Brayne, BMJ 2008); of older people who had such a 'long lie', about half died within six months (Wild et al., BMJ 1981) -- the delay, not the fall, drives the worst outcomes.

The Challenge

You fall, you are not seriously hurt, but you cannot get back up -- and no one is home to help

Hours can pass before anyone realises something is wrong, and a long time on the floor is dangerous in itself

A phone or a call alarm across the room is useless if you cannot reach it

How I'm Alive Helps

Check-first phone fall detection notices the fall and asks if you are okay -- if you cannot respond, it alerts your contacts for you

Your trusted contacts are notified with your location, so help is directed to you instead of waiting for a scheduled call

A daily check-in adds a second net: if you go quiet, your people are alerted even when no fall is detected

The real danger is the 'long lie'

A "long lie" is the clinical term for being unable to get up for 60 minutes or more after a fall. It is common, and it is dangerous. In a prospective study of people over 90, 80% were unable to get up without help after at least one fall, and 30% ended up on the floor for an hour or longer (Fleming & Brayne, BMJ 2008). The same research found that a long time on the floor was strongly associated with serious injury, hospital admission, and moves into long-term care -- and, critically, that 82% of falls happened when the person was alone and call alarms were mostly not used. The longer-term stakes are stark. In an older primary study, about half of the people who experienced a long lie died within six months of the fall, and roughly a quarter of all fallers died within a year -- five times the rate of matched people who had not fallen (Wild et al., BMJ 1981). Researchers are clear that much of this harm comes from the consequences of lying on the floor rather than the fall's injuries alone. Why is time on the floor so harmful? A long lie can lead to dehydration, pressure injuries, muscle breakdown that can damage the kidneys (rhabdomyolysis and acute kidney injury), hypothermia if the floor is cold, and chest infections such as pneumonia (long-lie clinical literature). None of these come from the fall itself -- they come from the wait. That reframes what fall safety is really about for someone who lives alone. The goal is not only to prevent falls; it is to make sure that when a fall does happen, you are found fast.

How check-first fall detection shortens the wait

Phone-based fall detection is designed to collapse exactly that discovery gap. When your phone senses a hard fall, I'm Alive checks on you first: a full-screen "Are you okay?" appears with a countdown. If you can, you tap "I'm OK" and nothing happens. If you cannot -- because you are hurt, cannot reach the screen, or have gone quiet -- the countdown runs out and your trusted contacts are alerted with your location. You do not have to crawl to a phone or press a button you cannot reach; the check-first alert does the reaching for you. Because it runs on your phone, keep your phone on or near you -- a pocket, a lanyard, or the counter beside you. A phone in another room cannot sense a fall, which is the honest limit of any phone-based system. Pair it with a daily check-in. Fall detection catches the sudden hard fall in seconds. A daily check-in catches the slower emergencies -- a fall you survived but cannot call about, or a sudden illness -- by expecting a simple tap each day and alerting your contacts if it does not come. Together they cover both the fast and the slow ways things go wrong when you live alone. Fall detection is coming to the I'm Alive app in our next update (v2.3.0), included from the Protect Me plan. It checks on you first and alerts your contacts -- it never calls 911 and it is best-effort, not a medical device.

If it happens to you: staying safe on the floor

If you fall and cannot get up, a few general steps can help while you wait for help. (These are general first-aid principles, not medical advice -- if you are seriously hurt, call for emergency help.) Stay calm and check yourself over before moving. Look for pain, bleeding, or a limb that will not move properly. If moving causes sharp pain, stay still and call for help. Try to reach warmth and a phone. A long time on a cold floor risks hypothermia, so if you can, pull a blanket, coat, or towel over yourself and get to something you can rest your head on. Keeping your phone on you means you may already have it within reach. If you can get up safely, do it slowly. Roll onto your side, then onto your hands and knees, crawl to a stable chair or sofa, place your hands on the seat, bring one foot forward, and push up to sit. Rest before standing fully. Tell someone what happened. Even a fall you recover from is worth reporting to a family member or doctor, because it can be a sign of a treatable problem and because the next fall might be worse. This is exactly the moment a check-first alert helps: if you could not get up, your contacts would already be on their way. For a full step-by-step, see our guide on what to do after a fall when you live alone.

Sources

- Fleming J & Brayne C, "Inability to get up after falling, subsequent time on floor, and summoning help..." BMJ 2008;337:a2227: https://pubmed.ncbi.nlm.nih.gov/19015185/ - Wild D, Nayak USL, Isaacs B, "How dangerous are falls in old people at home?" BMJ 1981;282:266-268: https://pubmed.ncbi.nlm.nih.gov/6779979/ - Long-lie clinical definition and complications (Physiopedia): https://www.physio-pedia.com/Long_Lie I'm Alive is a best-effort personal-safety app, not a medical device, and does not call 911.

Take the Fall Risk Assessment Get Free Emergency Contact Card

Get safety tips delivered to your inbox

Frequently Asked Questions

What happens if you fall and can't get up when you live alone?

The main risk is the time on the floor before anyone knows -- a 'long lie'. In a study of adults over 90, 80% could not get up unaided and 30% were on the floor for an hour or more (Fleming & Brayne, BMJ 2008). Getting help fast is what matters most, which is why check-first fall detection and a daily check-in are useful when you live alone.

How long can you survive on the floor after a fall?

It varies widely, but the longer the lie, the greater the danger from dehydration, pressure injuries, muscle breakdown, and hypothermia. About half of older people who had a long lie of over an hour died within six months of the fall (Wild et al., BMJ 1981). The priority is to shorten the time until someone reaches you.

What is a long lie after a fall?

A long lie is being unable to get up for 60 minutes or more after a fall. It is strongly linked with serious injury, hospital admission, and worse long-term outcomes -- much of the harm comes from time on the floor rather than the fall's injuries.

How do you get help if you fall alone with no one home?

Keep your phone on or near you so you can call or so fall detection can sense a fall. Check-first phone fall detection (coming to I'm Alive in v2.3.0, included from Protect Me) alerts your trusted contacts with your location if you do not respond, so help is directed to you without needing to reach a button.