Fall Risk and Mobility at Home in St. Louis

How mobility, falls and wounds are linked

Fall risk and mobility at home are primary care concerns, and they are wound concerns too. A fall can cause a skin tear, a deep bruise or a fracture that leads to weeks in bed. A wound can cause a fall, because pain, a bulky dressing, a protective boot or a swollen leg changes the way you walk.

The opposite problem matters just as much. When moving feels risky, people sit or lie in one position for long stretches. Steady pressure over the tailbone, hips and heels cuts down blood flow to the skin and can lead to a pressure injury.

So the goal is not only fewer falls. It is safe movement, as much of it as the person can manage.

Why falls happen more often during illness and recovery

Falls usually have more than one cause. Common ones include:

Weakness after a hospital stay or a long spell in bed
Dizziness or lightheadedness when standing up
Medications that cause drowsiness or lower blood pressure
Numb feet from nerve damage, which dulls the sense of where the floor is
An offloading boot or surgical shoe that leaves one leg higher than the other
Poor vision, dim lighting, loose rugs and clutter
Hurrying to the bathroom, especially at night

Most of these can be looked into, which is the reason to raise falls with a clinician instead of accepting them.

What a primary care clinician can review

At a home visit, the treating clinician sees how you really move: getting up from your own chair, crossing your own hallway, using the walker on your own floors.

The clinician may check blood pressure sitting and standing, look at your feet and footwear, ask about vision and bladder habits, and test strength and balance. A medication review can identify drugs linked to dizziness or drowsiness. Do not stop or skip a medication on your own.

The clinician may then order physical or occupational therapy, a home health evaluation, a walker or other equipment, a vision check or lab work.

Protecting skin when movement is limited

If someone spends most of the day in a bed or chair, the skin needs its own plan. The treating clinician or wound care team may recommend a repositioning routine, a pressure-relieving cushion or mattress, and regular skin checks over bony areas. Heels are easy to miss.

Helping someone move carries risk for both people. Dragging a person across the sheets can damage fragile skin, and caregivers often hurt their own backs. Our guide to lifting and turning safely explains what training to ask for.

If you have a foot wound and were told to keep weight off it, ask exactly how you are meant to get around the house. The guide on moving safely with a foot wound lists questions to bring.

What Gateway arranges

Gateway coordinates in-home primary care follow-up with Gateway clinicians in Greater St. Louis and the Metro East. If you already have a physician, that office stays involved. If not, we help connect you with a practice.

For mobility and fall concerns, that can include:

Scheduling the visit where the person lives, so the clinician sees the real setting
Sending therapy, home health or equipment orders to the right agency or supplier, and checking that they arrived
Telling the wound care team about a fall or a change in mobility
Telling the primary care clinician about wound-related limits, such as an offloading boot

The treating clinician decides what is needed. Gateway arranges the steps around those decisions.

What to report, and when a fall is an emergency

Tell the clinician’s office about:

Any fall, even one without an injury
Near falls, or grabbing furniture to stay upright
New dizziness, weakness or unsteadiness
More hours spent in a bed or chair
New redness or soreness over the tailbone, hips or heels

Call 911 after a fall if the person hit their head and is confused or drowsy, passed out, has severe pain, has a limb that looks out of shape, is bleeding heavily, or cannot get up safely. Anyone who takes a blood thinner should get medical advice right away after a blow to the head, even when they feel fine.

How to start

Call 314-325-0126, or ask for a callback with a name and phone number only. Family members can call for a relative, with or without a referral. To read more first, see our guide to fall prevention during wound recovery.

Common questions

Should I stay in bed so I do not fall while my wound heals?

Usually not, unless a clinician has told you to rest. Long stretches in bed weaken muscles, raise the risk of pressure injuries and can make balance worse. Ask the clinician how much activity is safe, what limits apply to your wound, and what help or equipment to use when you move.

Who decides whether I need physical therapy or a walker?

The treating clinician does. After looking at your strength, balance and home, the clinician can order therapy or equipment, and a therapist often fits the device and teaches you to use it. A borrowed walker or cane may be the wrong height, so mention any equipment you already use.

I fell but was not hurt. Do I really need to tell anyone?

Yes. A fall without injury is still a sign that something has changed, such as strength, blood pressure, a medication effect or vision. Tell the clinician when and where it happened, what you were doing and how you felt just before. Those details point toward the cause.

Will someone check my home for fall hazards?

The clinician may point out hazards during a home visit. A full home safety evaluation is usually done by an occupational or physical therapist when the clinician orders one. The therapist looks at stairs, bathrooms, lighting and furniture and suggests practical changes. Gateway can help send that order and follow up on scheduling.

General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.

Fall risk and mobility at home during recovery.