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Falls & Blood Thinners: How to Prevent & How to Respond

Falls & Blood Thinners: How to Prevent & How to Respond

With SMH Geriatrics Program Coordinator Tanya Hofmann, MSN and Nursing Quality Specialist Tricia Morgan, BSN

One in every three adults over 65 falls each year. And these falls are the leading cause of serious injury in the elderly, often leading to hospitalization, nursing home admission, and even death.

Falling increases as we get older and is influenced by many things, including health problems such as heart disease, arthritis and muscle weakness, vision and hearing deficits, poor balance, Parkinson’s disease and neuropathy. Even certain medications can affect balance and make someone more prone to a bad fall.

But these falls can be even more dangerous for a person taking blood thinners or anticoagulants. Since these medications affect the body’s normal clotting time, cuts and falls can become much more serious.

Blood Thinners & Anticoagulants

Blood thinners and anticoagulants are common medications used for various conditions, such as to prevent blood clots in those with a history of stroke, atrial fibrillation or heart valve replacement.

There are numerous anticoagulants/blood thinners on the market, with Warfarin, Coumadin, Xarelto, Eliquis, Pradaxa, Heparin, and Lovenox being the most common. Antiplatelet medications also affect the way blood clots, and Brilinta, Plavix and Aspirin are in this category.

If you or someone you know takes these medications, knowing what to do in the event of an unfortunate fall could make all the difference.

What to do in case of a fall

Always take a fall or cut seriously. Even one that appears mild at first could be hiding serious injury. Take the time to take stock of the situation and properly address all possible injuries.

Here are some general guidelines, so you can be sure to respond appropriately.

Note: Make sure to tell all emergency medical personnel that you are on a blood thinner.


“Consider wearing a medical alert bracelet or placing a card in your wallet that will inform emergency personnel of the blood thinner/antiplatelet agent that you take,” says Nursing Quality Specialist Tricia Morgan, BSN. “Just in case you are not able to tell them yourself.”

If you are bleeding, immediately apply direct pressure.

  • If the bleeding is heavy call 911 right away and seek emergency medical assistance.
  • If the bleeding is light and does not stop after 10 minutes of direct pressure, seek medical attention.

If you hit your head or face, contact your health care provider, even if you feel ok.

If you have severe abdominal pain, seek emergency medical attention.

If you have bruising that continues to grow, contact your health care provider.

And if you should experience any of the following after a fall, call 911 immediately and seek emergency medical assistance.

  • If you lose consciousness.
  • If you have any neurological changes, such as headache, dizziness, weakness, confusion, slurred speech, or having trouble getting the right words to come out.
  • If you have trouble with coordination or walking.
  • If you experience nausea and/or vomiting.

But even better than knowing how to react in the event of a fall, is knowing how to prevent one from happening in the first place.

After being discharged from the hospital for a fall-related injury:

  • Schedule an appointment with your healthcare provider to discuss your medications and your fall.
  • Watch for any new symptoms.
  • Contact your healthcare provider if you have repeated or unexplained falls.

Being Proactive & Preventing Falls

It may not be possible to make your home completely “fall-proof,” but there are many ways to stay proactive and help prevent falls from happening in the first place.

This means not only staying on top of the issue with your healthcare provider, but also modifying your living space to minimize the chance of falling.

“It is a good idea to have a ‘falls checkup’ on a regular basis. including a review of your medications and activity level,” says SMH Geriatrics Program Coordinator Tanya Hofmann, MSN. “Talk with your doctor about your concerns and discuss exercise, physical therapy or enrollment in a balance class. You may benefit from strengthening certain muscles or improving your gait.”

From an environmental aspect, common culprits that contribute to falls in the home are throw rugs, poor lighting and steps without rails.

Here are some tips to make your home more fall-friendly:

  • Ensure that any area rugs are taped down to prevent a trip hazard and keep cords away from areas where you walk.
  • Wear good-fitting, rubber-soled footwear to prevent slipping. If you have a cane or walker, use it instead of holding onto furniture.
  • Take your time, and avoid rushing to answer the phone or doorbell. Callers can always leave a message.
  • Make sure that hallways, paths and stairways are well-lit. Use nightlights in bedrooms, halls and bathrooms.
  • When going up or down steps use handrails. Consider adding them to both sides of steps/stairs, both inside and outside your home.
  • Add grab bars near the toilet and bathtub/shower and use non-slip decals or rubber mats inside the tub or shower.
  • If you are having trouble getting in or out of the tub or on/off the toilet, ask your provider to help you get a shower chair/bench or raised toilet seat.

More Resources

For more tips on staying active and preventing falls with SMH Injury Prevention Coordinator Susan Williams, click here.

Or check out the National Council on Aging website for access to information and resources all around the nation.