This research examined factors influencing older women’s post-fall decision making. We surveyed 130 independent older women from continuing care retirement communities and non-institutional homes. We categorized women’s post-fall decisions as medical, corrective, and social decisions, and examined the associations between post-fall decision categories, decisional conflict, number of post-fall changes, self-rated health, frequency of falls, severity of falls, health literacy, awareness and openness to long-term care institutional options, and demographics. Older women experienced greater decisional conflict when making medical decisions versus social (p = .012) and corrective (p = .047) decisions. Significant predictors of post-fall decisional conflict were awareness of institutional care options (p = .001) and health literacy (p = .001). Future educational interventions should address knowledge deficits and provide resources to enhance collaborative efforts to lower women’s post-fall decisional conflict and increase satisfaction in the decisions they make after a fall.