In the past, the hospitalized elderly had more to worry about than simply getting healthy; they also had to worry about how to avoid falling while in the hospital. Until recently, hospitals focused on drugs and restraints when it came to fall prevention. Medication was often given with the intent to decrease agitation, restlessness, and the risk for falls, but that same medication actually increased falls by altering judgment, balance, and gait. Likewise, physical restraints such as side rails on hospital beds have been shown to cause or worsen agitation, combativeness, and confusion, leading to more falls.
Recently, hospitals have shifted their fall prevention focus and incorporated the following strategies into patient care: integrate physical and occupational therapy and nursing into fall assessments, enlist the pharmacy to label medications associated with increased risk of falls, question family members about patients’ typical daily routines, and increase hourly rounds to address patients’ personal needs.
Elderly patients can also play a role in increasing their own safety. They can discuss their risk for falls with their doctor to devise a fall prevention plan such as asking for help when getting out of bed, walking, or toileting, avoiding sudden movements, wearing properly fitting shoes, checking for clear paths when walking, utilizing the call button on hospital beds, and using assistive devices such as canes and walkers.
Together hospitals and elderly patients can reduce the risk of falls and make hospitals safer for the elderly so they can focus on what is most important, getting healthy.
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