Falls in Elderly Patients in Hospital Settings

Falls in the elderly are common and pose a severe threat to their health. Older people who suffer from cognitive, sensory, and gait impairments are usually susceptible to falls. Thus, such a problem is common among those older people under the responsibility of health care institutions, such as nursing homes, rehabilitation centers, and hospitals. Falls in a hospital environment can lead to an increase in the length of the patient’s stay and an increase in the institution’s responsibility for the elderly.

Injuries sustained by patients due to falling is preventable but can lead to functional disability and death. Approximately 1 in 3 elderly patients falls annually in a hospital setting (Ehn et al., 2018). At the same time, falls are the number 1 cause of death from comorbid injuries among the elderly population aged 65 (Ehn et al., 2018). Approximately 27,000 deaths and about 2.5 million fall injuries occur each year in the study population (Ehn et al., 2018). Therefore, the problem of falling among the elderly population is severe and needs to be addressed.

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Thus, semi-structured open interviews with older people were conducted to collect statistics. The data was collected among patients who had recently fallen and were taken to the emergency room. The study excluded patients with dementia and those older adults whom doctors considered too ill. During the investigation, it was found that older patients are not sufficiently aware and understand the consequences and risks of falling (Shankar et al., 2017). More senior people cite factors such as the environment and medical conditions as causes of falls. Many patients blamed themselves, but none realized the multifactorial causes of falls.

Moreover, it was found that there was a different level of anxiety and emotional reaction among patients who had recently fallen. Thus, older people who have experienced a fall suffer from more anxiety. This is an important distinction, as the effectiveness of some fall interventions may depend on the patient’s level of stress (Shankar et al., 2017). The degree of fear is one of the critical factors in increasing self-awareness, due to which patients can visit the emergency room to raise awareness.

Additionally, the survey took into account the degree of fall prevention intervention. Thus, most participants of the study reacted positively to the idea of such an intervention. However, this population group viewed the intervention as potentially condescending advice and anxiety in society. Patients in the study were directed to accept advice and consultations. Therefore, the emergency department can be a safe place to improve the population’s health.

Falls that do not result in injury can also be a severe hazard to an older person. Thus, according to a report by the Office of the Inspector General, about 10% of people who experienced adverse events in the hospital were the victims of falls (King et al., 2018). More than a third of falls in healthcare facilities result in patient injury. However, falls without injury can seriously affect patients’ mental health, leading to increased levels of anxiety.

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In addition, interviews with nurses have shown that the primary goal of the health care facility is to minimize the incidence of falls in the elderly. However, healthcare workers note the pressure on nurses to reduce patient falls (King et al., 2018). Thus, patient care was changing, which could lead to a limitation of the mobility of an elderly patient. However, nurses working inwards with a low fall rate did not experience this pressure. Thus, the rate of falling patients and statistics on this issue also depends on nurses’ care of the elderly.

To improve the problem, it is necessary to take several measures to prevent falls. First of all, the participation of frontline staff plays an essential role in the care of elderly patients. Multidisciplinary education of health workers and subsequent training can reduce the risk of falling older people in the hospital. Since approximately 70% of bed-days are in patients over 65 years of age, physicians of all levels and specialties are needed to prevent events leading to falling injuries (Jonasson, et al., 2018).

Physicians need to consider and manage medications at the clinical interface, as psychotropic drugs can cause falls. Moreover, in a hospital, nurses must consider minimal interventions such as visual assessment of the patient’s condition and quick interviews. In addition, physicians can improve fall problems by thoroughly investigating with the patient the cause of the problem that caused the severe injury. This approach promotes patient safety and helps prevent a similar situation in the future.

References

Ehn, M., Eriksson, L. C., Åkerberg, N., & Johansson, A. C. (2018). Activity monitors as support for older persons’ physical activity in daily life: qualitative study of the users’ experiences. JMIR mHealth and uHealth, 6(2), 18-35.

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Jonasson, S. B., Nilsson, M. H., Lexell, J., & Carlsson, G. (2018). Experiences of fear of falling in persons with Parkinson’s disease–a qualitative study. BMC Geriatrics, 18(1), 1-10.

King, B., Pecanac, K., Krupp, A., Liebzeit, D., & Mahoney, J. (2018). Impact of fall prevention on nurses and care of fall risk patients. The Gerontologist, 58(2), 331-340.

Shankar, K. N., Taylor, D., Rizzo, C. T. & Lui, S. W. (2017). Exploring older adult ED fall patients’ understanding of their fall: A qualitative study. PMC Labs, 8(4), 231-237.

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