We all know that falls are the leading cause of injury for seniors.  So, protecting seniors from falling while in the hospital makes sense.  However, hospitals have gone to such an extreme that they now are causing more harm than good in their efforts to prevent senior patients from falling. 

As with most things in the American medical system, the motivation here is more money than love.

1.       Medicare Penalties.  In an effort to stop senior falls in hospitals, the Medicare system started levying financial penalties against hospitals when senior patients fall.  As a result, the hospitals go to extreme lengths to stop falls.  They literally force seniors, even those capable of walking, to stay in bed while in the hospital.  As a result, the patient’s condition actually deteriorates and they frequently leave the hospital more disabled than when they were admitted.

2.       Lack of Staffing.  Helping seniors safely take a walk often requires the help of a staff member.  Unfortunately, most hospitals are deeply understaffed and just don’t have the personnel to deal with what they see as “non-essential” patient needs.

3.       Liability.  And, of course, hospitals are afraid they will be sued if a patient takes a fall. 

More harm than good

But instead of safeguarding patients, this overzealous policy results in more harm than good.  said Kenneth Covinsky, a geriatrician and researcher at the University of California at San Francisco found that “Older patients face staggering rates of disability after hospitalizations”. In fact, according to his research, one-third of patients 70 and older leave the hospital more disabled than when they arrived. 

Because many seniors are already so weak, just a few days of enforced bed rest results in a significant decline in muscle strength.  This often requires them to go through weeks of physical therapy to recover from their hospitalization. 

It doesn’t take much

Patients don’t have to do much walking to gain a substantial benefit.  Recent research showed that taking just 275 steps a day results in a significant drop in readmission.  That’s just walking down the all and aback.

A change in attitude

Programs, like Hospital Elder Life Programs (HELP), have been started to encourage seniors walking in hospitals.  But, the biggest challenge is changing the mindset of doctors, nurses, and administrators.  They tend to see a patient walking as “a patient at risk of falling”.  It will take a system-level effort to reframe that to “a patient getting stronger”.

This is a link to the full article from the Washington Post.