Hospital Hazards That Can Harm Older People
Hospital stays can be risky, especially for older people. For example, many seniors who could walk on their own and care for themselves before entering the hospital lose these abilities during their stay. They may also develop delirium (sudden, intense confusion). As part of the Choosing Wisely series, the American Academy of Nursing has partnered with Consumer Reports to identify four over-used hospital practices. These practices are usually unnecessary, and they may harm you. Question these hospital practices. If you notice doctors or nurses using any of these practices, ask why. Explain your concerns to the nurse. Nurses can often stop these practices.
The problem: Usually, older people spend most of their time in bed during a hospital stay. This is because we used to think that bed rest helped the body recover. But research now shows that walking helps older patients recover faster. They get out of the hospital sooner, and they can walk farther when they get home. Bed rest can be harmful: When you’re not active, your leg muscles get weaker. You’re also more likely to become dehydrated. This can make you dizzy and lead to falls. These are serious issues because older people already have problems with dizziness and balance.
Some older patients grow so weak that they:
• Need help dressing and bathing.
• Need to go to a nursing home before they go home.
The problem: Restraints keep patients from moving freely or getting out of a bed or a chair. They might include wrist or ankle ties, waist belts, hand mitts, or bed rails. Nurses may use them to help protect older patients who may harm themselves or disrupt their treatment. But restraints can be harmful, too. While restrained, patients may struggle and injure themselves. They can suffer serious falls and broken bones. In some cases, these injuries can be fatal. Restraints can also increase emotional stress. If a patient is confused or agitated, ask the doctor or nurse to look for possible causes. Often, these symptoms are caused by an infection, dehydration, or side effects from medicines. These tips can help reduce the patient’s confusion and distress. They can reduce the need for restraints.
•Tell the nurse how the patient usually shows discomfort, hunger, or the need to use the toilet.
•Also tell the nurse what makes the patient calm or brings enjoyment.
•Arrange for someone the patient knows well to stay overnight for the first few days in the hospital. This may help the patient feel safe.
•Bring a few familiar objects from home, such as family photos.
•Also bring the patient’s eyeglasses, hearing aid, and dentures.
•Ask that IV lines, catheters, monitors, or other devices be removed from the patient’s body as early as possible.
Patients may need restraints if they are likely to harm themselves. The hospital should use the restraint that allows for the most movement and remove it as soon as possible.