After discharge from acute care, older patients are at high risk of falling and injury. A study explored whether advising these patients about tripping hazards at home could help prevent this.
Among older adults, falls are typical and present a challenge to their healthy life expectancy and quality of life. Especially patients discharged from acute care are at risk: Among those transitioning to home-based care after a hospital stay the incidence of falling again is much higher than among their community dwelling peers. For the most part these falls occur indoors in frequently used spaces of the patients’ home – living rooms, bedrooms and bathrooms.
Edges, stairs and carpets – potential tripping hazards mapped out. Credit: Osaka Metropolitan University.
So, what to do when you don’t want your freshly discharged patient right back at your doorstep merely one month after treatment? Fall prevention is key and it can be achieved by appropriate physiotherapy, of course. But additional fall prevention guidance tailored to the patients’ home might be of use as well. A research group at the Osaka Metropolitan University, Japan, set out to examine just that.
The team led by Assistant Professor Tetsuya Ueda conducted a preliminary study among 60 orthopedic patients with a fall history, all aged 65 years or older who were treated at a single acute care hospital. The participants were randomized to either a control (n = 30) or an intervention group (n = 30). Both groups were treated with general physiotherapy for their disease characteristics before their discharge. The intervention group however received additional guidance on how to navigate potential hazards, based specifically on floor plans of each patient’s home. Over the next 6 months, a follow up-survey was conducted to track patients’ falls and also incidents such as stumbling or slipping (near-falls). The survey was completed by 51 of the 60 subjects (85 %).
In the early post-discharge period, the additional effort seemed to pay off: While 7.7 % of the control group experienced a fall within two months after discharge, no falls occurred in the intervention group. The latter also showed significantly fewer near-falls within the first three months. However, the effect dissipated further down the road – after 6 months no difference could be observed between the two groups.
A few limitations should be considered, mainly that it’s a single-center study with only few subjects. The researchers also point out that they weren’t able to clarify whether the falls in the study were caused by environmental factors alone, or if internal factors like insufficiently recovered physical functions were at play. The group plans to advance the intervention to larger studies to these limitations.
Still the results of the study suggest that preventive intervention might be useful in the early post-discharge period, as Ueda points out. “In preparation for a rapidly aging society, fall prevention measures, that can be widely adopted, need to be established in busy acute care hospitals with a high patient turnover.”
Image source: Tiago Muraro, unsplash
