Comparison between elderly inpatient fallers with and without dementia

Abstract

INTRODUCTIONThis study aimed to examine the various factors associated with inpatient falls among patients with and without dementia in a hospital setting. METHODSThis was a retrospective one-year study using data collected from Singapore General Hospital's electronic reporting system for inpatient falls. RESUlTSIn the study period, 298 patients aged ≥ 65 years fell during their hospital stay. The majority of the patients (n = 248) did not have dementia. In our study, fallers with dementia were more likely to use ambulatory aids, be visually impaired and have urinary incontinence. More patients with dementia than those without had a history of previous falls, and were placed on fall precaution with restricted freedom of movement, which at times, included restraints. However, the difference between patients who were put on restraints and those who were allowed to move freely was not statistically significant. The majority of falls in both groups occurred at the bedside. We found that fallers without dementia were more likely to fall during the morning shift, whereas fallers with dementia were more likely to fall during the night shift. Fallers with dementia were more likely to be confused at the time of the fall. CONClUSIONIn our study, we found that fallers with dementia were more likely to have visual impairment, have urinary incontinence, use walking aids, and to be confused and physically restrained at the time of the fall. The fallers without dementia in our study may have undiagnosed dementia.

Analysis of the fall‐related risk of pharmacotherapy in Czech hospitals: A case control study

“…Dementia was significantly associated with the risk of falling in our study, a factor that is also discussed in some previous studies . However, in these studies, the authors suggested that the risk of falling is rather related to spatial and memory functions, or considered that the fall cases linked to dementia were more probably associated with visual impairment or urinary incontinence, as well as with the use of walking aids (eg, walking stick).…”

Understanding how to facilitate continence for people with dementia in acute hospital settings: a mixed methods systematic review and thematic synthesis

“…Throughout the literature, nurses consistently report that ‘containment’ through the use of disposable continence pads and catheters as a key strategy for the management of continence for hospitalised older adults [ 25 ]. These approaches have implications for the occurrence of avoidable harm and patient outcomes during an acute admission; incontinence is a common risk factor for falls [ 26 , 27 ], and catheters are associated with high rates of urinary tract infections [ 28 ]. These factors are also associated with a greater financial burden, prolonged hospitalisation, re-admission, and increased mortality [ 29 – 31 ].…”

Differences in the risk of severe falls between patients aged <65 years and patients aged ≥65 years at a psychiatric hospital based on 12‐year incident reports

“…Falls may result in injuries, such as fractures or subdural hematomas, leading to longer hospital stays 1 and higher medical costs 2,3 . Psychiatric patients are at a higher risk of falls owing to psychological disorders, 4 such as depression 5‐7 and cognitive impairment 8‐10 . These patients tend to incur injuries or functional decline 11,12 and worsening mental symptoms 13,14 after falls.…”

“…2,3 Psychiatric patients are at a higher risk of falls owing to psychological disorders, 4 such as depression [5][6][7] and cognitive impairment. [8][9][10] These patients tend to incur injuries or functional decline 11,12 and worsening mental symptoms 13,14 after falls. Psychotropic drugs are known to increase the risk of falls.…”