Dangers in the Hospital for Elderly Patients: What to Watch For

by Jennifer Grey, HousingForSeniors.com Columnist | December 15, 2011 | Comments

Hospital stays can be stressful—for both elderly patients and their families. And while the hospital is supposed to make people well, elderly patients sometimes come out worse off than they went in. Hospitals can be dangerous places for elderly patients—here’s why.

Hospital delirium

Man in Hospital

When a loved one is in the hospital, it's crucial family members stay with them and be an advocate.

This is a mental dysfunction signified by a sudden onslaught of confusion, inattention, and disorientation. It’s one of the more common complications of hospital visits for elderly patients—approximately 20% of all elderly patients, 50% of those in surgery post-op, and a whopping 60% to 85% of patients on ventilation exhibit the signs. But doctors don’t often talk about it—and are only just beginning to learn how to treat it.

Hospital delirium can occur in patients with no prior symptoms of dementia, and it’s often caused by common medications and the actions of health care workers. Medications such as sleeping pills, sedatives, and narcotic painkillers commonly prescribed in hospital settings can trigger delirium—and immobilizing the patient makes it worse.

Doctors in medical school were taught for decades that delirium passes quickly—but recent studies show it has rather alarming long-term effects. It’s been linked to long-term memory loss, mental impairment, and reduced brain size. Today, medical schools are only just beginning to teach that delirium is more dangerous for elderly patients than previously believed.

Lack of attention

Elderly patients are more fragile than younger patients. Even if an elderly person has had few health complications and no symptoms of dementia before the hospital stay, he or she is much more vulnerable in the hospital than a younger person with a similar illness or injury. Even a level of care that’s slightly less than perfect could derail an elderly patient’s recovery. The problem is that many hospitals are not set up to provide the exceptional level of care that elderly patients need.

Budget cuts at many good hospitals have reduced the number of nurses per ward, forcing nurses to spend more time on administrative tasks and less time taking care of patients. Sometimes, elderly patients are seen by several physicians rather than one—and physicians may or may not know the patient’s prior history. A disoriented elderly person may not be able to communicate effectively with doctors and nurses—which can be a problem if no family member is there to advocate.

When choosing a hospital, look for one with an Advanced Care for the Elderly (ACE) unit dedicated to providing exceptional care for the elderly.

Bed rails

Many hospital beds come equipped with side rails meant to prevent patients from falling out of bed. But those bed rails come with dangers of their own. Since 1985, approximately 480 people have died after becoming entangled in the bedrails—or trapped between the rail and the mattress. Almost all of these people were elderly and frail. And while 480 may seem like a small number compared with the approximately 11 million elderly patients in hospitals each year, it’s likely many instances of this go unreported.

When a confused or disoriented patient tries to climb over the bedrail, he often falls farther than if he had simply gotten out of bed. Rails make it more likely for people to fall in a way that injures their heads. It’s also possible for a patient to roll against the rail in a way that pushes the mattress toward the opposite side of the bed, creating a gap between rail and mattress. And a very frail or weak individual can get caught in this gap, sometimes suffocating.

Pressure sores

Elderly patients have more fragile and less resilient skin than younger patients—and are at particular risk of developing pressure sores. These form in areas where bones are closest to skin—along the back, heels, hips, ankles, and elbows. Pressure sores happen when a person is not able to change position in bed, as we naturally do when sleeping.

An elderly patient should not spend too long in one position in bed. Make sure an elderly patient is moved every two hours or so. Otherwise, the person could develop pressure sores that can cause life-threatening infections.

When your elderly loved one goes to the hospital, it’s crucial for you or another family member to stay with this person and be their advocate. Doctors and nurses may be too busy to pay attention to signs of delirium, move your loved one as often as needed, or take the time to provide the best level of care. In addition—especially if your loved one already has symptoms of dementia, but even if this is not the case—your loved one may be too disoriented to communicate effectively with hospital staff, and will need someone to advocate for them. If you do, your loved one is much more likely to get out of the hospital without preventable complications.

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