“Hospitals have become so overzealous in fall prevention that they are producing an ‘Epidemic of Immobility'” — The Washington Post
In an article by Melissa Baily in today’s Health and Science Section of the Washington Post and produced by Kaiser Health News (not affiliated with Kaiser Permanente), the writer describes how people like you and me, who may have been admitted to a hospital as a result of a fall, may have their condition complicated as a result of both current law and the hospital’s internal “Cover Your A__” policy.
This article is SCARY and should serve as a warning as to what can happen when hospitalized after a fall. It seems that many hospitals, in their attempt to avoid financial penalties, are restraining patients who should be up and moving around, from doing just that. They are not allowed by hospital edict, to leave their beds. The article reports that some patients leave the hospital with major muscle deterioration that could have been prevented and could result in future problems.
According to the article, there are a number of reasons. Financial penalties to hospitals began in 2008 and were increased by Congrress under the Affordable Care Act. The Centers for Medicare and Medicaid Services (CMS) reduced payments to hospitals with the highest rates of falls and other “hospital related injuries”. Thus hospitals kept patients in bed and even have “movement alarms” for those patients who try to move.
In addition, because of pressures from hospital managements, nurses are reluctant to help patients get up and move for fear of repercussions if the patient falls while there. Understaffing of nurses aggravates the problem.
The article cites research by a U of California (San Francisco) geriatrician and researcher who found that “one-third of patients 70 and older leave the hospital more disabled than when they arrived.” The article was unclear about whether this referred to all patients, or just those patients who were admitted as a result of a fall.
The article says that there are efforts to change this. Private initiatives are spreading the message of this problem across the country. Nurses are being encouraged to get patients out of bed and moving. Other initiatives are in play but the article made no mention of any potential changes in the law that penalizes hospitals financially for patients who fall while under hospital care.
So what’s the takeaway here? DON’T FALL! At least don’t fall in a way that requires a visit to the hospital.
How do you prevent a fall? The best way is to have strong legs, a strong core and good balance. Will that prevent you from falling? No, but it will help. Most falls are accidents. They result from slipping or tripping. I have strong legs, a strong core, and decent balance. Yet, I fell on my hip last winter— after dark on ice I didn’t see. I had a bad bruise and hurt for a week, but I didn’t need to go to the hospital.
Winter is approaching. Slipping on ice is one of the main reasons seniors make trips to Emergency Rooms in the Winter. Much more so than a heart attack or a stroke.
So stay strong and pay attention to your surroundings. Be bold but be careful.
Thank you for reading.