For nurses and other staff who care for older adults (especially those with cognitive impairment) in acute care settings, the prospect of having a patient fall is SCARY! But keeping a patient in bed and discouraging ambulation (for example, by encouraging use of a bedpan or bedside commode instead of helping a patient walk to the bathroom), results in them becoming weaker and increases their risk of falling once they return home. Instead, work with your team to keep your patients moving and as strong as possible so they have better chance of resuming their normal activities safely after discharge.
In addition, for patients with dementia who may want to get up on their own, keeping them in bed may lead them to become frustrated and agitated, and result in challenging behaviors. Try the strategies below…
Tricks of the trade:
- Review with staff why people with cognitive decline (who may not be able to communicate their needs verbally) want to get up and walk on their own. Are they bored? Do they hurt from sitting for a long period of time? Do they need to use the bathroom? Do they forget they need help to walk?
- A supervised 5-minute walk could be enough to satisfy their need to move for a while, and may help decrease negative behaviors later on due to boredom or discomfort.
- Instead of saying, “Sit down, you might fall!”, try to get in the habit of saying something like, “I see you want to walk. Please wait and someone will help you very soon.” Then take the individual for a short walk down the hall, to the nurses station or a window to look outside. Spending those 5 to 10 minutes walking can up end up saving lots of time in the long run. Have staff take turns doing supervised walks.
- Perform “sit to stand” exercises using the handrails in the patient’s room or hallway. These help keep leg muscles strong and use up excess energy too.
- Spread the love and encourage physical function…..ask the patient, “Could you stand up and give me a hug?” –The reward back is a big hug from you!
Have a Happy Halloween!