Comparison between elderly inpatient fallers with and without dementia

Lim SC, Mamun K, Lim KH
Correspondence: Dr Lim Si Ching, si_ching_lim@cgh.com.sg

ABSTRACT
INTRODUCTION This study aimed to examine the various factors associated with inpatient falls among patients with and without dementia in a hospital setting.
METHODS This was a retrospective one-year study using data collected from Singapore General Hospital’s electronic reporting system for inpatient falls. 
RESULTS In 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.
CONCLUSION In 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.

Keywords: delirium, dementia, inpatient falls, restraint use, urinary incontinence
Singapore Med J 2014; 55(2): 67-71; http://dx.doi.org/10.11622/smedj.2014017

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