Protecting Hospice Patients: A New Look at Falls Prevention

Abstract

Falls prevention is a critical priority in hospice and palliative care settings. To keep patients safe and comply with national standards, hospice professionals must have available appropriate assessment, prevention, and intervention tools. Existing procedures engaging patients in strengthening exercises and reducing or eliminating medications that cause dizziness, imbalance and confusion are fitting and useful in environments where first-line fall reduction efforts are possible. These current tools are based on research in facilities for nonhospice patients and run counter to the goals of palliative care. By definition, hospice patients have a terminal illness and are, or will become, too weak to manage strengthening exercises. Without their medications, many would experience intolerable pain and unmanageable anxiety and depression. This article proposes assessment guidelines and pragmatic interventions to reduce the risk of falling that are consistent with the hospice philosophy of comfort.