Merck Manual

Please confirm that you are not located inside the Russian Federation

honeypot link

Falls Due to Hospitalization


Michael Joseph Pistoria

, MEng, DO, Lehigh Valley Hospital - Coordinated Health

Reviewed/Revised Oct 2023

Conditions in a hospital can increase the risk of falling Falls in Older Adults A fall is defined as unintentionally or accidentally dropping down to the ground or another lower level. Most falls occur when older adults with one or more physical conditions that impair mobility... read more , particularly for older adults. After being in bed a long time (bed rest), leg muscles can become weak and less able to squeeze the leg veins and thus force blood toward the heart. Thus, blood pools in the legs when people stand up, causing blood pressure to drop and making people feel dizzy or light-headed (a disorder called orthostatic hypotension Dizziness or Light-Headedness When Standing Up In some people, particularly older people, blood pressure drops excessively when they sit or stand up (a condition called orthostatic or postural hypotension). Symptoms of faintness, light-headedness... read more ).

Also, people may be given medications that make them feel dizzy, drowsy, or confused. A bed may be too high or have rails, making getting out of bed more difficult. Lighting may be dim, so people may not see obstacles. People who are confused or disoriented are more likely to fall.

Because being in the hospital disrupts usual routines, parents who are staying in the hospital to care for a sick infant or small child may forget their usual precautions, such as keeping the crib rails up when the infant is in bed.

Prevention of Falls in the Hospital

If people who are hospitalized or their family members realize what can cause falls in a hospital, they can take steps to prevent them. For example, to counter weak muscles, people can get out of bed as soon as possible and exercise. Family or staff members can accompany people while they walk down hospital corridors until muscle strength is regained.

Most falls occur when people get out of bed. So family or staff members can help by doing the following:

  • If a bed is too high, asking whether the bed can be lowered

  • Making sure people know how high the hospital bed is

  • Encouraging people to be careful and move slowly when getting out of bed

  • Making sure people are wearing slippers or shoes with nonskid soles

  • Showing people where the toilet is and how to get there (to prevent missteps and bumping into furniture)

  • Showing people how to call for help

  • For infants and small children, making sure the crib rails are raised

Often, staff members try to identify and provide extra help to people who are likely to fall. Staff members may check on them at regular intervals or put them in rooms near the nursing station.

If people seem unable to get out of bed safely without help, staff members ask them to use the call bell to get help. If people do not realize or accept that they cannot get out of bed safely by themselves, a bed alarm may be used. It makes a loud beeping noise to summon help if people try to get out of bed by themselves.

Family members can ask a doctor to check the medications being taken and identify any that can increase the risk of falling. If such a medication is being used, family members can ask the doctor about possibly changing the medication or reducing the dose.

quiz link

Test your knowledge

Take a Quiz!