Emergency department staff should observe senior mobility prior to discharge

Older adults who are treated in hospital emergency departments may not accurately report limitations on their physical mobility and should be observed by staff to ensure that they can be safely discharged, according to the results of a study that was reported in the Annals of Emergency Medicine. The study noted that such observations could prevent falls and costly hospital readmissions for older adults.

Study

The study set out to determine whether older emergency department patients accurately reported their ability to complete a simple mobility test. According to the study, there is currently no widely accepted method of assessing mobility for elderly patients who are discharged from emergency departments.

As part of the study, 272 patients aged 65 years and older who lived independently were asked whether they could get out of bed, walk 10 feet, turn around, and get back in bed without requiring assistance. If the patients reported that they could not perform the tasks, they were asked whether they could do so with a cane, walker, or assistance. The participants were then asked to perform the requested tasks.

Reporting

Out of 272 patients, 161 (59 percent) reported that they could perform the tasks unassisted, while 45 (17 percent) reported that they could do it with a cane or walker. Twenty-one (eight percent) said they could perform the tasks with assistance, and 45 (17 percent) reported that they could not do it even with assistance.

Results

The study found that discrepancies between the self-reported ability to perform the tasks and the actual performance of the tasks were common. Out of those who reported that they could perform the tasks without assistance, 12 percent actually required some assistance or were unable to perform all of the tasks. Additionally, out of those individuals who reported that they could perform the tasks with a cane or walker, 48 percent needed assistance or were unable to perform the requested tasks.

Conclusion

The study participants often did not accurately self-report their ability to perform mobility tasks. The participants who stated that they required assistance were especially poor at judging their physical mobility. Therefore, emergency department staff members should directly observe older patient mobility to ensure that they can be safely discharged from the hospital. Such observations may limit falls and hospital readmissions.