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En español | A hospital is usually thought of as a safe place where sick people go to heal from injury or illness. But that perception isn't always accurate.
Even a short stay can put patients at risk for dangerous health outcomes, including falls and infections. Sleep deprivation and disorienting medications can induce delirium; constant bed rest can result in a number of complicated health conditions.
You can do several things, however, to avoid common inpatient health hazards and improve your rate of recovery in the hospital. Experts share their top tips:
Reduce your fall risk
No matter how healthy and active you are at home, it's important to exercise caution when attempting to get up and move around in the hospital, says Sharon O'Brien, a pulmonologist and chief quality and patient safety officer at MedStar Georgetown University Hospital in Washington, D.C. And that's because “your fall risk changes dramatically once you are admitted.”
You may be on new medications that make you weak or light-headed, O'Brien explains. And tubes and wires from IVs, catheters and monitoring devices could cause you to trip.
Plus “you may not be eating and drinking regularly, either because of your illness or because you're fasting for testing,” O'Brien says. “So the way you navigate at home may not be appropriate for the way you're going to navigate in the hospital.”
Falls, especially in older adults, can result in serious physical and cognitive complications — even death, according to the Centers for Disease Control and Prevention. At the same time, staying in a hospital bed all day can delay healing and lead to frailty, which is why O'Brien says: “We want people to get up and walk, but we want to do it in the right way and in the safe way.”
Because your balance can be off “for a lot of reasons” in the hospital, O'Brien recommends calling for help before you get up so that a staff member can lend a hand if you need it. Ask your care team about walkers and other assistive devices to make your stroll stumble-free. You can also request physical therapy, O'Brien says.
If you can't stand up and move around but are able to sit up, transferring from the hospital bed to a chair can help improve mood and aid in recovery, explains Melissa Bartick, a physician who specializes in managing the care of hospitalized patients at the Harvard-affiliated Cambridge Health Alliance in Cambridge, Massachusetts.
"Sometimes, we'll even put people in a chair in the hallways,” Bartick says. “It's much better than being in the bed in a room.”
Stick to your routine
When you're ill, napping on and off all day may feel like the right thing to do, but if you can, try to stick to your normal sleep schedule as much as possible. This can help ward off delirium — a state of confusion and reduced awareness that is common among older hospital patients.
Ask your care providers to open your blinds in the morning to “stimulate the brain to get up and go for the day,” O'Brien says. Turn on the TV and avoid sleeping pills and sedatives, if you can.
"You've got to really make an effort to preserve that sleep-wake cycle so that people don't get reversed when they're in the hospital,” O'Brien adds.
At night, ask your nurses if it's possible to limit the number of overnight interruptions. If you're stable, it may not be necessary for them to take your vital signs in the middle of the night, O'Brien explains.
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Earplugs can come in handy to block out noise from “the cafeteria cart rolling down the hallway outside your room or that conversation at the nurses’ desk,” O'Brien notes. And if you have sleep apnea, be sure to pack your own CPAP (continuous positive airway pressure) machine, which will be more comfortable than the hospital's unfamiliar model.
You can also ask the staff to put your IV in a spot on your arm where it won't irritate you or trigger an alarm every time you move, Bartick says. And if you need help going to the bathroom, arrange for assistance before you settle in for the evening.
"If you don't make it to the bathroom [in the middle of the night], then it becomes this whole big thing that you need your sheets changed in the night, then the whole night is disrupted,” Bartick says. “So make sure you plan ahead for bedtime routines.”
Finally, a blanket from home or your own set of pajamas can aid in better sleep and may help prevent delirium. It's common for older adults to “get confused in the hospital at night,” Bartick says. “So having familiar objects is really helpful.”
Ask people to wash their hands
At any given time, about 1 in 25 hospital patients have an infection related to inpatient care, government data show. These infections can lead to serious illness and death.
To prevent an infection during your stay, make sure all the people who come into your hospital room — visitors and hospital staff alike — wash their hands when they enter. And if they don't, you have the right to ask them to do so, O'Brien says – especially if they are touching you or your bed. This includes doctors and nurses.
Your health care provider may also recommend removing central lines and urinary catheters sooner, rather than later, to reduce the risk of infection. Often, this is met with reluctance from patients who worry they won't be able to get up every few hours to use the bathroom, O'Brien says. But “the sooner we remove those devices, the less risk of introducing an infection via that piece of plastic,” she says.
Understand (and follow) discharge instructions
By the end of your hospital stay, your focus may be on getting home as fast as you can. But don't rush through your discharge instructions. Knowing what to do when you get home increases the likelihood that you'll be able to stay there.
If you are confused about something, ask for further explanation, O'Brien says. And clarify whether you need to make a follow-up appointment or the appointment has been made for you.
Be sure you understand your medication instructions, including any changes that were made to the medications you took before being admitted. The hospital's pharmacist is a great resource for drug-related questions and may even be able to fill your new prescriptions before you leave.
Lastly: Make sure you have an after-hours number in case you need help unexpectedly. “If you have a fever, you have chest pain at 2 in the morning, you need to know who you can call after hours,” O'Brien says.