--- url: 'https://www.healthinaging.org/age-friendly-healthcare-you/care-settings/hospital-care' title: 'Hospital Care' author: name: 'LiChia Chansanchai' url: 'https://www.healthinaging.org/user/100' date: '2026-10-09T18:45:35+00:00' updated: '2026-10-09T21:18:59+00:00' type: page summary: 'Hospital Care > Older adults (age 65 and older) make up only 16 percent of the population. But they account for 40 percent of hospital stays. Older adults disproportionately experience certain health problems during their stay, including:' published: true --- ## [Hospital Care](/age-friendly-healthcare-you/care-settings/hospital-care) Older adults (age 65 and older) make up only 16 percent of the population. But they account for 40 percent of hospital stays. Older adults disproportionately experience certain health problems during their stay, including: - Losing the ability to do daily tasks, like using the bathroom - Mental health problems, like depression or delirium - Bad reactions to medicines To prevent these problems, hospitals should: - Regularly check older adults to find any health problems. - Provide care that meets the special needs of older adults. ## Health Problems Related to Older Adults' Hospital Stays Older adults in the hospital may have problems with physical abilities, mental abilities, and medicines. ### Physical Abilities #### Hospital-related disability One in three adults age 70 or older gets a new disability while in the hospital. Hospital stays cause half of all new disabilities in frail older adults. #### Malnutrition About 40 percent of older adults in the hospital are not eating well. Vitamin deficiencies are also common. These adults are more likely to have serious health problems during their stay. Older adults may not eat enough because of trouble chewing or swallowing, depression or low appetite, constipation, immobility, or not having enough time to eat. In the hospital, staff should watch older adults for their ability to eat and drink, bowel and bladder habits, reactions to medicines, and thinking ability. All of these can affect nutrition. Only 38 percent of older adults are checked for these problems. #### Sleep disturbances About one in three older adults have trouble sleeping in the hospital. Causes include medicines, illness, noise, bright lights, and frequent health checks. Poor sleep is a problem because it can raise the risk of delirium. The best way to improve sleep is to reduce noise, dim lights, and cut back on unnecessary checks overnight. Care teams should strive to keep the wake-sleep cycle as regular as possible. Sleep medicines are not a good solution because they can cause delirium and falls. However, melatonin may help some patients. #### Venous thromboembolism (Blood Clots) Blood clots in the lungs (pulmonary embolism) are a common cause of death in older hospital patients. Many of these clots can be prevented. Older adults in the hospital are also more likely to get blood clots in their legs (deep vein thrombosis or DVT). Yet older adults get effective treatment for these clots less than half the time. Older patients need to be checked for blood clot risk and treated with blood thinners when needed. Sometimes clots must be removed with a procedure, but this carries higher risks for older adults, especially those with dementia. #### Sensory Deficits Many older adults in the hospital have trouble seeing or hearing. This can lead to falls, trouble using the bathroom, delirium, and loss of daily skills. Glasses or hearing aids prevent or fix many of these problems. But they may be forgotten, out of reach, or left at home to avoid losing them. Health care providers need to know if a patient has trouble seeing or hearing, and whether they use glasses or hearing aids. It is important to regularly check for these issues and ask patients if they have their glasses or hearing aids with them. Pocket talkers are available on most inpatient units. #### Mobility Not moving enough causes older adults to lose strength and may cause problems with talking. When possible, patients should move during their hospital stay. When an older adult is admitted, staff should check how well they can do daily tasks. They should find the cause of any problems and offer therapy to help maintain or improve abilities. Progress should be tracked, and patients should be encouraged to become more independent. #### Frailty Frailty increases the risk of poor health outcomes. Health care providers should check whether older patients are frail and use that information when making care decisions. #### Falls Eight in ten hospital falls happen among older adults, especially among those age 80 and over. About 30 percent of these falls cause serious injuries, including broken hips and severe bruises (hematomas). It is important to check an older adult's fall history and take steps to lower fall risk, including: - Keeping the patient’s area clear of clutter. - Placing personal items within the patient's reach. - Encouraging the use of walkers or canes. - Reducing medicines that raise fall risk. - Teaching good sleep habits. - Setting up a regular bathroom routine. - Making sure vision and hearing aids are being used. - Helping patients move and offering physical therapy as needed. #### Serious pressure ulcers Pressure sores are painful and slow down recovery. They can delay going home and make it harder to regain physical abilities. Risk factors include very old age, physical problems, poor nutrition, and circulation issues. Older adults at risk need daily skin checks. Prevention includes using the right mattresses and moving patients to different positions regularly. #### Urinary tract infections Using urinary catheters (tubes that drain urine from the bladder) when they are not needed can lead to poor health outcomes, including delirium and death. In one study, about 75 percent of infections in hospital patients age 70 and over were linked to having a catheter. If a catheter is not needed long-term, it should be used for as short a time as possible. Older patients may need a catheter when they: - Cannot release urine on their own. - Cannot control urine release and have nearby wounds. - Have very limited ability to move. - Need comfort care at the end of life. Up to 75 percent of catheter-related infections may be prevented through: - Training health care providers on proper use. - Inserting catheters correctly and providing proper care. - Using voiding options than catheters when possible. ## Mental Abilities Thinking problems (cognitive impairment) in hospitalized older adults are often caused by dementia, delirium, depression, or related conditions. These conditions sometimes co-exist. #### Dementia Between 13 and 63 percent of older adults in the hospital have dementia. Those with dementia are more likely to: - Move to a nursing home after developing delirium or after long hospital stays. - Move to a nursing home after losing the ability to do daily tasks. - Have a higher risk of delirium, restraint use, falls, readmissions, and death. Up to 75 percent of older hospital patients with dementia have related mental health symptoms. These can include yelling, aggression, false beliefs, hallucinations, and wandering. These behavioral and psychological symptoms can disrupt medical care, upset caregivers, and lead to poor health outcomes. Health care providers need to recognize when a patient has dementia or a mental health problem and keep communication clear with patients and their caregivers. #### Delirium Up to 64 percent of older adults in the hospital may develop delirium. They quickly become confused, have trouble paying attention, and cannot think clearly. Delirium can cause patients to lose mental and physical abilities. It may lead to a longer stay in a care facility or even death. Older adults in the hospital should be screened for delirium at least once per shift. Management includes finding and managing the causes, keeping the patient safe, and using non-drug approaches. Medicine should only be used when a patient is at risk of hurting themselves or others, or when they are experiencing psychosis. #### Depression Up to 45 percent of older adults in the hospital have signs of depression. This raises the risk of losing physical abilities and moving to a nursing home. All older adults should be checked for depression during their hospital stay. It is also important to find out if patients misuse alcohol or other substances. Management plans exist which can help prevent severe withdrawal symptoms while the patient is in the hospital. ## Medications Managing medicines for older adults in the hospital involves many steps, from prescribing to monitoring effects. Errors can happen at each step. One study found that 88 percent of older adults in the hospital had at least one medicine problem, and 22 percent had at least one serious related event. Up to half of these events can be prevented. Older adults have a higher risk of medicine problems because: - Their bodies process medicines more slowly, which can increase the risk of side effects. - They often take multiple medicines that may interact and cause problems when combined. About half of older adults take more than one medicine. Admission to and discharge from the hospital are good times to review all of a patient's medicines, including ones bought without a prescription. Changes may be needed before a procedure or after discharge. The review should also check whether the patient is taking medicines that are known to be harmful for older adults. These include certain medicines used to treat anxiety and psychosis. Stopping or reducing these high-risk medicines should follow a clear plan in consultation with health care providers and the patient's caregivers. ## Ageism in Hospital Care Ageism (treating people unfairly because of their age) can affect the care older adults receive in the hospital: - Older adults often receive fewer services and less expensive care than younger patients. This difference is not always based on the severity of their illness or their choices about end-of-life care. - Health care providers may make wrong assumptions about older adults' physical and mental abilities, prescribe too many medicines, leave out family caregivers, or deny life-saving treatment. - Decisions about treatment often focus on age rather than the person's actual physical and mental abilities. Health care providers need to: - Avoid using age as a reason to deny care. - Look at each patient's full situation and other health conditions. - Make sure people of color and ethnic groups do not face denial or reduction of care in hospitals and emergency departments. ## Advance Directives and Emergency Health Procedures Hospitals and health care providers must find out and respect the older adult's wishes about life-sustaining treatments. This means learning: - Whether the patient has legal documents that say when to use or withdraw life-sustaining treatment, who makes health care decisions if the patient cannot, and whether there are medical orders such as Do Not Resuscitate (DNR). - The patient's wishes about life-sustaining treatment (only 25 percent of patients have the necessary legal documents). These wishes should be reviewed and adjusted if relevant as the patient's condition changes. Reviewing the patient's condition involves: - Predicting patient outcomes using the right tools. - Considering the patient's thinking abilities and physical frailty, since these affect outcomes and the ability to make decisions. - Having early talks about possible comfort care (palliative care) for patients who are likely to have poor health outcomes. - Helping patients and their families understand what to expect. This should be done with attention to health literacy and cultural sensitivity. In all of these discussions, health care providers need to assess how well the patient can think and make decisions. If a patient cannot make a given health care decision, it is important for health care professionals to involve the right people (for example, a health care proxy) to make decisions for that patient. ## Hospital Services Older adults may use a hospital's emergency, surgery, or intensive care services. After that, they may use recovery services or be readmitted to the hospital. Each service plays a unique role in caring for older patients. #### Emergency Department The emergency department is the main way older adults enter the hospital. In the United States, older adults are twice as likely as younger adults to visit an emergency department and more likely to be admitted from there. Hospitals should have teams trained to handle the needs of older adults. Some hospitals now have geriatric emergency departments that specialize in caring for older adults. #### Surgery Half of older adults will need surgery at some point in their lives. Older adults are more likely to experience health problems after surgery. However, health outcomes may improve with programs designed specifically for the needs of older adults. #### Intensive Care Older adults make up about half of all admissions to intensive care units. The most common reason is severe breathing problems. Older patients recover from breathing problems about as well as younger patients, but it generally takes them longer to leave the intensive care unit. Older adults who survive intensive care often have more disability than they had before. Life support is limited before death in about 20 percent of older adults on ventilators. Decisions about stopping life support for older patients should include the patient's goals of care, when known. #### Post-acute Care Care after a hospital stay may include follow-up visits and rehabilitation. To get the best care, the discharge process should involve the patient and their caregiver(s), the health care team, a care manager, pharmacist, physical therapist, and social worker. This team should choose the best health care professionals to help the patient recover well. This will help reduce problems after the hospital stay, which may include pain, constipation, depression, and falls. #### Readmissions Being readmitted to the hospital is hard for patients and their families. Health care professionals can help reduce readmissions by providing a range of services that help the patient regain their abilities. These services may include seeing a primary care provider, receiving home health services, and involving and training caregivers. *Last Reviewed and Updated:* **October 2026** *By:* [**AGS/HiAF Public Education Committee, HealthinAging.org Content Reviewers**](https://www.healthinaging.org/about-us/about-website/content-contributors-and-reviewers)