A systematic review of falls in hospital for patients with communication disability: highlighting an invisible population

Bronwyn Hemsley*, Joanne Steel, Linda Worrall, Sophie Hill, Lucy Bryant, Leanne Johnston, Andrew Georgiou, Susan Balandin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)
162 Downloads (Pure)


Background: Patients with communication disability, associated with impairments of speech, language, or voice, have a three-fold increased risk of adverse events in hospital. However, little research yet examines the causal relationship between communication disability and risk for specific adverse events in hospital. Objective: To examine the impact of a patient's communication disability on their falls risk in hospital. Methods: This systematic review examined 61 studies on falls of adult hospital patients with communication disability, and patients at high risk of communication disability, to determine whether or not communication disability increased risk for falls, and the nature of and reasons for any increased risk. Results: In total, 46 of the included studies (75%) reported on participants with communication disability, and the remainder included patients with health conditions placing them at high risk for communication disability. Two thirds of the studies examining falls risk identified communication disability as contributing to falls. Commonly, patients with communication disability were actively excluded from participation; measures of communication or cognition were not reported; and reasons for any increased risk of falls were not discussed. Conclusions: There is some evidence that communication disability is associated with increased risk of falls. However, the role of communication disability in falls is under-researched, and reasons for the increased risk remain unclear. Practical applications: Including patients with communication disability in falls research is necessary to determine reasons for their increased risk of adverse events in hospital. Their inclusion might be helped by the involvement of speech-language pathologists in falls research teams.

Original languageEnglish
Pages (from-to)89-105
Number of pages17
JournalJournal of Safety Research
Publication statusPublished - 1 Feb 2019

Bibliographical note

Copyright the National Safety Council and Elsevier Ltd 2018. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • Communication disability
  • Falls
  • Hospital
  • Patient safety incidents
  • Risk


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