factors. Using measures that restrict freedom instead of providing proper care and implementing evidence-based fall prophylaxis is reprehensible from both a human rights and an economic perspective. When being admitted to hospital, all patients should be observed and questioned with regard to fall risk factors. Then it should be decided whether they are at risk for falls. Additionally, there should be analyses in each ward with regard to frequent reasons for falls in order to minimise risks inherent in the environment (damp or slippery floors, poor lighting, lack of grab bars, high steps, etc.). Also situational circumstances, such as the staff structure of a department, can affect the risk of falls. In an individual case – best done by a multi-professional team – measures must be planned and developed, information distributed and, if applicable, therapeutic interventions implemented. It has been proven that orientation training, exercises, investing in lowprofile beds, bed, chair and floor mat alarms, individually adjusted hip protectors, visual aids, grab bars in hallways, etc. contribute to the prevention of falls. Possible consequences of falls, such as hip fractures, traumatic head and brain injuries and immobility, cause suffering. From the perspective of the NPM, it can be expected that a systematic fall prophylaxis in all hospitals and medical facilities would result in a reduction of measures that restrict freedom. As is the case with most Western countries, Austria is in the midst of a demographic change. The over-80 segment of the population is increasing most significantly. According to estimates, by 2040 there will be a million persons over 80. Hospitals and medical facilities must begin to prepare themselves now. In the NPM Report 2013 (pp. 38 et seq.), it was set out that the NPM urges that a recommendation by the CPT to set up a central register to record measures that restrict freedom be implemented in all psychiatric medical facilities and wards in order to be able to evaluate their use and frequency without consulting patient records. The commissions found that despite discussions with experts initiated by Gesundheit Österreich GmbH (national research and planning institute for health care, GÖG) and the Federal Ministry of Health, such registers are not yet available in most psychiatric medical facilities. Solely the University Clinic for Psychiatry of the Regional Hospital in Graz had an IT-supported central register that recorded all measures to restrict freedom (as confirmed by Commission 3), which should be positively highlighted. In July 2014, the Tyrolean hospital operating company TILAK (TILAK = Tiroler Landeskrankenanstalten GmbH) provided Commission 1 with a concept to set up such a register for the first time. Plans in this direction were held out to Commission 4 by the Baumgartner Höhe Social Medicine Centre and the Otto Wagner Hospital and Care Centre. The NPM will continue to push for a seamless set-up of such registers. 41 Central register to record measures that restrict freedom

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