Don’t let older adults lie in bed all day during their hospital stay unless they’re terminally ill or they’ve got a specific medical advice
For older patients, hospital admission is a significant risk factor for functional decline and loss of independence. It has been known for over 20 years that nearly 20% of older adults who were previously able to self-mobilize were no longer able to walk without assistance at discharge from medicine units. Many complications of bedrest occur and can be significantly deleterious, including loss of muscle mass, increased fall risk, atelectasis with subsequent pneumonia and respiratory failure, pressure ulcers, delirium, venous thrombo-embolism, prolonged hospital stay and increased risk of institutionalization. Several programs which increase mobility in inpatients- including Acute Care of the Elderly (ACE) units, Enhanced Recovery After Surgery (ERAS), Mobilization of Vulnerable Elders (MOVE) and the Hospital Elder Life Program (HELP)- have proved able of reducing Hospital-associated disability (HAD). Early mobilization (occurring in the first 24 hours) and importantly three times each day is the key-point that has come out of these programs. The introduction of an exercise program for acutely hospitalized elderly medical patients showed meaningful improvements not only at discharge but also after 1-year follow-up. Comprehensive geriatric assessment in hospitalized elderly patients can not be separated from increasing mobility with nursing and patient’s family help.
1. “Fare di più non significa fare meglio - Le 3 pratiche a rischio di inappropriatezza” . Progetto Aziendale dell’Azienda Ospedaliera S. Croce e Carle di Cuneo (2013)
2. Mahoney JE, Sager MA, Jalaluddin M. New walking dependence associated with hospitalization for acute medical illness: incidence and significance. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 1998;53:M307-M312.
3. Surkan MJ, Gibson W, Interventions to Mobilize Elderly Patients and Reduce Length of Hospital Stay, Canadian Journal of Cardiology (2018), doi: 10.1016/j.cjca.2018.04.033.
4. Martínez-Velilla N, Cadore L, Casas-Herrero Á, Idoate-Saralegui F, Izquierdo M. Physical Activity and Early Rehabilitation in Hospitalized Elderly Medical Patients: Systematic Review of Randomized Clinical Trials. J Nutr Health Aging. 2016;20(7):738-51. doi: 10.1007/s12603-016-0683-4.
Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.