Why older patients need less bedrest and more mobility in the hospital


By pH health care professionals

Bedrest is toxic to older adults. That’s the lesson of a new study published in JAMA Internal Medicine that calls out the immobility of older patients in hospitals, bringing attention to the damage it can do. Bedrest is associated with disability, ending up in a nursing home, and ultimately, death, the authors wrote. Half of permanent disability in older adults begins with hospitalization, they said, and 2/3 of them will either be placed in a nursing home or dead within a year of being sent home from the hospital.

The solution? Older adults in hospitals need to be more mobile. They can’t spend only 45 minutes a day out of bed (which is the current average); that’s less than 5 percent in a 24-hour period.

So why aren’t they mobile?

Well, the study authors wrote, this “pervasive culture of bedrest” dates back to over a century ago when hospitals transformed from places of last resort to places where one stays to receive treatment and tests, safe from the germs and hazards of the outside world.

In the modern hospital, the patient doesn’t need to leave the bed – with meals, medical appointments and bed pans all conveniently provided. But why would a patient want to leave anyway? Outside the room, the hallways aren’t really patient-friendly; they are for busy, working health care professionals.

Lastly, another reason patients are so immobile in hospitals is an overblown fear of falling, for the sake of safety, the study authors pointed out. Patients miss out on the opportunity to work on their balance, maintain their mobility, and ultimately, their independence suffers.

Be proactive

The researchers found success with a simple program that can be implemented anywhere. They trained “mobility coaches,” who were not health care professionals, to help older patients walk and move safely, assist with troubleshooting, and provide positive reinforcement. Simple, yet effective.

If you know an older adult in a hospital setting right now, advocate for his or her mobility to the doctor. Provide physical support to help your loved one walk at a comfortable and safe pace. Encourage him or her! Consult with a pH Patient Advocate to see what other proactive strategies may help the patient get the best possible care and outcomes.

Enjoy Your Healthy Life!
