Regardless of why an older person is admitted to hospital, their ability to move and care for themselves will determine the care and services they will need while in hospital and after discharge.

Older people in hospital are at risk of functional decline and de-conditioning as early as two days after admission1. As clinicians, we should encourage older people to maintain or improve their mobility and self-care skills participating in activities.

This topic gives an overview of the importance of mobility and self-care, tools to identify issues, and strategies to improve an older person’s mobility and self-care. In addition to following health service policy and procedures, consider the following actions and discuss them with colleagues and managers.

1. Hirsch, C.H., et al., The Natural-History of Functional Morbidity in Hospitalized Older Patients. Journal of the American Geriatrics Society, 1990. 38(12): p. 1296-1303.

All Australian hospitals are being accredited under The Australian Commission on Safety and Quality in Healthcare’s (ACSQHC) National Safety and Quality Health Service (NSQHS) Standards. Each of the ten standards relate to optimising clinical care and better outcomes for all patients. While identifying and responding to issue of mobility and self-care are not directly referred to within the NSQHSS, it is closely aligned with preventing falls and harm from falls (standard 10). This topic also highlights the need to approach the clinical issues older people face in hospital in a holistic and person-centred way in order to identify and respond to multiple modifiable risk factors throughout their stay. Doing this will improve our systems, clinical care and, ultimately, the outcomes for older people to improve medication safety (standard 4) and prevent and manage pressure injuries (standard 8).

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