By maintaining mobility and adequate self-care, it is possible for older people to maximise their opportunities for personal independence, social connectedness, security, activity and dignity.

During a hospital stay, a person-centred partnership with the older person is necessary to ensure mobility and self-care are maintained or improved. Mobility and self-care are fundamental to many of the other functional domains addressed on this website. For example, an older person's ability to walk to the toilet may help to maintain continence. Promoting or facilitating mobility and self-care is recommended for minimising the risk of depression, delirium, under-nutrition and can reduce the likelihood of falls and fall-related injuries and loss of confidence due to fear of falling.

Bed rest has considerable impacts on an older person’s ability to be independent. This includes impacts on self-care and walking. Bed rest during hospitalisation can lead to functional decline and deconditioning as early as two days after admission1.

Effects of bed rest

2,3

System

Effects of bed rest

Cardiovascular

Postural hypotension

Reduced aerobic capacity

Respiratory

Reduction in arterial oxygen level

Increased potential for atelectasis

Musculoskeletal

Loss of muscle strength

Loss of muscle mass

Muscle shortening

Joint contractures

Reduced bone density

Increased risk of falls/injury

Pain

Gastrointestinal

Constipation

Malnutrition

Genitourinary

Continence issues

Skin

Potential for breakdown in skin integrity

Psychological

Confusion

Social isolation

Depression

 


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.

2. Creditor, M.C., Hazards of Hospitalization of the Elderly. Annals of Internal Medicine, 1993. 118(3): p. 219-223.

3. Convertino, V.A., Cardiovascular consequences of bed rest: Effect on maximal oxygen uptake. Medicine and Science in Sports and Exercise, 1997. 29(2): p. 191-196.