Last Updated on January 19, 2025 by Analgesia team
A deconditioning syndrome is the ‘condition of physiological, psychological and functional decline that occurs due to complex physical changes’, which happens with prolonged bed rest and the associated loss of muscle strength.
Currently, Bedford Hospital, United Kingdom, is making efforts to ensure the movement among our older generation so they can remain active, independent, and mobile. This not only improves outcomes but can also prevent falls and long stays in hospital, with better mental health and wellbeing.
We now know that half of admitted frail older patients experience functional decline between admission and discharge. Also, 50% of older people can become incontinent within 48 hours of admission. In the first 7 days of admission, inpatients have reduced muscle strength by up to 10%, reduced circulation by up to 25%, and reduced dignity, quality, confidence, independence, and choice.
In a study by the National Library of Science of hospitalized community‐dwelling older people at 6 months after discharge, 43% needed continuing help with medications, 24% were still unable to walk a quarter of a mile, and 45% were still unable to drive.
For many years in the past, there has been much concentration on the physical and functional decline of patients due to acute inactivity but we now know that cognitive decline also takes its toll.
10 days of bed rest in the hospital ages the muscles by the equivalent of 10 years in people over 80 years old.
The findings in favour of activity and exercise for older people confirm how important it is for us to identify effective approaches to behaviour change, to share the best practice and to put in place strategies to prevent deconditioning, at scale and speed.
What Hospital/Home Associated Syndrome (HAD) can cause are:
- Bone strength: Reduced mobility can lead to reduced bone strength.
- Cardiovascular system: Three weeks of bed rest can cause a decline in the cardiovascular system similar to 40 years of aging.
- Functional decline: 35% of 70-year-old in-patients experience functional decline during their hospital stay, and 65% of people over 90 do.
- Muscle loss: One study found that healthy older adults lost 0.95 kg of lean leg mass after 10 days of bed rest.
Early mobilization can help reduce the risk of complications and improve patient outcomes. It can also help reduce the length of a hospital stay and the cost of care.
To prevent deconditioning, you can:
- Encourage movement: Encourage patients to get out of bed, sit in a chair, and move around as much as possible.
- Promote independence: Encourage patients to wash, dress, and use the toilet independently. If your loved one is at home, see that he can do things by himself if he can.
- Provide physical therapy: A physical therapist can help with exercises to improve balance and strength.
- Maintain nutrition: Eat a balanced diet and stay hydrated.
- Keep the environment supportive: Ensure that chairs are available at the bedside, and that corridors are clear of clutter.
- Keep the brain active: Read, learn new skills, do word puzzles, or develop new hobbies.
- Maintain social contacts: Stay in touch with friends and family by phone, video conference, or in person.
- Provide walking aids: We should ask is the chair and mobility aids are of the right height. Ensure the walking sticks or frames are accessible at all times.
- Access to all other aids: We could ensure that glasses and hearing aids are readily availableand calendars and clocks are visible to promote awareness. If they are in the hospital, it would be preferable for them to be in their clothes.