Narrator (0:07)
When an old person comes into hospital, and lies in bed it can affect their appetite, hydration and mood as well as leading to deterioration in physical function. This is known as deconditioning.
Studies have shown that when people are admitted to hospital, they can spend up to 70% of their time lying in bed. Sometimes this is necessary, but in most cases getting up and dressed will help maintain a person's mobility and function
Here's Betty's story.
Betty, who's 82 tripped and fell in her bathroom on Monday night. She hit her head and had a nasty bruise over her right hip. She also felt very dizzy. Jim, Betty's husband, brought her to the A&E department.
The X-ray showed that luckily she had not broken any bones.
The doctor still wanted to keep an eye on Betty for a few days, so she was asked to stay in hospital. Betty was asked to change into a hospital gown. The nurses were unsure whether Betty could stand or walk safely. So they advised Betty to stay in bed until they were sure
Betty (1:08)
One of the nurses kindly helped me change into a gown. She also helped me pack away my belongings into a green bag for safekeeping. The nurse asked my husband Jim to bring in some nightwear for the next few days.
Narrator (1:24)
The following morning, the therapist came to assess Betty she was lying in bed. Betty was waiting for the doctor to review her and told her therapists that she did not want to get out of bed.
There was no further discussion with Betty on the importance of being able to move around safely, or the importance of getting dressed into her own clothes.
Betty (1:43)
The nurses were very kind and brought me food and drinks during the day. At home, I normally get myself up and cook for myself and Jim. I only like small meals. But I have snacks in between to make sure I eat enough over the day.
I can't manage big meals, but I didn't want to be a nuisance so I just left what I couldn't eat. I didn't have any snacks to have in between meals. So sometimes I was a bit hungry.
Narrator (2:12)
On Wednesday, Betty was moved to an elderly care ward, where she was reviewed by a therapist team.
She needed assistance walking with a zimmer frame and getting herself dressed. The nurses also noted that she needed some help in eating and drinking.
Betty (2:27)
I felt very stiff after being in bed for a few days. I needed the Zimmer frame to walk to and from the toilet. There was only one toilet in the bay I was sleeping in. I couldn't get there in time one day and wet myself, which was really embarrassing and upsetting.
The nurses helped me and tried to move me to a bed closer to the toilet. But there weren't any free.
The nurse had to give me a pad just in case. Every day I felt like I needed more help. And I didn't understand why I thought coming into hospital would make me feel better. But now the nurses, the doctors and the therapists are telling me that I'm going to need more help. When I go home.
Jim (3:14)
It broke my heart seeing Betty like this. And I didn't know how we would manage at home or if things would even ever get back to normal. They said she would need care. But I didn't know what this meant, or if Betty and I could even manage at home.
Narrator (3:28)
Deconditioning can lead to reduce muscle strength, loss of independence, increased risk of falls, infections and pressure ulcers. Inactivity also reduces appetite, social contact, and wellbeing
Inadequate food or drink intake coupled with a lack of mobility can have real detrimental impact on patients recovery.
If a person can use the toilet independently at home, they should continue in hospital. Encouraging patients to walk to the toilet can reduce risk of incontinence.
Spending a few days in bed may seem like a kindness to help someone rest to get better. But it can quickly lead to muscle wasting and deconditioning.
Eat, Drink, Dress, Move.
It's that simple way we can support our patients in being active participants in their recovery to help them maintain their mobility and function.
Now let's see how Betty's story is different using this approach.
Instead of staying in bed, the nursing team helped Betty get up and dressed into her own clothes as soon as possible. The doctors and nurses asked Jim and Betty about their daily routine at home and what Betty's favourite foods were.
Jim was advised on what snacks, clothes and footwear to bring in for Betty.
When she finished her breakfast, the physiotherapist and occupational therapist assessed her ability to walk and identify what equipment Betty needed.
Betty was feeling stronger every day. Nurses helped her walk to the toilet. She brushed her hair and put on lipstick just like she would at home.
The therapist and nurses encouraged Betty to walk during the day. Soon she didn't need the walking stick and didn't need to press the buzzer for help.
When Jim came to visit, he was so pleased to see Betty looking like herself happy in her own clothes and with makeup on and ahead of just how she likes it. It made him feel more confident about her coming home and things returning to normal.
The nurses and therapy staff also gave Jim and Betty some handy tips to help Betty stay healthy and strong at home and advise them both on food and exercises.
Getting dressed each day helps motivate patients to get moving. It's in the best interest of our patients to encourage them to eat, drink and be as mobile as possible. Everyone can encourage our patients to do this. Let's stop people deconditioning in hospital. Let's encourage patients to eat, drink, dress and move to help make a positive difference.