Choosing Wisely:

Don’t let older adults lie in bed or only get up to a chair during their hospital stay.

Rationale and Comments: Up to 65% of older adults who are independent in their ability to walk will lose their ability to walk during a hospital stay. Walking during the hospital stay is critical for maintaining functional ability in older adults. Loss of walking independence increases the length of hospital stay, the need for rehabilitation services, new nursing home placement, and risk for falls both during and after discharge from the hospital; places higher demands on caregivers; and increases the risk of death for older adults. Bed rest or limited walking (only sitting up in a chair) during a hospital stay causes deconditioning and is one of the primary factors for loss of walking independence in hospitalized older adults. Older adults who walk during their hospital stay are able to walk farther by discharge, are discharged from the hospital sooner, have improvement in their ability to independently perform basic activities of daily living, and have a faster recovery rate after surgery.
Sponsoring Organizations:
  • American Academy of Nursing
  • Sources:
  • Expert consensus
  • Disciplines:
  • Geriatric Medicine
  • References: • Creditor MC. Hazards of hospitalization in the elderly. Ann Intern Med. 1993 Feb 1;118(3):219-23.
    • Gillis A, MacDonald B. Deconditioning in the hospitalized elderly. Can Nurse. 2005 Jun;101(6):16-20.
    • Kortebein P, Symons TB, Ferrando A, Paddon-Jones D, Ronsen O, Protas E, Conger S, Lombeida J, Wolfe R, Evans WJ. Functional impact of 10 days of bed rest in healthy older adults. J Gerontol A Biol Sci Med Sci. 2008 Oct;63(10):1076-81.
    • Doherty-King B, Bowers B. How nurses decide to ambulate hospitalized older adults: development of a conceptual model. Gerontologist. 2011 Dec;51(6):786-97.
    • Padula CA, Hughes C, Baumhover L. Impact of a nurse-driven mobility protocol on functional decline in hospitalized older adults. J Nurs Care Qual. 2009 Oct-Dec;24(4):325-31.
    • Pashikanti L, Von Ah D. Impact of early mobilization protocol on medical-surgical inpatient population. Clin Nurse Spec. 2012 Mar-Apr;26(2):87-94.

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