Our elderly population seems to age faster or decline after hospitalization. Many factors contribute to the functional decline of elderly patients during and after hospitalization.
Many elderly patients are admitted for diagnoses that lead to functional decline, for example, pneumonia, urinary tract infections, or hip fractures (Admi et al., 2015). Often these diagnoses require or cause prolonged bed rest, urinary catheters, mechanical ventilation, and altered nutrition during recovery. However, these interventions come at a cost. Many elderly individuals suffer from depression and delirium when hospitalized, secondary infections, and functional decline. Infection, disruptions in environment and routine can cause acute confusion. Providing a more familiar environment can help offset these symptoms. Nurses must implement daytime lighting schedules which include lights on, windows open, and out of bed routines during day-shift hours.
This routine promotes mobility, prevents day-night rest confusion, and promotes upright positioning for better lung capacity, bowel motility, and skin pressure distribution. Early mobilization in elderly patients helps prevent muscle atrophy and functional decline. Early mobilization helps to avoid skin breakdown and promotes self-care and motivation. Early mobilization allows nurses to evaluate patients’ skin, mobility challenges, and overall function. Mobilizing patients provides early detection of any complications and provides early intervention opportunities for therapy or treatment. Early mobilization also includes the option for discontinuation of infection risks such as urinary catheters, adult briefs, and mechanical ventilation.
Early mobilization is proven to shorten the duration of intensive care unit stays and hospitalizations in general. As much as COVID has provided challenges with visitation, allowing patients time with the family offers a sense of normalcy. Familiar interaction also prevents delirium and depression. Family interactions also help alleviate a sense of helplessness with illness (Admi et al., 2015). Including family in care promotes trust and provides an insight into the patient’s condition and treatment. Family interaction also helps with nutrition deficits. Patients tend to eat more when the family is present and available to help with feedings.
Malnutrition is associated with a functional decline during hospitalizations and after discharge (Admi et al., 2015) Although illness cannot be prevented, physical and mental health are equally important when treating patients. Providing as close to a regular daily routine as possible helps our elderly patients maintain their functional abilities and quality of life. When nurses incorporate daytime and nighttime practices, early mobility and minimizing incontinence and bedrest techniques aid our elderly in maintaining their independence and function during hospitalizations. References Admi, H., Shadmi, E., Baruch, H., & Zisberg, A. (2015). From research to reality: Minimizing the effects of hospitalization on older adults. Rambam Maimonides Medical Journal, 6(2).