Graf, C. (2006). Functional decline in hospitalized older adults. AJN Journal, 106 (1), 58-67.
In his article titled “Functional decline in hospitalized older adults,” Graf (2006) brings to the limelight how the rate of functional decline in hospitalized older adults is increasingly becoming high in the US. Hospitalized older adults are mostly on bed rest, and at the same, they are undergoing aging changes which lead to permanent psychological changes. The consequences of the mental changes lead to functional decline which entails the inability to perform activities that ensure independence like rising from a sitting position. Hospitals concentrate on treating the illnesses and neglect the physical and cognitive aspects of the patients. Functional decline happens rapidly especially in older adults where it begins as soon as the second day of hospitalization (Graf, 2006). Functional decline leads to reduced quality of life, increased dependence, increased the risk of illness and death and often leads to institutionalization.
Older adults go through “a cascade of dependency” when hospitalized which is a process that leads to disability when an elderly undergoing regular aging changes becomes immobile for any reason. Regular aging changes include declined muscle strength, baroreceptor insensitivity, reduced bone density and vasomotor instability among others. Hospitalization agitates these changes especially since hospitals are set up in a way that favors the caregiver instead of the patient. The patients are often left to lie in bed most of the time de-conditioning them. Muscle strength reduces at a rate of about 5% per day without frequent contraction. Restoring muscle strength for older adults is barely possible, and hence they lose their mobility faster (Graf, 2006). A series of biological processes are affected by aging such as the cardiovascular system where the blood vessels stiffen, Cardiac output and stroke volume due to reduced movement and the respiratory system undergoes diminished expansion and contraction of the rib cage. Hospitalization worsens these conditions leading to irreversible effects in the elderly.
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Graf (2006) argue that caregivers’ task should go beyond treating the illness to taking care of the physical and cognitive needs of the patients to help manage the decline in functionality in hospitalized older adults, Frequent assessment upon admission and during the whole period of hospitalization will be helpful in keeping track of the patient’s functionality. Assessment will help give clinicians ideas on how to handle patients to prevent functional decline (Graf, 2006). Special considerations should then made for cases of the elderly whereby they undergo physical exercise during hospitalization under supervision to keep them operational. The care of aged patients should incorporate practices to maintain or improve the patient’s cognitive aspects such hearing and vision.
In conclusion, there is a high rate of functional decline among the hospitalized older adults with very adverse effects. Therefore, hospitalization of older adults requires particular attention and care to the physical and cognitive aspects of the patient given their weak state due to aging changes. Bed rest recommendations for the elderly need revisiting since immobility has proven to be destructive to the general health and quality of life for older adults. There is a crucial need to fight function decline in order to maintain the dependence of the older adults during and after hospitalization.
