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Fighting Physical, Mental Decline After a Hospital Stay

  • Publish Date : 2012/10/10
  • Author : Mayo Clinic


Steps patients can take to regain strength, stamina and mental sharpness after time in the hospital.

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Physical and mental decline are common side effects of hospital stays, particularly among older patients. That can hold true even if someone is hospitalized for just a day or two for a common procedure such as knee replacement surgery.

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There are steps patients can take to regain strength, stamina and mental sharpness after time in the hospital, say Mayo Clinic aging and fitness experts Nathan LeBrasseur, Ph.D. (www.mayoclinic.org/bio/15423883.html), and Michael Joyner, M.D. (www.mayoclinic.org/bio/10482784.html), who are highlighting the issue as part of National Physical Therapy Month.

One of the most important moves a hospitalized patient can make is to simply get moving again as quickly as possible, to whatever extent is possible, Dr. LeBrasseur says. As people age, it takes less and less to push them off track, and being incredibly inactive during a hospital stay further stresses the body and can induce another degree of disability and functional decline, he says.

"This kind of long-held belief or dogma that 'rest is best' is clearly not the right answer. We know from a number of different studies in different settings that exercise plays a very active role in the recovery process," says Dr. LeBrasseur, who is with Physical Medicine & Rehabilitation(www.mayoclinic.org/physical-medicine/) and the Mayo Clinic Robert and Arlene Kogod Center on Aging (mayoresearch.mayo.edu/aging_center/). "Also, just simple forms of activity are very important."

Physical de-conditioning during or after a hospital stay or illness isn't something that only happens to frail patients, says Dr. Joyner, an anesthesiologist and physiologist. Cognitive issues can also emerge. Anesthesia and pain-relieving drugs can sometimes cause confusion or delirium or make existing cognitive problems worse, Dr. Joyner says.

"It can happen to anyone and it can happen quickly. Older people are at higher risk because they typically start at a lower baseline, so there is less reserve," Dr. Joyner says. "Each person and each case is different. However, the evidence for all sorts of conditions is that more aggressive rehabilitation strategies typically work far better than people realize."

Among tips from Dr. LeBrasseur and Dr. Joyner:

  • Work to maintain the strongest physical and mental health possible so that if you do fall ill, you start at a high baseline and have reserve and motivation to bounce back.
  • If you are hospitalized, get moving again, however you can, as soon as possible.
  • Find ways to stay mentally active, even in the hospital bed. Computer use, such as surfing the Internet, and gaming can help.
  • Careful use of sedation.
  • Have signs and clocks in the hospital room to help stay oriented.
  • Work with the care team to minimize physical de-conditioning and develop a rehabilitation plan.

The ultimate goal is helping people maintain the lifestyle they want for as long as possible,

Dr. LeBrasseur says. That would benefit patients, insurers and the economics of health care, he says.

"Keeping people healthy and independent and safe at home for as long as possible is important to all of us," Dr. LeBrasseur says. "I think we all desire to experience that, so that's what a lot of our work is centered on."

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