A staggering 30 per cent of patients aged over 70 go home from hospital more disabled than when they arrived.
So says a visiting Irish professor of nursing, who said part of the reason is deconditioning – substantial loss of muscle and physical strength due to lack of activity.
“People go to hospital, get into their pyjamas and they are then paralysed in their pyjamas until they leave,” Brian Dolan told a master class at Bond University, where he was a special guest in November.
Patients who spend a week in bed lose 1.5kg of muscle, 20 per cent of the power in their quads, and 10 per cent of aerobic fitness, he said.
Professor Dolan, director of service improvement for the Canterbury District Health Board in New Zealand, is on a personal crusade to save lives in hospitals around the world.
To do so, he created the EndPJParalysis and Last1000Days movements.
End PJ Paralysis is about encouraging patients to get up, dressed and moving while in hospital, he said.
“Instead of asking, ‘Is this patient safe to be discharged’, a better question may be, ‘Is this patient safe to be admitted?’
“This is about how do we look at the health system where we value patients’ time so they spend as little time as possible in the hospital.”
Professor Dolan, who also works in Australia and the UK, is not trying to demonise hospitals.
Rather, he is seeking to usher in simple and effective social change that can be implemented by everyone from experienced practitioners to first-year clinical students.
(In the UK, he is director of Health Service 360, which provides professional support to people working within the National Health Service.)
Almost 40 health services around Victoria are involved in the EndPJParalysis program and Gold Coast University Hospital has started running with it.
Professor Dolan said Last1000Days is predicated on the question: “If you had 1000 days left to live, how many would you choose to spend in hospital?”
“The answer for most of us would be none or as few as possible,” he said.
Professor Dolan’s top tips for seniors admitted to hospital:
- Go for a walk. If you have a test, walk, don’t get in the wheelchair.
- Meet your family in the canteen, rather than by your bed.
- Use that walking frame. Not only do frames reduce patient falls by 40-60 per cent, they get patients walking and talking. This is in turn reduces loneliness, which increases the likelihood of an early death by 27 per cent.