Functional Decline

What is functional decline?

Functional decline is a new loss of independence in self-care capabilities and is typically associated with deterioration in mobility and in the performance of activities of daily living (ADLs) such as dressing, toileting, and bathing.  When older adults are hospitalized, the medical illness causing hospitalization can cause a decline in functional status.  Functional decline can also be caused by other factors related to hospitalization such as extended bed rest, reduced daily participation in ADLs, and inappropriate use of mobility-restricting devices such as indwelling catheters and intravenous lines.

Why is Functional Decline an Important Issue in Hospital?

  1. Functional Decline is a common problem in older people admitted to hospital:
    • 30-60% of older people experience functional decline when acutely hospitalized
    • One year after hospital discharge, less than 50% of older adults recover to their pre-illness level of functioning and rates of long-term care placement are high
  2. Processes of hospitalization may lead to Functional Decline:
    • It is estimated that up to 50% of older adults experience functional decline during hospitalization that is largely independent of their presenting medical illness
    • Many factors related to processes across the hospital organization can contribute to functional decline
  3. Functional Decline is associated with negative outcomes:
    • Functional Decline is often difficult to reverse, and may lead to long term loss of independence, social isolation, and reduced quality of life
    • Increased hospital length of stay and increased rate of long term care admission

What can I do to prevent functional decline?

NBRHC encourages patients to keep mobile and perform tasks they are able to do at home such as dressing or walking with or without assistance. If unsure what would be safe to do, patients should ask a member of their health care team.

Benefits of Getting out of bed while in hospital

  1. Getting out of bed can help prevent bed sores
  2. Improved breathing
  3. Improved mood and sleep
  4. Improved appetite/less risk of choking when eating
  5. Less weakness, prevents loss of strength
  6. Improved circulation
  7. Meet other people/socialization
  8. May reduce length of time spend in hospital

(Information retrieved from

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