Most people expect their elderly parent to come out of hospital better than when they went in. Medically, that’s often true. The infection is treated, the fracture fixed, the crisis resolved. But something else can happen during a hospital stay — something that leaves families shocked: “She went in walking and came out barely able to stand.”
This isn’t unusual. And it isn’t inevitable.
⚡ Key Takeaways
- 10 days of bed rest in someone over 80 can cause the equivalent of 10 years of muscle ageing
- Families can help prevent deconditioning with simple actions: getting dressed, encouraging movement, supporting nutrition
- The NHS #EndPJparalysis campaign encourages patients to “get up, get dressed, and get moving”
- Recovery after discharge is critical — home-visiting therapy can help rebuild strength and confidence
📋 In This Article
What Is Hospital Deconditioning?
Deconditioning is the loss of strength, stamina, balance and independence that happens when someone is inactive for even a short period. In older adults, it happens frighteningly fast.
Here’s what the research tells us:
Many people go into hospital managing reasonably well at home. They might need some support, but they can get out of bed, walk to the bathroom, make a cup of tea. After a prolonged hospital stay, they may suddenly need significantly more care — not because of their original illness, but because their body has weakened during admission.
When someone’s care needs increase, discharge becomes harder. The right care package may not be immediately available, and so people remain in hospital longer than medically necessary. This is the “delayed discharge” that dominates NHS headlines every winter — but at its heart is often this quieter, less visible problem: deconditioning.
Why Does This Happen in Hospital?
Acute hospitals are designed to provide medical and nursing care, not rehabilitation. Although physiotherapists and occupational therapists do work in hospitals, there simply isn’t the capacity to provide the level of therapy needed to fully prevent deconditioning for every patient.
But there’s something more subtle at play too.
Have you ever wondered why someone in hospital is called a “patient”?
Because in hospital, people are expected to be… patient.
They wait for doctors’ rounds. They wait for medication. They wait for tests, results, decisions, and discharge plans.
Patients often stay by their beds because hospitals are large, unfamiliar, and overwhelming. They may be attached to drip stands, worried about falling, or scared of missing the doctor’s once-daily round. And when everything — food, medication, clothes, commodes — comes to them, there’s very little reason to move.
At home, people have a reason to get up: to answer the door, use the toilet, make a drink. In hospital, all of that disappears.
Unfortunately, not moving is exactly what causes deconditioning — and prolongs the hospital stay.
What Families Can Do: 5 Ways to Help Prevent Deconditioning
Families often feel helpless during a hospital admission. But small actions make a real difference — both to your loved one’s physical condition and their eventual discharge.
encourages patients to “get up, get dressed, and get moving.” You can support this at the bedside.
Free Daily Checklist Tool
Track these 5 goals during each hospital visit. Share with family on WhatsApp so everyone can help.
👕 Help Them Get Dressed — Every Day
There’s a concept known as “pyjama paralysis.”
When we stay in pyjamas, we feel sluggish and unwell. We want to snuggle under the covers. But when we get washed, dressed, and brush our teeth, we feel human — and we’re far more likely to sit up, move around, and engage.
✅ What you can do:
- Take dirty clothes home, wash them, and bring in fresh outfits
- Bring comfortable day clothes and proper footwear (preferably not slippers! And avoid the hospital socks unless necessary!)
- Encourage getting dressed every morning, unless they’re genuinely too unwell
- Avoid hospital gowns unless absolutely necessary
📊 Research shows that patients who get dressed have shorter hospital stays, fewer falls, and better outcomes.
🚶 Encourage Movement — Little and Often
Movement doesn’t have to mean laps of the ward. Even small efforts help maintain strength and prevent further decline.
🟢 If they can stand and walk:
- Help them get out of bed and into a chair — for meals and visits as a minimum
- Walk short distances on the ward together
- Ask nursing or therapy staff about walking aids if needed
- Aim for sitting out of bed for meals, not eating in bed
🟡 If they’re bed-bound or very weak:
- Wiggle toes and circle ankles
- Lift legs up and down while lying flat
- “March” legs gently in bed
- Raise arms, reach for the ceiling
- Bring in small hand weights or resistance bands if you have them
Even these small movements help maintain circulation, prevent blood clots, and slow muscle loss.
🍽️ Support Good Nutrition and Hydration
Our bodies need fuel to recover from illness and to maintain muscle mass. Hospital food isn’t appetising for everyone, and many patients don’t eat enough.
✅ What you can do:
- If allowed, bring in nourishing food they actually enjoy (higher protein content is ideal)
- Sit with them during mealtimes — eating together encourages better intake
- Encourage regular drinking (unless they’re on fluid restriction — this will be clearly signed above the bed)
- Speak to nursing staff if you’re concerned they’re not eating or drinking enough
⚠️ Note: Some patients may have specific advice from the doctor or dietician. The advice in this article is generic and applicable to most elderly patients, but not all.
☀️ Take Them Off the Ward
If it’s safe to do so, getting away from the bed area can lift mood and encourage movement.
💡 Ideas:
- Find a wheelchair and take them for a coffee in the hospital café
- Sit in a quiet courtyard or garden area — vitamin D is hugely beneficial
- Get outside for fresh air — even 10 minutes makes a difference
Many hospitals have beautiful grounds. Bournemouth Hospital, for example, has lovely gardens and a lake — a short visit can feel like a mini-break from the ward environment.
Fresh air and gentle movement aid recovery
🏥 Important: Always tell the nurse if you’re leaving the ward. Consider leaving a note on the tray table: “Doctor — gone for a short walk, back soon.”
🧩 Keep the Mind Active
Deconditioning isn’t just physical. Cognitive function can decline during hospital stays too, especially in older patients. It’s a complex issue, but certainly boredom and lack of stimulation contribute to confusion and low mood.
📦 Bring in:
Mental engagement matters just as much as physical movement for overall recovery. If you can’t visit, a regular phone call or text message can be really helpful.
A Note on Delayed Discharge
If your loved one is medically ready to leave but waiting for a care package or assessment, ask the ward team whether it might be possible to:
- Spend time at home during the day while awaiting formal discharge
- Trial the home environment with family support
Sometimes, getting back into familiar surroundings — even briefly — can help prepare them for the transition home and demonstrate to themselves and the family what they can actually manage.
Why This Matters
Preventing deconditioning helps people:
In an ideal world, people wouldn’t deteriorate in hospital. It’s unlikely our NHS will ever have the capacity for comprehensive rehabilitation within acute settings, so family awareness and involvement are vital.
A hospital stay doesn’t have to mean getting weaker — and your small, thoughtful actions can make a lasting difference.
When They Come Home: How We Can Help
The first few weeks after hospital discharge are critical. This is when people either regain their strength and confidence — or continue to decline.
If your parent or loved one has lost mobility, strength, or confidence during a hospital stay, home-visiting physiotherapists and occupational therapists can help them rebuild.
We provide:
All our therapists have a minimum of 12 years experience (our team average is 18 years), and we specialise in working with older adults across Hampshire, Dorset, and Wiltshire.
We don’t have a clinic — we come to you. Because recovery happens best in the environment where it matters most: home.
Ready to help them recover at home?
Speak to Naomi, our Clinical Director, for free advice about your situation.
We cover: Southampton • Bournemouth • Salisbury • Poole • Christchurch & surrounding areas
The information in this article is intended for general educational purposes only and should not replace professional medical advice. Every patient’s situation is different — always follow guidance from the medical team caring for your loved one. If you have concerns about their care or recovery, speak to their doctor, nurse, or therapist.