Why Hospital Stays Can Make Elderly People Weaker -- and What Families Can Do

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.

What Is Hospital Deconditioning?

Deconditioning is a loss of strength, stamina and ability to manage everyday tasks associated with inactivity. It can begin quickly during illness, particularly in older adults living with frailty, but the extent and speed vary.

Why appropriate activity matters:

The British Geriatrics Society describes how rapidly deconditioning can start in frail older inpatients. NHS campaigns have also compared prolonged bed rest in the most vulnerable older people with years of muscle ageing. These comparisons highlight a preventable risk, not a fixed daily rate of strength loss or a prediction for your relative.

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 need significantly more care. Deconditioning can contribute alongside their illness or injury, so the team should assess the reasons for any change.

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?

Hospital physiotherapists and occupational therapists work with the ward team to support recovery. Illness, treatment and an unfamiliar environment can still make it harder to keep up everyday routines. Ask the team how you can support appropriate activity between planned treatment or therapy sessions.

Patients may stay close to their beds because they are tired, attached to equipment, worried about falling or unsure when they need to be available for treatment. Discuss these concerns with staff so the activity plan fits the person’s care.

At home, routines such as getting a drink or answering the door provide opportunities to move. During a hospital stay, the ward team can help identify appropriate ways to maintain everyday activity.

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.

1. 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.

Getting washed and dressed, when appropriate, is one way to support a daily routine and encourage activity as part of the NHS campaign. It does not by itself guarantee a shorter stay or prevent a fall.

2. Encourage Movement – Little and Often

Movement doesn’t have to mean laps of the ward. Ask the nursing or therapy team which activities, walking aids and level of help are safe before assisting. Follow any surgical, weight-bearing or other medical precautions, and ask staff to show you how to help with transfers.

If they can stand and walk:

• Support the agreed plan for sitting out of bed for meals or visits, with staff assistance if needed.
• Walk short distances together only if the ward team has confirmed this is safe and shown you how to help.
• Ask nursing or therapy staff about walking aids if needed.
• Ask whether sitting out for meals is appropriate that day.

If they’re bed-bound or very weak:

• Ask the physiotherapist which gentle movements they can manage and how often to do them.
• Follow the prescribed plan; this may include ankle or limb movements, depending on their condition.
• Do not introduce leg lifts, weights or resistance bands unless the treating team recommends them.

Appropriate movement can support circulation and function. It does not replace prescribed blood-clot prevention, medicines or other treatment.

3. 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.
• Ask staff about the drinking plan, including any fluid restriction or swallowing advice, before encouraging drinks. Do not rely on a bedside sign to tell you whether restrictions apply.
• Speak to nursing staff if you’re concerned they’re not eating or drinking enough.

4. 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 cafe.
• 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.

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.”

5. 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:

• Magazines and newspapers
• Puzzles and crosswords
• Familiar objects from home
• Photos of family
• Audiobooks or podcasts

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:

• Maintain independence rather than needing increased care.
• Reduce time in hospital once medically ready.
• Lower the risk of falls when they return home.
• Recover more fully in their own environment.

Families can support recovery alongside NHS staff by sharing what their relative usually manages, raising concerns about changes and following the agreed activity and care plan. Ask the ward team what would be helpful and safe for you to do.

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:

• Strength and balance programmes tailored to their current ability.
• Walking practice and gait retraining in their own home environment.
• Falls prevention assessment to identify and address risks.
• Equipment advice – from grab rails to walking aids.
• Confidence building – helping them regain the independence they’ve lost.

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.