The Experience of Early Mobility after One Week of Hospital-acquired Deconditioning

Abstract Older adults who are hospitalized spend most of their time in bed. Prolonged bed rest and immobility in older adults may result in deconditioning of the muscles, leading to a loss of muscle mass and strength. The loss of muscle mass results in weakness and reduced physiological functioning post-hospital discharge. Immobility is especially problematic in older adults who naturally lose muscle mass and strength due to the aging process. Older adults who experience weakness post-hospital discharge face challenges with mobility. The purpose of this study was to describe the early mobility experiences of adults who are 60 years old and older and had been in the hospital for at least one week due to a medical condition, and then discharged. This focused ethnography study included in-depth interviews and observations of natural movement. Participants were male and female adults who were 60 years and older (n=10), admitted to the hospital for at least one week, and then discharged. The audio-recorded interviews were transcribed, and then analyzed by a team of three researchers. Mobility is Life was identified as the overarching pattern. Two subpatterns and six themes were identified. The first subpattern, The Crushing Assault: Consequences of Immobility, included three themes: Physiological Consequences of Immobility, Changes in Moods and Emotions Resulting from Immobility, and A Change in Identity Resulting from Immobility. The second subpattern, The Rocky Road to Regaining Mobility, included three themes: Physiological Responses to Regaining Mobility, Influence of Attitude on Recovery and Regaining Mobility, and Resources and Strategies to Regaining Mobility. The findings revealed that a loss of mobility post-hospitalization is problematic for older adults who have difficulty with activities of daily living and providing self-care, including personal hygiene. The change in the ability to function is distressing to the older adult, and results in frustration and self-reported depression. The inability to function leads to feelings of uncertainty and a challenging recovery. Regaining mobility is prolonged and difficult for the older adult who must combat weakness and fatigue during recovery. The most successful recovery from immobility includes the use of resources, including a supportive family and healthcare team