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Deconditioning syndrome

Get up - Get Dressed - Keep moving

Immobility is dangerous

Whilst we all need to maintain our physical activity, it is essential that older people move around regularly in order to maintain their physical and mental health.  Studies of hospital patients have shown that lack of movement can lead to loss of bone mass and muscle strength, reduced mobility, increased dependence, confusion and demotivation. These problems are part of a phenomenon known as ‘Deconditioning Syndrome’.

Because deconditioning syndrome affects general wellbeing as well as physical health, it can be a significant contributor to all sorts of problems including falls, constipation, incontinence, depression, swallowing problems, pneumonia and general decline. Deconditioning can happen in any setting - hospitals, care homes and also at home.

Hospital studies show that in older people with frailty, deconditioning can begin within hours of lying on a bed or trolley.  Regaining strength and function (re-conditioning) can often take twice as long as deconditioning i.e. if it has taken one month for someone to reach a lower low level of function, it may take two months of hard work to return to their original level.  Increased recognition of the dangers of immobility in hospital and care homes  means that  “get up, get dressed, keep moving” is a key mantra in elderly care. 

The same mantra is relevant at home too.  Health experts are concerned that the COVID 19 control measures (distancing, shielding, isolation) could place older people living in the community at an increased risk of deconditioning.  Spending months at home means that older people are at a much greater risk of increased sedentary behaviour and all its dangers for physical and mental health with implications for their continued ability to live independently.  

Deconditioning combined with increased levels of isolation or loneliness can also lead to a loss of cognitive and emotional wellbeing which in turn can increase the risk of dementia.  

Activity guidelines for frailer older adults

The chief medical officers (CMOs) of our four nations have considered the special needs and circumstances of older adults including those who are frailer. 

Frailer older adults are those who are identified as being frail or have very low physical or cognitive function, perhaps because of chronic disease such as arthritis, dementia or advanced old age itself.  The CMOs’ mobility advice for this group is:

“any increase in the volume and frequency of light activities, and any reduction in sedentary behaviour, is a place to start and contributes towards health. For this group, more strenuous activities are less likely to be feasible. A programme of activities could focus instead on reducing sedentary behaviour and engaging in regular sit- to-stand exercise and short walks, stair climbing, embedding strength and balance activities into everyday life tasks, and increasing the duration of walking, rather than concentrating on intensity."

What can you do?

Your approach will undoubtedly depend on your parent’s needs, and circumstances. However, a shared understanding of the risks of deconditioning and the benefits of maintaining mobility and motivation may be invaluable.  

Keep in regular contact, encourage a routine with activity and movement. Remember

 “Get up, get dressed, keep moving”. 

You might also find the Health Innovation Network online booklet useful (see link below) - it comprises safe, expert and practical ideas and resources to keep older people active and motivated.   The collection is tailored to the needs and interests of older people, including those living with dementia and includes:

  • Activities to access online eg Online jigsaw puzzles and the BBC reminiscence archive
  • Access to online newspapers eg Sporting memories
  • Ways to exercise at home eg Chair Yoga with Sherry 
  • Films, Music and TV eg The British Film Institute free collection, 
  • Livestream concerts, nature and museums eg interactive safari

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