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Functional Decline in Hospitalized Older Adults: It’s often a consequence of hospitalization, but it doesn’t have to be.

Graf, Carla MS, RN, APRN, BC

AJN, American Journal of Nursing: January 2006 - Volume 106 - Issue 1 - pp 58-67

OVERVIEW: In older adults who are hospitalized, functional decline can occur in a matter of days. This devastating outcome is a common result of the older adult’s “cascade to dependency,” in which normal aging changes—combined with bed rest or immobility—result in irreversible physiologic changes, poor outcomes at discharge, and for many, placement in a nursing home. Routine walking schedules, activities to prevent sensory deprivation, and timely hospital discharge are among the interventions that can help prevent functional decline.

One recent study found that nearly one-third of hospitalized older adults showed a decline at discharge in the ability to perform activities of daily living. Such decline leads to increased risk of illness and death, often irreversibly diminishing autonomy. But this need not be an inevitable consequence of hospitalization.

Carla Graf is a geriatric clinical nurse specialist at the University of California, San Francisco Medical Center. Contact author: This article is 10th in a series that’s supported in part by a grant from the Atlantic Philanthropies to the Gerontological Society of America. Nancy A. Stotts, EdD, RN, FAAN (, a John A. Hartford scholar, and Carole E. Deitrich, MS, GNP, RN (, are the series editors. The author of this article has no significant ties, financial or otherwise, to any company that might have an interest in the publication of this educational activity.

© 2006 Lippincott Williams & Wilkins. All rights reserved.