Negative effects of bedrest

All about caring
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This post is a follow-up to the recent thread by Albert (21/12/19) wherein reasonably independent people go into hospital for a checkup after a fall, uti, or other ill-defined reason and so often end up confined to bed for no good reason, apart from nurses’ convenience and the patient often being meek, respectful and desire to do what they’re told. This happened to my mother and that led me to research the effects of bedrest, especially after mum’s astute consultant, who had just treated me!, asked exactly why are you bedbound?!? There was no good reason, apart from the request for community physiotherapy had been made to the wrong community physiotherapy unit! Law. case pending!

I just googled a few nursing/medical articles and I’d like to make us carers informed that just staying in bed, not sitting in a chair for part of the time, or moving our bodies, stretching, do have consequences after a relatively short time.

At one point, mum told me she was simply unable to stretch her arms up and wide because the neighbouring bay had spread over into her space. The nurses didn’t understand that my 94year-old mother wanted to do some exercising!

Bodily functions, mobility and psychological functions are all impacted by being confined to bed. Just sitting in a chair makes some difference.

My experience makes me wonder if hospitals did more to keep patents mobile, rather than confine them to bed, wouldn’t that help patients remain independent and reduce the amount of social care?

Interesting papers on bedrest:

There are many more accounts of the effects of bedrest. It has so many implications on the quality of life for those we care for, and the cost to us and the community. Bedrest may be necessary and appropriate, but ought not be used for convenience sake for the compliance it affords, imho!

Michael: Any interest in pursuing this campaign against unnecessary hospital bedrest by Carers Uk? So often your membership and local authorities are left to care for their loved ones who have been left immobile in bed for days/weeks etc., when they are capable of more…

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Just to support everything said by Rosemary.

My father suffered a fractured humerus last year (through the negligence of patient transport staff). He was then subject to six months in bed whilst the hospital/ LA debated his care needs. The impact on his health has been awful. We have submitted a complaint to the Ombudsman but legally it is proving very hard to determine what was caused by the injury and what was caused by being stuck in bed for 20 plus/ 24 hours a day for six months . When I made a complaint to the Hospital Trust they simply said they were short of therapists - that doesn’t explain why nursing staff can’t help those who are able to sit in chairs/use commodes etc. The hospital has numerous posters asking about respect and dignity but doesn’t treat patients with the same.

It is very frustrating to see vulnerable patients ts suffer in this way. I would support Carers Uk acting on this as proposed by Rosemary.

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I would support Carers UK acting on this as proposed by Rosemary.

Good luck with that … anyone recall hospital discharges ?

Still up in the air … problem getting worse … almost week by week.

Bed rest … not part of the care plan when being discharged from hospital ?

Ongoing problem for many carers with carees … outside care support needed by many … at a price ?

Rosemary has raised a very good issue … part of a much larger one ?

On the one hand , The NHS and social care … on the other , the carer army.

Never the twain shall … be integrated ?

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Many thanks for your support Faye and Chris!

Bedrest is convenient and sometimes may be the best practice. But not always. Literature has and is documenting the real and adverse effects of bed rest.

As I learnt, immobility can disqualify the patient from surgery. And not having surgery can lead to death. Immobility can lead to a life not worth living or the thought that it is.

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Your welcome.

Now … outside of those reading this post , anyone else … preferably with some clout ?

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Can’t say I have any clout ( unfortunately,) but I will highlight this thread to Michael and Lizzie.

Melly1

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Hi Chris, would like to think Michael would take this up. Mum died when she did because she was deemed ineligible for surgery, although it was stressed that age wasn’t a delimiter, but immobilty was.

Encouraging/promoting mobility in hospital, where appropriate, as opposed to confining people to bed could help keep people mobile, independent and help prevent psychological and physical demise, and minimize social/community costs?

MICHAEL, what do you think please??

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As an extension of the existing HOSPITAL DISCHARGE issue ?
https://www.carersuk.org/forum/support-and-advice/all-about-caring/please-tell-us-about-your-experiences-of-hospital-discharge-31980?hilit=hospital%20discharges
_( A few " bed rest " cases posted in that thread. )
_

Bed bound with a broken hip and cancer but will deemed well enough to go home.

My experience of elderly social care in the UK.

__In CarerLand , every issue tends to interlock with others.

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Thanks, Melly!

If the hospitals would care for each patient’s needs, it might save on social care services down the road. In mum’s case, at least in part, but not exclusively, nurses gave way more attention to those with dementia versus the few without. Mum hardly ever was got up or even turned in bed…

Michael, please consider instigating a campaign in this area. Mum is dead now but I gather others are suffering a similar, unnecessary but costly demise.

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Associated issue: if you are on bedrest, how often are you turned? I would often ask mum if she’d been repositioned and she would say never. District nurses would tell me to turn mum every 2 hours but this was only ever done once in hospital!

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My caree was severely disabled, wheelchair bound, when they were in hospital needed help going to the toilet, frequently the nurses were too busy.
Was often in bed like stated for the convenience of the nurses, but could not get out of bed so was in bed for days, wired up catheter etc.
Other patients physically well and just in for minor op etc, could get out of bed, go to the bathroom themselves, for a bath/wash, my caree never had a proper wash/bath in hospital.
My caree had carers every day, wash dress, etc, in the hospital that was just forgotten.
The well patients could wander to the shop, go to the café for a cup of tea with friends/relatives, go outside, for fresh air, sit in the hospital garden.
My caree was just stuck in bed and isolated, no fresh air, dependent on visitors to go to the shop for them, could not even look out the window.

So its’s not just the physical effects, the social effects, isolation causing depression, lack of freedom, waiting for visitors rather than being out in the community able to see friends on a daily basis.

A lot more could have been done, I saw frequently staff from the mental health unit take patients out side for a bit of fresh air or a cigarette or 2.

There just needs to be a lot more thought and support for the severely disabled in hospital, as soon as they are in hospital, all the care ceases.
Couldn’t the paid carers go and do the same in hospital, wash, dress, help feed etc, NO it’s all cancelled.

Not everyone has relatives who can visit the hospital every day, some carees are 100 per cent dependent on paid carers for care and social interaction.
But are then expected to rely on nurses they have never met and do not understand their disabilitys.

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And families who do visit, such as myself, more often than not believe that the nurses are doing the best and all for the paients rather than what suits the nurses the best…

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The same has happened to my aunt. She broke a shoulder at the end of October and spent a month in hospitals and then a month in a ‘re-enablement’ care home. In hospital she had virtually no physio, and didn’t walk at all. In the ‘home’ she was meant to be having physio but she had virtually nothing. On getting her home the week before last we found that she could barely walk, although prior to her accident she’d been in and out of town on buses virtually daily, and walking everywhere pretty briskly.

We’re now in the process of trying to get her back on her feet, and today we hope to take her to a local park for a walk (obviously we’ll be right next to her, just in case). The problem initially was her arm but now that we’re home the problem is 85% inability to walk. We still hope we’ll get her fixed, but if we don’t it won’t be as a result of having broken her shoulder.

This is really nuts. I wasn’t aware of this issue until now because we’ve not experienced it before, but hospitals and local authorities must be aware that it’s happening all the time.

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Isn’t this why there is so much “bed blocking”? People are worse after a stay in hospital than they were when they went in!

My own mum went into hospital able to walk with a Zimmer frame, but the ambulance staff left the Zimmer at home.
I was on holiday at the time of the admission, I saw mum 2 days later. The Discharge Nurse told me that they were about to discharge her…but there was no Zimmer by her bed. I therefore asked if she had seen mum walk? No!
I then insisted that mum had a full Continuing Healthcare Assessment before discharge, much to the annoyance of the nurse. After a physio assessment it was agreed that mum could not walk any more, and needed 2 nurses to hoist her at all times.

Then after a long delay, mum was off to the rehab hospital in Hampshire, happily nearer to me.
No rehab at all, they didn’t know that mum had been able to walk when first admitted to Royal Bournemouth.
Why not?
Because Royal Bournemouth is in Dorset, and the hospital local to me is in Hampshire. They had different computer systems that can’t talk to each other!!!
Mum hated being hoisted, it was incredibly painful as she had a rare spinal problem. It meant she had to spend her last year in a nursing home.

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Up to 8,000 deaths a year may be caused by rising bed-blocking.

Only early this year from the Daily Telegraph … posted in main NHS thread.

Turning / moving the patient within this ?

Nothing recorded as a factor when the academics look at the whole question of " Bed blocking. "

A little surprising as it’s obviously a factor !!!

Certainly a major factor when we look at unsafe hospital discharges !

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Is nursing training now too focussed on technology, not enough about personal care?

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I certainly think so. My parents were both trained nurses (met while training in the late 50s). Nursing was then a vocation and the main emphasis was on provision of personal care with kindness and efficiency, even though the course was also academic. The nursing auxiliaries also helped with care and with keeping the environment clean and safe.

It doesn’t work that way any more. During my aunt’s recent stay in hospital we barely saw a trained nurse, and the only cleaning was provided by one person who visited the ward once a day with a mop for the floor. I’m not sure who the people were who responded to calls for help from patients on the ward, but most of the time there was simply no time for the good ones to provide the help that was needed. My sister and/or I were there 6+ hours per day to make sure our aunt ate and drank, and I fell into the habit of trying to help on the ward by feeding, chatting, holding hands of distressed patients as there was simply nobody else to do it.

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Michael: Any interest in pursuing this campaign against unnecessary hospital bedrest by Carers Uk? So often your membership and local authorities are left to care for their loved ones who have been left immobile in bed for days/weeks etc., when they are capable of more…

Hi Rosemary. Thanks for your interesting point on the negative effects of bedrest. Carers UK offices reopen this Thursday, so once we’re back in the office we will pass on your comments to our policy team and get back to you. Wishing you a happy new year in advance.

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Thanks Lizzie. Happy new year to all!

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Whilst I think of it, frequently a reclining chair was not available, sometimes no chair was in mum’s cubicle at all. I was constantly demanding a chair or insisting the right one be provided, or that mum be put in the one next to her bed. Provision of a recliner approved by PT as being required on one ward needed to be reapproved by the new ward PT whenever mum was transferred to a different ward! I was told there were only three recliners for two large intake wards!

A standard trick was for the nurses and therapists to say they’d just started their shift so they were new on the ward! No hand over?? After I d had that excuse five times in three days from various staff, I told them I didn’t buy it. Staff looked at ward sister as if to say, “that excuse isn’t working on her!” .

Hospitals need to buy or lease the appropriate chairs for their patients! Costly? Perhaps, but much more economical than the social care and quality of life costs involved with those people when discharged to social services, families, care homes…