Editorial

It’s not always kind to keep older people in bed

Nurses can promote the health and well-being of people living with frailty by encouraging mobility and social activities, and countering vulnerability

Nurses can promote the health and well-being of people living with frailty by encouraging mobility and social activities, and countering vulnerability
Picture: Tim George

In geriatric medicine and nursing older people, we often say ‘it’s not about age’, which could be viewed as inaccurate given our specialty is defined as the care of people aged over 65. However, we do not define patients by their chronological age.

We view our patients holistically and know that chronological ageing does not always match an individual’s level of fitness or frailty. We understand that age and frailty are not intertwined; rather, fitness and frailty are on a spectrum, not a linear course on par with ageing.

Caring for people with multimorbidity is the foundation of practice

However, frailty is more prevalent with increased age and in individuals with multimorbidity. As nurses, particularly as gerontological nurses, caring for older people and people with multimorbidity is the foundation of our practice.

We are ideally placed to assess for frailty, intervene to reduce the risk of iatrogenic harm and improve the lives of people living with frailty – but only with an understanding of and respect for the syndrome.

For example, decreased mobility and decreased social activity can be common in acute illness and acute hospitalisations. For those who are fit and healthy, these factors may not be much more than a minor annoyance, but for someone living with frailty they could trigger a catastrophic deterioration in health and well-being.

As #EndPJparalysis creator Brian Dolan, nurse and honorary professor in leadership in healthcare at the University of Salford, said in a Nursing Older People analysis on patient mobilisation: ‘We are killing a patient with kindness when we keep them in bed’.

Awareness of frailty helps us to protect older people from vulnerability

Frailty is synonymous with vulnerability, delirium, falls and deconditioning, to name but a few. Awareness of frailty and associated vulnerability allows us the opportunity to take measures to counter vulnerability.

My CPD article explores frailty and what we, as nurses, can do to promote the health and well-being of people living with frailty.


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