Walkabouts’ for the elderly shorten their hospital stays

Study finds mild exercise such as walking helps patients; IMA announces doctors’ sanctions if the current labor dispute is not resolved.

By JUDY SIEGEL ITZKOVITCH
Doctors demo311 (photo credit: Marc Israel Sellem)
Doctors demo311
(photo credit: Marc Israel Sellem)
If the health system wants to reduce the length of elderly patients’ hospitalization and save money, the simplest way to do so is by encouraging them to walk around the wards.
This is the lesson of a new University of Haifa study that found such simple exercise significantly cut the number of days these patients stayed in the hospital.
“Given the over-occupancy of many hospitals, this finding can be of great importance,” said Dr. Efrat Shadmi and Dr. Anna Zisberg of the University of Haifa’s nursing department.
The study was funded by the Israel Science Foundation and just published in the Archives of Internal Medicine journal. Shortening elderly patients’ hospital stays by getting them walking in the internal medicine departments is equivalent to increasing the number of beds, nurses and doctors – a major achievement given the last four months of hospital strikes and sanctions.
The study surveyed 485 participants aged 70 and older, who were hospitalized for at least two days in the internal wards of an Israeli hospital. Their physical condition was determined by questionnaires; those who were confined to a bed or immobile were excluded from the study.
Patients who were not restricted in mobility were asked about their physical activity during the course of their hospitalization. Based on their answers, they were divided into two study groups – those who remained in bed or seated next to it, and those who walked around their rooms and the ward.
The study found that all the patients who walked around shortened their hospital stay by an average of 36 hours, compared to those who did not exercise physical mobility.
The study found, in addition, that those who walked around the ward on their first day of hospitalization shortened their stay more than the others. This was found to be relevant regardless of the patients’ health status.
The University of Haifa researchers said older patients might mistakenly believe that when they are hospitalized, they must stay in bed. But the opposite is true.
“The muscle’s reserve capacity can decompose quite quickly in older people.
If they shift from a mode of mobility – even if it was minimal – to a state of almost complete immobility, and even for just a few short days of hospitalization, they could very quickly lose their muscle reserves, resulting in more difficulties functioning and other complications. This study, along with other new studies in the area, shows that walking really does pay off,” Shadmi and Zisberg wrote in the journal.
They also noted that the study results show that simple intervention to encourage walking in the geriatric internal medicine wards ought to be considered seriously, especially in the current period of the Israel Medical Association’s labor strife.
Meanwhile, the IMA has announced doctors’ sanctions for the next week if the current labor dispute is not resolved. On Thursday, outpatient departments, day hospitals and diagnostic institutes in general, geriatric and psychiatric hospitals will be closed to receiving patients who are not already hospitalized.
But physicians will be on the job to give consultation to patients in the wards.
Only emergency and oncological surgery will be performed.
All other hospital activities will be conducted normally on Thursday.
On the same day, medical facilities in the community will also be affected. Clalit Health Services’ clinics in the North, Central, Jerusalem and Tel Aviv will be shut.
However, gastro, oncological day clinics, dialysis and invitro fertilization will function in those districts.
On Friday, all medical facilities will function according to their usual reduced schedule, and on Saturday, the usual Shabbat schedule will be in force.
On Sunday, August 14, a general strike will force a reduced Shabbat schedule on all general, geriatric and psychiatric hospitals around the country. In addition, Clalit’s community clinics will be shut except for the above-mentioned clinic services. On Monday, work will go on as usual.