So just how fast does the Cascade of Dependency (AKA HOSPITAL ACQUIRED FRAILTY) happen?
Changes begin virtually overnight, and the stampede of systemic attacks on our bodies quicken.
UTIs, cognitive decline (no this isn't dementia), muscle wasting, pulmonary challenges, BP changes, etc., etc.
We've all seen this happen with older patients. Sometimes, they hit home a LOT harder.
This is my own grandmother who was VERY clearly mobile and healthy, and smart as a whip 2 weeks prior to her hospitalization.
In 2024, 75 years after we realized how detrimental bed immobility is.
For the first week in the hospital following a fall and surgery, she was to get PT 2x per day. 14 treatments ordered.
How many did she actually get? 2 times....TOTAL.
Never out of bed, never sitting up at bedside, she just laid in bed while her whole body shut down.
But she was seen by a number of 'specialists' as multiple systems were failing. Awesome, but they missed the root cause.
Family requested repeatedly for therapy and even nursing help to get her out of bed. Didn't happen.
Can we at least get her sitting up for meals? Didn't happen.
I should have flown out there to help. I didn't. I trusted the hospital would keep their promises to finally start getting her up. And then it was too late.
We finally got her into skilled nursing with the help of the orthopedist. I called ahead to give them the details and to ensure they got her moving and kept an eye on her--with her cognition now she may be impulsive and try to get up.
She did try to get up (even in her state, she didn't want to be stuck in the bed) and fell all over again. Back to the hospital and back to being confined in bed.
My family lost her in 3 short weeks. Several months later and the emotions for many of us are still raw.
Much of this is and was preventable.