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Hospital-associated deconditioning — SCE Geriatric Medicine MCQ

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ModerateRehabilitationHospital-associated deconditioningSCE Geriatric Medicine

An 86-year-old man with moderate frailty has community-acquired pneumonia. On day 4 his infection markers improve, but he is now bedbound, has postural dizziness and needs two assistants to transfer; he walked independently indoors before admission. NEWS2 is 1, Hb is 118 g/L and lying-standing BP falls by 28 mmHg systolic. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Start an early multidisciplinary rehabilitation plan and treat reversible contributors to deconditioning

Functional decline during admission is often driven by deconditioning, bed rest, orthostatic hypotension, nutrition and delirium risk. The appropriate response is early MDT rehabilitation with attention to reversible contributors such as hydration, medication and mobilisation. A nursing home decision at this stage would be premature. Older adults can lose function rapidly in hospital, so rehabilitation must begin during acute care.

Reference: JRCPTB geriatric curriculum; BGS CGA guidance