UP 4 Mobility

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Let’s move to a healthier you in the hospital: Get moving to keep your mind and body health!

MYTHS about moving

"I'll get better faster if I stay in bed to rest."

Studies show that patients who are more active in the hospital tend to have shorter stays (Liu, et al., 2018)

"It's not safe for me to get out of bed."

Staying in bed is a health risk. Rarely is it not safe for a patient to move at all.
Talk to your health-care team about what you can do safely.

"I'm not supposed to do my personal care, such as washing or dressing."

Doing or helping as much as you can with your personal care is a great way to add some movement to your day.

FACTS about moving

Your body will thank you for getting out of bed at the hospital. Being more active can improve your:

Brain health:

Less confusion and dizziness
Give you better sleep & mood

Skin health:

Prevent skin problems like pressure injuries (bed sores)

Lung health:

Improve your breathing
Fight infections better

Stomach health:

Improve your appetite
Lower your risk of choking
Help with constipation

Heart health:

Improve your circulation
Improve your blood pressure

Muscle and bone health:

Keep your strength
Prevent injuries from falls
Reduce joint stiffness

Muscle and bone health:

You can lose 1-5% of your muscle strength for each day that you stay in bed at the hospital.

Losing strength can make you more likely to fall, have skin problems, become confused, or stay longer in the hospital.

There are simple and easy ways to keep moving and active while you are in the hospital!

[source: MOVE Canada]

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HOW to get moving

At Sunnybrook, we identify your mobility level based on how safely you can move. Below is a list of what each level means:

Mobility Level
A1	I can walk by myself
A2	I can walk with assistance
B	I am able to move from bed to chair
C	I cannot stand to move to a chair

WHAT can I do to move?

There are many ways to be active during your day! We have some guidelines on how to get moving in hospital using your everyday routine. The next few cards have some suggestions based on how you or your loved one moves right now.

1 / 2 - Next: WHAT can I do to move?

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I move by myself or with some help: Mobility Level A1 or A2

Transfers

Move out of bed as often as you can.

If needed:

Family, visitors or your health-care team can help.
Walkers and canes are available.
Use the call bell to ask for help.

Eating

Sit in a chair for all meals.
Even if you are not eating, it is important to get in the habit of sitting during mealtimes.
Stay sitting for 30 minutes after each meal.

Toileting

Walk to the bathroom for toileting.
If you have a catheter or other lines, take them with you or use your call bell to ask for help.

I move by myself or with some help: Mobility Level A1 or A2 (continued)

Grooming

Stand or sit in a chair at the sink to do your grooming activities, such as:
Brushing your teeth, brushing your hair, washing your face, or shaving your face

Dressing

Put on your regular clothes and shoes during the daytime.
If needed:

Family or staff can help.
Sit down in a chair or at the side of the bed while you get dressed.

Bathing

Stand up to shower on your own.
If energy or safety is an issue:

Sit on a commode or shower chair
Family or staff can help or supervise

Talk to the occupational therapist or physiotherapist on your health-care team if you have trouble doing an activity on your own. They can show you tools and give you tips to make these activities safer and easier.

If your family plans to help you with these activities, please have them talk to your nurse or therapist first to make sure they learn how to safely and effectively help you.

1 / 3 - Next: I move by myself or with some help: Mobility Level A1 or A2 (continued)

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I move with lots of help or with a lift: Mobility Level B or C

Transfers

Make a plan with your health-care team to move out of bed at least once a day.
Your health-care team and/or equipment can be used to help you move.
Ask your health-care team if family or visitors can help too.

Eating

Make a plan to sit in a chair for at least one meal each day.
If staying in bed:

Ask for help to sit at the edge of the bed to eat, or
Use your bed controls to sit all the way up to eat.

Bathing

Sit on a commode or shower chair to shower.
If safety or energy is an issue:

Ask family or your health-care team to supervise.
Try taking a sponge bath while sitting up.
Help by moving yourself as much as you can while you get a bed bath.

I move with lots of help or with a lift: Mobility Level B or C (continued)

Grooming

Sit in a chair at the sink to do your grooming activities, such as:

Brushing your teeth, brushing your hair, washing your face, or shaving your face

If staying in bed:

Ask for help to sit at the edge of the bed, or
Use your bed controls to sit all the way up and ask for help to set-up the items you need.

Toileting

Make a plan with your health-care team to move to a commode chair for toileting.
If you are unable to get up to a commode, help position your body to use the bed pan or urinal.

Dressing

Help out as much as you can to put on your regular clothes or the hospital gown.

Talk to the occupational therapist or physiotherapist on your health-care team if you have trouble doing an activity on your own. They can show you tools and give you tips to make these activities safer and easier.

If your family plans to help you with these activities, please have them talk to your nurse or therapist first to make sure they learn how to safely and effectively help you.

1 / 3 - Next: I move with lots of help or with a lift: Mobility Level B or C (continued)

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Energy Conservation

It is important to conserve (save) physical and mental energy so you have energy during the day to get moving and do activities you enjoy. Use the Four P’s when you think about your day:

Prioritize: Think about what is important to do each day and focus on them first. Ask yourself:

Does this need to be done today or can it be done later?
What part of my care routine can I do, by myself or with help?
How can I plan my day to save energy to do the things that I enjoy?

Pace: You don’t have to do everything all at once.

Plan breaks so you rest before you become tired.
Think about how you can split a task up into smaller steps.
Move slowly and don’t rush yourself.

Plan: Make a plan before you start. Do the hardest tasks when you feel rested or have the most

Spread out the hard and easy tasks so your body has time to recover in between.
Give yourself extra time to do things and take breaks.
Have a back-up plan for times you are not able to do things on your own.

Position: Think about how to position your body to do activities using the least amount of energy.

Standing or sitting hunched over for too long can make you more tired.
Doing an activity while sitting can use up to 25% less energy compared to doing things while standing.
Set up items you need to use close to you before you start.

1 / 5 - Next: Prioritize: Think about what is important to do each day and focus on them first. Ask yourself:

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Resources: Here are some resources if you would like to learn more:

Track Your Progress!

Set a mobility goal with your nurse, occupational therapist, or physiotherapist. Look for the tracking sheet in your room or ask a team member for one.

You may also download the tracking sheet here (PDF).

Other exercises

You can get moving by walking and helping with your personal care routine as much as you can, as long as it is safe. Here are some exercises to try when you have energy and time in the day. Only do these exercises if they do not cause pain. Make sure you talk to your health-care team before you start any of these exercises to make sure these exercises are safe for you to do.

Physical Activity sheets from the Regional Geriatric Program of Toronto

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UP 4 Mobility: It’s Important to be active while you are in the hospital