Should elderly patients be made to sit in chairs?

As a geriatrician I have encountered innumerable distressed elderly women in hospitals and nursing homes slumped and sliding out of chairs and begging to be allowed to lie down. What is the evidence that elderly patients benefit from extended periods of sitting in chairs? How many patients need further investigation or palliative care rather than “mobilisation”? What about patients' rights to reject such “treatment”?

Surgeons introduced early “ambulation” after operations in the 1940s as an alternative to the time honoured tradition of nursing virtually all patients in bed. As curative surgery and other treatments became available, it was realised that prolonged inactivity not only did not help but might even retard recovery. An army of physiotherapists was recruited to help patients walk and become independent after treatment.

Prescribed bed rest is not the same as rest resulting from felt need

The most famous advocate of ambulation for elderly patients was Richard Asher, a humane iconoclast who liked to poke …