Tackling PJ paralysis in long-term patients

Earlier this year, a global social movement challenge was organised to try and raise awareness of the benefits to hospital patients of being up and dressed, rather than remaining in bed in their nightclothes.

The challenge was embraced by occupational therapy and other health staff across the country, and #endPJparalysis launched on social media in April 2018. It was a 70-day challenge to encourage as many patients as possible to get out of their pyjamas, get dressed and start moving about.

As occupational therapists, we have long known the benefits of our patients being able to engage in the everyday activities that matter most to them. Being dressed, rather than remaining in your nightclothes, gives patients more dignity and choice and makes them feel more like themselves. The ultimate aim is for patients to have a quicker recovery and, where possible, reduce their stay in hospital.

For older adults, in particular, even a short space of time like a week can mean a significant loss in muscle bulk and strength, which can put them at greater risk of falls and increased dependency on others. Getting people dressed and moving early in their recovering aims to improve their motivation and general feeling of wellbeing.

The national challenge was taken up by a number of professionals across the country including occupational therapists, physiotherapists, nursing and other health staff involved in patient care. Staff were asked to monitor the number of patients who became dressed and mobile on the wards and in care settings, who would normally have remained in their nightclothes.

The importance of everyday activities

The impact on patients who remain in bed and not dressed is well documented. If patients remain in bed unnecessarily, they often fail to engage in everyday activities and their dependence on others to help them with simple tasks such as dressing, feeding and toileting can increase. This can result in longer periods of rehabilitation and longer hospital stays. In some cases, patients lose mobility to the extent it can affect their ability to return to their own homes. Older adults are at particular risk of this so-called PJ paralysis.

The perception of others is also a key factor in terms of encouraging patients to be up and dressed. Visitors and other care staff are more likely to perceive individuals who are dressed as people who are no longer unwell but able to engage in more tasks and conversations. This can further have a positive effect on the patient’s experience and motivation to engage in rehabilitative tasks.

As part of their professional programme, Occupational Therapy students have to undertake a minimum of 1,000 hours working in a health or social care settings. Occupational therapists are trained to understand the impact of everyday tasks and activities on a person’s wellbeing. Occupational therapists call these activities ‘occupations’.

The more meaningful and achievable occupations can be for individuals, the greater the link to positive mental and physical health and wellbeing. The #EndPJparalysis campaign links well to the values of the occupational therapy profession.

The #endPJparalysis campaign

During their practice placement modules, many of our students have been involved in the #endPJparalysis campaign. To celebrate national Occupational Therapy Week 2018, pre-registration occupational therapy students at the University of Derby chose to incorporate this campaign into a week of events to raise awareness.

Students and staff have worn their pyjamas to class to promote discussions on campus about the importance of patients being in their everyday clothes, both in terms of how they feel about themselves and how others perceive their abilities. They hope that by wearing their PJs around campus, they can engage other students and staff in conversations about the importance of rehabilitation and the work of occupational therapists in all health and social care settings.

You can find out more about the national campaign #endPJparalysis on their website.