OVERVIEW: In older adults who are hospitalized, functional decline can occur in a matter of days. This devastating outcome is a common result of the older adult’s “cascade to dependency,” in which normal aging changes—combined with bed rest or immobility—result in irreversible physiologic changes, poor outcomes at discharge, and for many, placement in a nursing home. Routine walking schedules, activities to prevent sensory deprivation, and timely hospital discharge are among the interventions that can help prevent functional decline.