Helping older people in hospital stay active: meet Dr Stephen Lim

Trained volunteers are supporting older patients to stay active during their hospital stay in a compassionate research study.

The selfless work is helping stop muscles getting weaker and the body from losing fitness when they’re not moving for a long time. This can lead to better outcomes.

Dr Stephen Lim is carrying out this project thanks to an NIHR Advanced Fellowship. It is called PIVOT: Promoting Increased physical actiVity in hospitalised Older adults with Trained volunteers.

Dr Lim is a Consultant Geriatrician at University Hospital Southampton (UHS). His research is supported by the UHS Research Leaders Programme.

He speaks about his research career and what he hopes to achieve during his fellowship.

What is the focus of your fellowship?

My project aims to encourage older adults in hospital to stay active. This helps prevent muscle wasting and physical deconditioning - a decline in their physical function, fitness and muscle strength due to prolonged inactivity, such as bed rest.

We're doing this by training hospital volunteers to work alongside physiotherapists. These volunteers engage patients in chair-based bedside exercises or take them for short walks, helping to reduce sedentary behaviour.

This is an implementation feasibility study. This means we're testing how well this approach works in different hospital settings.

The original trial, which formed the basis of my PhD, was conducted in Southampton. Now, thanks to the fellowship, we’re expanding to a multicentre trial across three hospitals, with a fourth acting as a control site.

We're exploring how different contexts – such as hospital size and volunteer availability – affect the success of the intervention. We’re also investigating what adaptations might be needed to roll it out across the NHS.

Building on this work, we have also collaborated with researchers from the NIHR Southampton Biomedical Research Centre to test the feasibility of training hospital volunteers to engage with older adults living with frailty to exercise and eat well following their hospital stay.

Why is this research necessary?

Hospitals are essential when someone is unwell, but they can also contribute to physical decline in older patients. A change in environment often leads to increased dependency, such as meals being brought to them and tasks being done for them. Being unwell also reduces energy levels and appetite. This all means they move less.

Research shows that 30-60% of older adults lose physical function during a hospital stay. This loss can significantly impact their quality of life. Our goal is to preserve that function as much as possible, helping older people maintain independence and wellbeing.

Why did you apply for the NIHR Advanced Fellowship?

The NIHR Advanced Fellowship is designed for postdoctoral researchers. It’s been incredibly valuable.

It funds both my clinical and research time, allowing me to continue working as a Consultant Geriatrician at UHS, while also leading a research team. This dual role means I can stay connected to clinical practice, and ensure my research is grounded in real-world needs.

How has research career support enabled you to apply for this fellowship?

The UHS Research Leaders Programme provided important protected research time which allowed me to develop my NIHR fellowship application. The Southampton Academy of Research (SoAR) were supportive and provide guidance, advice and signposting to experienced researchers who provided input into my fellowship application. I had guidance from mentors, some now retired, who reviewed my application and provided sound advice.

The university’s Research and Innovation Services (RIS) team and NIHR Research Support Service’s input were both helpful. The helped organise reviewers and mock interviews to help prepare me for the fellowship application process.

Having experienced researchers and other senior colleagues within Southampton review my application proved invaluable. Their feedback really strengthened my application.

What impact has the fellowship had on your career?

It’s been transformative. The fellowship has given me the time and resources to focus on delivering the study, developing as a researcher and building a research team to deliver on our programme of work in healthy ageing research.

It supports mentorship, training, and collaboration. I’ve been able to present at global conferences, expand my research network, and strengthen my leadership skills. It has given me the opportunity to take on leadership roles with the NIHR Applied Research Collaboration (ARC) Wessex and NIHR Research Delivery Network.

What advice would you give to others considering a fellowship?

Go for it! Fellowships can be career-defining. They give you protected time and open doors for growth. My advice is to start preparing early, ideally a year in advance, and aim high.

NIHR values ambition, not just for your personal development but for your team, your organisation, and most importantly, for patients. Think about how your work can contribute to the wider research community to improve health and care outcomes.

What do you value about your work?

I love being able to do both clinical work and research. Seeing patients helps me identify real-world problems and research gives me the tools to find solutions.

It’s incredibly rewarding to translate clinical challenges into research questions, and work with others to improve patient care.