Abstract Background Low levels of physical activity in older patients during hospitalization have been linked to loss of functional ability. Practical methods of measuring physical activity are needed to better understand this association and to measure the efficacy of interventions. The aims of this study were: to evaluate the feasibility of using accelerometers to discriminate between lying, sitting, standing, and standing and moving; and to determine the acceptability of the method from the patients’ perspective. Methods A convenience sample of 24 inpatients was recruited. Participants wore accelerometers on their thigh and on their lower leg (just above the ankle) for 48 hours during their hospitalization. Postural changes and movement during the 48 hours were differentiated using derived pitch angles of the lower leg and thigh, and non-gravity vector magnitude of the lower leg, respectively. Results On average, patients were lying for 61.2% of the recording time, sitting for 35.6%, standing but not moving 2.1%, and standing and moving 1.1%. All participants found the accelerometers acceptable to wear. Conclusions The methodology described in this study can be used to differentiate between lying, sitting, standing, and moving, and is acceptable from a hospitalized older person’s perspective.