Purpose <p>Older adults hospitalised for acute illness are highly vulnerable to functional decline, often exacerbated by inactivity. Although exercise interventions may reduce this risk, uncertainty remains regarding how such programmes should be designed and tailored for frail patients. Embedded within the PREV_FUNC randomized controlled trial, this study explored older patients’ experiences of two in-hospital exercise programmes.</p> Methods <p>This qualitative study was conducted at a geriatric hospital in Stockholm, Sweden. Using an inductive approach within a constructivist paradigm, semi-structured interviews were conducted with 24 patients aged ≥ 75&#xa0;years who had participated in either a comprehensive or a simple exercise programme. Data were analysed inductively using reflexive thematic analysis.</p> Results <p>One overarching theme emerged: Structured exercise disrupted inactivity and sparked hope for a turning point. This theme comprised four subthemes: Exercise awakens hope for improvement; Getting out of bed can be challenging; Overall confidence in structured exercise; and Support from the physiotherapist is crucial.</p> Conclusion <p>From the patients’ perspective, the exercise programmes helped break periods of inactivity and fostered hope for recovery. These findings suggest that in-hospital exercise may support physical activity in geriatric wards, although individual adaptation and support remain essential.</p>