Rehabilitation in Seniors after Surgery for a Hip Fracture
Hip fractures are a major cause of disability and also have complications that can lead to early death in seniors. Fractured hips among seniors are mainly the result of falls. Some seniors will die of complications within the first year and some will go on to be rehabilitated and will eventually learn to walk again.
Normally, rehabilitation begins within the first 24 hours after the patient has come out of the recovery room after surgery to repair a fractured hip. Patients must not lie too much in bed to prevent blood clots and to keep their muscles from getting atrophied and weak. For some seniors, however, the rehabilitation for a hip fracture can be very long and expensive, as sometimes they cannot get out of bed, cannot learn to sit in a chair or do the exercises necessary to strengthen muscles in order to start walking again. In fact, 25-75% of seniors who survive the first year after the surgery will not be able to ever be rehabilitated to the physical state they were in before they fractured their hip. However, it is very important for family members and the staff not to convey a hopeless outlook to the recovering senior, but to do their utmost to keep up their morale. To this end counseling may be necessary for both the patients and their families.
Physical therapists will teach them how to do exercises to be performed every day to strengthen muscles in their arms, torso and leg muscles.Those seniors who were in good shape before the hip fracture may be able to keep up with some of these exercises and will eventually walk again although they may need a cane, crutch or walker.
Most complications show up in the first year after surgery. Most complications are medical like blood clots, pneumonia, urinary tract infections (UTI), heart and lung problems and bleeding. However, about 10% will have neurological and cognitive complications.
After about a week after the surgery, patients will be encouraged to begin walking usually with a crutch or sometimes with a walker. They will also soon be taught how to climb stairs, depending on physical condition of the patient. However, recovery and rehabilitation will take much more time in a senior who was not in the best physical condition before the hip fracture took place. This is especially true for seniors with osteoporosis. It is estimated that only about 50% of seniors who were independent and functioning well before the hip fracture will be able to walk again without a cane, crutches or a walker. The main focus on treatment in seniors is how to get them into the best quality of life possible. For some this will mean having to leave their homes and go into short or long-term care rehabilitation facilities.
The social worker’s job is to help the family decide what kind of rehabilitation is best for the senior recovering from a fractured hip and advise them to what extent insurance and medicare will pay for their treatment.
The main focus after a hip fracture is to find the best quality of life possible for the afflicted senior and to this end doctors, families, physical therapists and social workers all work together to decide what kind of rehabilitation is most suitable for the senior to regain a hold on life.