Hip Fracture & Fall Prevention in the Elderly

Hip Saver - Hip Protectors

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What is a Hip Fracture?

Why is hip fracture prevention so important? Hip fractures usually occur in the femoral neck (the part of the femur, or thighbone, that connects to the ball that fits into the hip socket) or the trochanteric area (the area below the neck of the femur). The trochanteric area is the most vulnerable to fracture. It lies at the very top of the thigh bone in close proximity to the pelvic joint.

The trochanter feels like a small bony elevation on the side of the hip. This ball will notably move, when the knee is slightly raised. Most people can locate their trochanter by placing the fingers on the side of the hip whilst standing and slightly raising their knee. The trochanter should not be confused with the pelvic bone that is located higher and further towards the front of the body and does not move on raising the knee.

Hip fractures are usually treated with orthopedic surgery (surgery that corrects problems of muscles, bones, and/or joints). Sometimes damaged parts of bones or joints are replaced with artificial components.

Hip fractures are most commonly sustained during a fall. Falls and hip fractures have serious implications on an elderly persons' life as the consequences can be very severe. There is a high degree of morbidity and mortality, pain and hardship. The majority of people suffering hip fracture never regain their previous mobility and permanently lose their independence. The costs to the health services and social care systems are extremely high. Preventing hip fractures is, therefore, of the utmost importance.

Hip fractures are a major public health problem. In the U.S. alone the cost of hip fracture is approximately 7 billion dollars annually, and hip fracture is the second most common cause of admission to nursing homes, accounting for some 60,000 admissions each year. Osteoporosis in the elderly contributes to most of these fractures. Many elderly patients who break a hip face a broad array of problems that transcend the treatment of the injury itself. In many cases, an elderly person's independent existence is impacted by a fall that causes a hip fracture, an event that can forever lessen the patient's level of function. Medical treatment for hip fracture can lead to complications in older people depending on their health status.

Rehabilitation from hip surgery often is prolonged and discouraging to aged patients anxious to return to their homes. Confusion and agitation result from depression, a condition often experienced by the elderly when they have been removed from familiar surroundings and brought to the hospital environment. This injury may be complicated by the failure to regain the ability to walk, sores resulting from persistent pressure on the skin during confinement to bed, pneumonia, confusion and dementia (decreased intellectual functioning). Osteoporosis in the elderly contributes to most of these fractures.

How are Hip Fractures caused and how are they treated?

YES! The chance of sustaining a hip fracture can be greatly reduced by putting some simple procedures in place. Some Hip Fracture Prevention Strategies include:

The prevention and treatment of osteoporosis
Falls prevention strategies and implementation
Protection of the hip with external hip protectors
Hip fracture prevention is very important !

Can Hip Fractures be prevented?

Assesment. Elderly nursing home residents, especially those who have previously had a fall, should be assessed to confirm all individual risks.
Hip protection. Hip protectors should be offered to all residents who are at risk of falling.
Medication. Reviews should be carried out as part of falls risk assessment.
Education. Falls risk minimisation training should be provided for all staff in residential aged care facilities.
Exercise. Programmes that improve strength, balance and reaction times may be implemented by trained personnel for fall provention in the elderly

Fall Safety in Nursing Homes and Hostels and other Residential Aged Care Facilities with falls prevention strategies for fall prevention in the elderly

Information given to older people during falls prevention programmes and during rehabilitation of those who have fallen is likely to be better understood and acted upon when supported by written materials. Professionals involved with the preparation of informative materials should ensure that the written materials and the key messages are standardised throughout the institution to prevent costly duplication and potential confusion.

Following are some elements which may be considered in falls prevention programmes. These basic suggestions are presented as a guide only to enhance the implementation of best practice principles and should not replace the clinicians judgement in each individual case.

The following are some simple things that can be done to help prevent falls in the home:

Remove loose mats or ensure they are firmly secured and have non-slip underlays. Always wipe up spills as soon as they occur.

Place nightlights in dark passageways or stairs to provide light at night.

Lay non-slip flooring in the bathroom.
Paint on or stick non-slip strips in the shower and bath.
Arrange your kitchen so the most frequently used items are easy to reach.
Make sure all outside steps are highly visible by painting the front edge of the step a contrasting colour or by adhering non-skid treads.
In the lounge room, high chairs and chairs with solid armrests are easier to get in and out of.
Do not place fans and heaters in walkways or in the middle of the room.
Have a light within reach of your bed. Consider a touch lamp or night lamp, and keep a torch next to your bed at night.
Wear shoes and slippers that have non-slip soles, patterned tread, and rounded broad heels.
Have regular eye checks - poor eyesight can cause you to trip or slip and fall.
See your doctor if you are experiencing dizziness or fainting.
Ask your doctor about the possible side effects of any medication that you are taking.
Exercising regularly to help to maintain the strength of your muscles and bones.
Discuss your health concerns with your doctor, a nurse or a health visitor.

Fall Safety in the Home

Reduce Slips, Trips and Broken Hips

Most falls occur at home, so it is important older people ensure the likelihood of a slip, trip or fractured hip in their home is reduced. As we get older the risk of a fall increases for many reasons such as impaired eyesight and mobility, poor balance, effects of medications (especially if several types are being taken), or simply due to an unsafe home environment.

Because the effects of falls in older people can be devastating, falls prevention strategies are extremely important - however, all falls simply cannot be prevented and seniors continue to fall. It is very important therefore to give very serious consideration to the wearing of hip protectors to protect the vulnerable hips and to protect against devastating hip fractures.

Remember -not all falls can be prevented and despite all efforts our seniors continue to fall. If you have had a fall recently, or are at risk of falling, protecting the vulnerable hips with hip protectors should be given very serious consideration along with other falls prevention strategies