QUESTION: My elderly mother slipped in the rain and broke her hip and is now looking at a lengthy recovery. Is there anything she can do (once she’s healed) to improve her balance and mobility? What are some suggestions for older folks to stay active?
Dr. Raskin: Do you remember the 1980s commercial with the elderly woman who fell in her bathroom and said, “I’ve fallen and I can’t get up!”? It’s a good reminder of how often this scenario happens, and you need to be prepared.
Hip fractures are a major public health problem with more than 300,000 reported annually in the United States alone. Studies show that shockingly, even if an elderly person is in excellent health, a patient with a hip fracture faces double the risk of dying within the next year compared with a patient without a hip fracture.
This scary statistic is most likely due to the fact that hip fracture patients typically spend time in the hospital, which makes them more susceptible to infections such as pneumonia. In addition, because patients may become more immobile due to pain, they are more likely to get blood clots, which can be deadly.
Before I get to advice on improvement after healing, it is important to discuss fall prevention in the elderly.
First, as we age, bones can become more brittle and susceptible to fracture. All elderly people—especially women—should talk to their doctors about osteoporosis. Screening can be done easily with a test called a DEXA scan. I have one of these machines in my office, and I urge all my age-appropriate patients to have this test. Be sure to discuss your results and treatment options with your doctor.
I also suggest that all older patients review their medications—both prescription and over-the-counter—with their doctor to see if any of them could make them sleepy or dizzy, which increases the risk of a fall.
Regular vision checks, wearing appropriate footwear and having safety bars in bathtubs and showers are other important preventive strategies to reduce fall risk. Don’t forget about adequate lighting in the home and reducing clutter to prevent tripping over things.
Alas, the slippery road from the rain, as you described, is something that cannot be prevented, especially with winter storms expected this year due to El Nino.
Following a hip fracture, the most important thing is to improve strength and get back on your feet. Your mom should work with a good physical therapist at first to learn the best exercises and proper technique. Exercises that improve leg strength and balance are the most crucial.
After the initial recovery phase, continuing with exercises such as Tai Chi can really help improve mobility.
Keeping older folks active often takes work. Gently push and encourage your mom. It may help to take some exercise classes with her or get her in an organized group of her peers so it becomes a social event as well as a physical outing.
If she lives alone, visiting often or hiring a caregiver are ways to make sure she gets out of the house and stays more active. Also, make sure she is eating and sleeping well as both are vital to her stamina and vigor.
That 1980s commercial is a good reminder for elderly people to have some type of medical alert system that allows them to push a button to call for help if they have fallen and are unable to reach a telephone. Getting help immediately is imperative to prevent further complications.
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