Devising a new model for hip fracture recovery
A fall-related hip fracture is often devastating for older adults. As many as 20 per cent of people die in the following year. Up to half never regain their previous level of mobility and face a risk of further falls, fractures and loss of independence.
The Centre for Hip Health and Mobility, with funding from the Canadian Institutes of Health Research, is trying to understand why some older adults recover faster than others. The outcomes of patients receiving standard orthopedic and post-operative rehabilitation treatment are being compared with the outcomes of others enrolled in a clinic at St. Paul’s Hospital, led by Wendy Cook, where they receive enhanced care and follow-up.
That extra attention includes an overall geriatric assessment, a cognitive and functional assessment by an occupational therapist, and a balance and gait assessment by a physical therapist. Patients taking sedatives – which raise the risk for falls – are more closely evaluated, and given guidance on sleep hygiene, relaxation and anxiety management, in conjunction with sedative tapering. Those with urinary urgency – another risk factor for falls – are evaluated with an eye toward optimizing their medication, diet and fluid intake. Patients also return for weekly balance practice sessions.
“We believe the additional assessment and follow-up with appropriate multi-disciplinary team care is the differencemaker for optimum recovery,” says Dr. Cook, a Clinical Assistant Professor in the Division of Geriatric Medicine.
The average hospital cost of a hip fracture resulting from a senior falling is $18,508, and the annual average hospital costs for all senior hip fracture hospitalization cases in B.C. is over $75 million. With an aging population, the number of falls – over 225,000 a year – will likely double in 20 years if prevention strategies are not in place.
“There is an enormous economic and social burden related to fall-related fractures in older adults, and we need to aggressively seek community-based solutions in falls management and prevention,” says Maureen Ashe, an Assistant Professor in the Department of Family Practice and a Research Scientist at the Centre for Hip Health and Mobility, a UBC-Vancouver Coastal Health research partnership.
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