Irene is a feisty 90 year-old.

She lives in the community in her own home with her daughter Margaret. She has survived two husbands, lived through the Second World War bombings, was sold into servitude at age eight and bought herself and her sister out by age twelve.

She has had two hip replacements, has profound hearing loss and often jokes with a smile that she may be easy but she’s not cheap.

She has worked all her life, retiring at age 75 from her last position as an elementary school supervision aide. She smokes a package of cigarettes a day and loves to eat fish and chips. She is a strong, smart woman with a lifetime of experience.

Yes - she has opinions about her health care. Yes - she can articulate her needs and preferences.

However, two years ago she fell down 17 stairs fracturing her wrist.

Despite numerous attempts to convince health professionals that her arm was not set properly she was sent home from hospital (with c. difficile).

It has taken Irene 18 months to recover with limited use of her wrist and hand. How is it that a feisty, articulate smart woman like Irene could not make her health needs known or acknowledged?

Drs. Sims-Gould and Byrne and Ms. Hicks are examining patient and family experiences after a hip fracture.

With a focus on the use of health information, we are employing ethnographic methods, including face-to-face interviews, observations and document review.

We are talking to and observing patients, their family members and health care providers involved in their care - starting in acute care and following them through the continuum of care.

Findings will inform quality improvement initiatives for older hip fracture patients and contribute to family caregiver support programming as hip fracture patients move from hospital to home.

Patients and families are the common linking thread from hospital to home – our research will underscore their perspectives and enhance the emerging body of research on patient and family perspectives of care transitions.

For more information on this project: http://www.inforehab.uwaterloo.ca