Broken hips in the elderly can lead to death

Yesterday, I posted a link to a story about hip protectors not reducing the number of broken hips among seniors in nursing homes. According to the National Center for Health Statistics; Centers for Disease Control and Prevention; 2003 National Hospital Discharge Survey, there were about 345,000 hospitalizations of elderly men and women in the US during 2003. Statistics show that only 1 of 4 patients recovers completely and nearly 1 in 4 will die within a year of the fracture because of complications.

Broken hips among the elderly is a serious problem. What makes it such a problem is not the broken hip itself, but all the issues that surround it.

Picture this: a healthy 75-year-old, walks daily, is fully independent at home and is happy with her life. She visits her grandchildren and volunteers in her community. One morning, she slips on the stairs, falls, and breaks her hip. She’s brought to the emergency, where she waits to be seen. The doctors admit her so they can operate and replace the broken part.

While waiting, she can’t move, she can’t go to the bathroom without help. Her pain level is sky-high. So, this previously active woman is now lying in bed, completely dependent on others to help her.

She has her surgery and works on recovery. However, her bedrest has led to pneumonia (How Can You Die from Pneumonia?), or because she couldn’t urinate in a bedpan, she was catheterized and may develop a urinary tract infection.

She has little appetite because she isn’t moving around, has pain, there’s no-one to help her, and/or doesn’t like the food. The lack of appetite makes her lose weight and get weaker.

She could develop confusion from the pain, the different medications she’s given, or an infection. The hip may not heal, causing further problems. And the list goes on.

While these scenarios are all maybes and perhaps, they happen and they happen often. To the point that this once healthy, active person is now dependent on others and may not be able to live alone again. According to the American Geriatrics Society Foundation for Health in Aging, for seniors the risk of death in the year following a hip fracture is as high as 20% to 25%. The rate varies depending on the person’s sex, age, race, physical condition, and previous medical history.

Women are more prone to breaking a hip, 2 to 3 times more often than men. Hip fracture rate doubles every 5 years or so after the age of 50 years. The American Academy of Orthopaedic Surgeons reports that white, post-menopausal women have a 1 in 7 chance of fracturing a hip, and that almost half of women who react the age of 90 years fractured a hip.

What can be done to protect our seniors? Prevention is pretty well the only thing that will help. Wherever an older person lives, the environment has to be as fall-proof as possible.

While falling from dizziness or illness happens, most falls happen as accidents. The American Association of Orthopaedic Surgeons offers this page with many tips for seniors to reduce their risk of falls. Some tips include not getting out of bed as soon as they wake up, but to sit on the side of the bed and wait for a moment to make sure their blood pressure doesn’t drop and don’t leave clothes or newspapers on the floor.

I often add other tips such as, no scatter rugs – they are dangerous for slipping. Make sure all electrical cords are tucked away and not where they can be a cause of a trip. If there are runners on the stairs, make sure they’re fastened down well. And, make sure that slippers or shoes have good tread and grip on the floor to prevent slipping.

Since women with osteoporosis have a higher chance of breaking a hip, getting regular check ups, taking medications if prescribed, doing weight-bearing exercises, all help prevent bone mass loss, reducing the risk of a hip fracture.

As the population ages, more hips are going to break. We need to be vigilant and try to prevent as many of them as possible.