Senior Health and Fitness: Surviving A Hip Fracture

Slips, falls and hip fractures are all part of the big picture.   I read the article by Tom Slear “The Deadliest Break” (AARP magazine, November 2011) with great interest.  I liked that he put an optimistic spin on surviving a hip fracture, and found the article well worth recommending.   After years of working in health care, I quite agree that the statistics are grim.   Every year several of our residents would be whisked off to the hospital after weather related falls.  Many of them never returned to independent living status again.   The author pointed out that prevention will always be the key.   No argument there.  I think we all agree with that, but no matter how careful we are, accidents will happen.   A friend of mine fell off from her bike and broke her collar bone recently, and I tripped over a root and went head over heels into a ravine while walking my dog in the park.   Minimum damage on both accounts but it could have been a hip fracture for either one of us.  You can’t plan for every eventuality.

A hip fracture is not good and it could mean that your ability to function normally will be seriously compromised.   What is it that makes a hip fracture so deadly?  Mr. Slear wrote that the decline had less to do with the break itself than with your reaction to it, and I quite agree.  This is no time to give up on yourself.

You have often heard the expression that the surgery was a success but the patient died anyway.  Hip surgery is usually pretty straight forward, but the recovery isn’t always what it should be.   What stands in the way of a complete recovery?  As the author stated, a lot of the trouble is attitude.  Both patients and caregivers often do not approach rehabilitation with a positive attitude.   If the thoughts running through your mind include saying “it’s over for me,” “it’s just too much to deal with,” “it hurt’s too much,” “I’ll never walk again,” or “I will have to go to a nursing home,” or “I might as well be dead”, you are going to have a tough time.    Instead you must think “I can do this,”  “I’ll get through this,” “I can be better than I was before,” I can go home again,” and “I am going to work hard and stop feeling sorry for myself.”

Surgery is only the first step.  It is not a quick fix; it is just the beginning.  Physical Therapy and a lot of hard work is what will get you through this.    Therapists will teach you the exercises, but if you persist in complaining and whining the program won’t work.  You have to decide that you are going to exercise, even if it kills you (just kidding, but if you don’t make the effort it could very well kill you).

Get over yourself.  Get over the mindset that you are going to be okay if you just sit still until the pain goes away.  Rehabilitation requires a great deal of determination and you are going to have to work through it.   Of course you will have pain, but has that every stopped you before?  Talk with your doctor and find out what you should be able to do in two weeks and in a month.   Set goals and celebrate like crazy when you reach them.  We are talking about the rest of your life here.

Rehabilitation starts the day after surgery.  You won’t think you are ready and you will be whining about mean nurses and mean therapist pushing you too hard.  It hurts.  Who would have thought that standing up was so much work?

There is a method to their madness.  Pushing is what it takes to stimulate bone repair, keep stiffness at bay and stimulate the circulation in your legs.  They aren’t being firm because they enjoy seeing you in distress.  They are helping you realize your goal of getting out of bed, getting out of a chair, getting around with a walker or a cane, or maybe even navigating stair steps.

Depending on how well you do in the hospital, decisions will be made as to whether you will go home with outpatient therapy or to a rehab care facility for the rest of your training.   If you go home you will need a cheerleader to push you or you will have to remarkably self disciplined.  A therapist will come to your house to teach you what to do, but you must practice, practice, practice on your own.    This is the hard part.  Hardly anyone fails because they worked too hard.  If you get lazy about doing your exercises or forget what your goal is, you will be in big trouble.

If you go to a care facility you still have to focus on your goals, which should be to get back home.   A lot of people get what we called “hospitalities,” which means that you start liking having someone wait on you.    Herein lays the trap.  You get a little too comfortable.  It soon becomes easier to let someone else do things for you.  Therapy sessions are not as regular or as hard as they were in the hospital and guess what?  If you say you don’t want to exercise today, they cannot force you.  If you decide that it hurts too much, someone is always available to listen to your whines and complaints and to commiserate with you.  This is not in your best interest.  You have to be the one establishing the pace whether you are in a step-down hospital program or a care facility.   

Your goal is independent living.  Your goal is to be better than you were before, which is quite possible if you weren’t into physical fitness before your accident.  Rehabilitation is hard work.  You have to make up your mind that you can do it.   Be sure to share your goals with those helping you (your support system).   The people who love you the most will kill you with kindness if you let them.  Remind yourself every day that a partial recovery is not good enough.

Comments

[physical therapy documentation]

Thanks for the encouraging words. My mother recently fell and broke her wrist (thankfully it wasn't her hip) and she has had a hard time healing. We've contemplated physical therapy, but we're not at that point yet.