Home Care for Elderly Hip Fracture: Mobility and Pain Management Tips

Nursing Care for Hip Fractures

An elderly person at home has long-term mobility issues and recently suffered a hip fracture.
The physician has advised the family to consider the risks of surgery and prognosis, and currently, surgery is not being considered.
Regarding home care before the pain at the injury site is alleviated, is it necessary for the patient to remain bedridden? Can they turn over or adopt a sitting position? Since the patient requires long-term dialysis treatment, what precautions should be taken during movement?

paula, 30~39 year old female. Ask Date: 2008/11/08

Dr. Zhou Lizhi reply Orthopedics

Hip fractures are currently generally treated with surgery, as patients may need to remain bedridden for a month and a half, and the fracture may take at least three months to heal.
This can lead to several complications: 1.
Pressure ulcers: Patients experience pain and are reluctant to move, requiring repositioning at least every two hours (alternating between lying flat and on the opposite side).
2.
Urinary tract infections: Urination must be completely clean (for dialysis patients, cleanliness is crucial).
3.
Pulmonary secretions: Patients may be prone to sputum accumulation, requiring semi-sitting positions or chest physiotherapy.
4.
Abdominal distension.

Reply Date: 2008/11/08

More Info

Caring for an elderly person who has suffered a hip fracture can be challenging, especially when surgery is not an option due to age or underlying health conditions. In this situation, effective home care focuses on pain management, mobility, and preventing complications associated with prolonged immobility.

Pain Management
First and foremost, managing pain is crucial. Ensure that the elderly person is on an appropriate pain management regimen as prescribed by their healthcare provider. This may include over-the-counter pain relievers like acetaminophen or prescribed medications. It’s important to monitor their pain levels regularly and communicate any changes to their healthcare provider.

Mobility Considerations
While it may seem that complete bed rest is necessary, this is not always the case. Prolonged immobility can lead to complications such as pressure sores, muscle atrophy, and decreased overall health. Here are some guidelines for mobility:
1. Position Changes: Encourage the patient to change positions frequently to prevent pressure sores. If they are in bed, they should be repositioned every two hours. If they are able to sit up, they can alternate between sitting and lying down, as tolerated.

2. Assisted Movement: If the patient is in pain but can tolerate some movement, gentle assisted movements can be beneficial. For example, if they can sit up, they may benefit from sitting in a chair for short periods, which can help improve circulation and reduce the risk of complications.

3. Use of Mobility Aids: If the patient is able to stand or walk with assistance, using a walker or cane can help them maintain some level of mobility. Ensure that the environment is safe, with clear pathways and no tripping hazards.

Activities of Daily Living (ADLs)
For activities such as bathing, dressing, and using the restroom, consider the following:
1. Bathing: If the patient cannot stand, a sponge bath may be necessary. If they can sit up, a shower chair can provide safety and comfort.

2. Dressing: Use adaptive clothing that is easier to put on and take off. Consider using long-handled reachers to help them dress without excessive bending.

3. Toileting: If the patient needs assistance, a bedside commode may be helpful. Ensure they have easy access to the bathroom and that it is well-lit and free of obstacles.

Nutrition and Hydration
Maintaining proper nutrition and hydration is essential for recovery. Ensure that the patient is eating a balanced diet rich in calcium and vitamin D to support bone health. Hydration is equally important, especially if they are undergoing dialysis.

Monitoring for Complications
Be vigilant for signs of complications such as:
- Pressure Sores: Check the skin regularly for any signs of redness or breakdown.

- Deep Vein Thrombosis (DVT): Look for swelling, redness, or pain in the legs, which could indicate a blood clot.

- Respiratory Issues: Encourage deep breathing exercises to prevent pneumonia, especially if the patient is spending a lot of time in bed.

Communication with Healthcare Providers
Regular communication with healthcare providers is essential. Keep them informed about any changes in the patient’s condition, pain levels, or mobility. They may recommend physical therapy or additional interventions to aid in recovery.

Conclusion
In summary, while bed rest may be necessary initially, it is important to encourage some level of mobility and position changes to prevent complications. Pain management, nutrition, and regular monitoring are key components of effective home care for an elderly person with a hip fracture. Always consult with healthcare professionals for personalized advice tailored to the specific needs of the patient.

Similar Q&A

Caring for Elderly Hip Fracture Patients: Home Care Tips and Considerations

Hello Doctor, last Friday (the 28th), my grandmother fell and fractured her hip. The doctor recommended surgery, but considering her advanced age and chronic illnesses, the family decided against it due to concerns about anesthesia risks. I would like to ask what we should pay at...

Dr. Shi Guozheng reply Orthopedics
The preferred treatment for fractures near the hip joint is surgical intervention. In older adults, as long as anesthesia is managed carefully and the surgery is performed, most patients can recover to a state similar to that before the fracture. Therefore, it is best to choose s...

Rehabilitation Strategies for Elderly Patients with Osteoporosis

Hello, doctor. My grandmother is currently 93 years old and has osteoporosis. Last year, she underwent a vertebroplasty, but due to unsatisfactory results, she can only lie in bed now and is unable to get up, although she can still turn herself. However, there are some issues: ...

Dr. Xu Zhenrong reply Rehabilitation
Hello, Li Li's online friend: Based on your description, your grandmother has osteoporosis and has been bedridden for a long time. Regarding osteoporosis, it is generally understood that bone density begins to gradually decline after the age of 35, with a significant loss oc...

Managing Chronic Pain After Hip and Knee Fracture Surgery in Seniors

Hello, my mother had a car accident in 2020 (at the age of 80) that resulted in fractures of the distal femur in her left leg and the proximal tibia near the knee in her right leg. She underwent surgery, which was successful, but she has been experiencing sharp pain at the surgic...

Dr. Wang Jiacheng reply Orthopedics
If walking causes pain, an X-ray should be taken to check for potential arthritis issues. If there is no pain, it may not be necessary to remove internal fixation devices. An X-ray can help determine the underlying cause, allowing for targeted treatment.

Essential Care Tips for Managing Fracture Patients Effectively

How to care for a patient with a fracture?

Dr. Shi Qiming reply Orthopedics
To begin with, it is essential to assess the patient's mobility. If the patient is unable to move due to a fracture and requires bed rest, rehabilitation should be conducted in bed to prevent joint stiffness and muscle atrophy, typically with assistance for joint activities....