The best way to prevent the devastation of hip fractures is to prevent the falls that most often cause them. And if prevention fails, there is plenty of room for patients and their families to help themselves.
º Exercise. Brisk walking is helpful, but strength training for the legs offers the most protection.
º Improve balance. Tai Chi is a proven way to do this. It also helps reduce fear of falling.
º Reduce hazards at home. Remove clutter from floors and stairs. Install grab bars in bathrooms and non-slip mats in baths. Improve lighting and install handrails on stairs.
º Wear shoes, not slippers.
º Stop smoking and limit alcohol consumption. Smoking reduces the level of bone-protecting estrogen.
º Control blood pressure. Many falls are caused by dizziness resulting from low blood pressure or from a rapid drop in pressure after getting up.
º Limit use of medicines that affect the mind, such as sleeping pills and anti-anxiety drugs, or those, like cortisone, that weaken bones.
º Maintain a healthy diet. Good nutrition is essential for bone and muscle strength, as are Vitamin D and calcium. Get tested for anemia and take iron if needed.
º Get a bone density test to check for osteoporosis, and get treatment to prevent bone loss or rebuild bone.
º Watch for warning signs. Falls that don't cause injury often foreshadow harmful falls. Seek medical help to identify causes.
º Prevent infections. Make sure the surgeon prescribes antibiotics before and immediately after surgery.
º Prevent blood clots. Take anti-clotting drugs, as prescribed, for weeks after the surgery.
º Watch for delirium and depression and seek immediate treatment.
º Get out of bed. Walking a day after surgery improves the chances of full recovery.
º Seek as much physical therapy and occupational therapy as possible, both inpatient and outpatient.
º Get a home assessment. A physical or occupational therapist can inspect the home for safety.
º Start seeking help in the hospital from a geriatrician, family doctor, or nurse who can oversee longterm follow-up.
º Draw on friends and family for support. Even phone contact helps improve recovery.
On preventing falls: Federal Centers for Disease Control: cdc.gov/ncipc/duip/preventadultfalls.htm
On preventing hip fractures, home safety checklist: American Academy of Orthopaedic Surgeons: orthoinfo.aaos.org/
On osteoporosis: National Osteoporosis Foundation: nof.org/prevention/index.htm
Surgeon general's report on bone health and osteoporosis: surgeongeneral.gov/library/bonehealth/
-- ALICE DEMBNER