There's No Place Like Home to Heal Hip FracturesOnce upon a time, patients did most of their recovery in the hospital. Today the trend is to send patients home as early as possible. This is cheaper for insurance companies. It can also be better for patients. Hip fractures usually occur in older adults. These patients usually stay in the hospital while they heal. This study from Australia compared the traditional approach to a home rehabilitation program.
All patients were over 65 and living on their own and in fairly good health before hip fracture. All of them spent two days in the hospital. Then one group stayed in the hospital for conventional rehab. The other group was sent home. Nurses, therapists, and other specialists and helpers were sent to their homes as needed. Both groups did hip exercises as part of rehab.
Researchers looked at the two groups over one year. Patients answered questions about their activities and quality of life. Researchers also tested patients' ability to move. Importantly, caregivers also answered questions about the burden of helping the patients.
At one year, there was no real difference between the two patient groups. Yet there was a difference in the caregiver groups. The caregivers for patients getting home therapy reported a bigger decrease in their burden over the year.
The authors note that doctors should choose patients for home therapy very carefully. Patients and caregivers need to understand what they're getting into. The patient must have a home that will work for a person who can't get around well. And there needs to be good support in the patient's community. But overall, this study suggests that home therapy can be effective for older patients with hip fractures.
Maria Crotty, FAFRM, et al. Patient and Caregiver Outcomes 12 Months after Home-Based Therapy for Hip Fracture: A Randomized Controlled Trial. In Archives of Physical Medicine and Rehabilitation. August 2003. Vol. 84. No. 8. Pp. 1237-1239.
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