Help, please! Dad is in the hospital for a hip fracture. They've pinned it and started him on physical therapy. The doctor and therapist insist he has to get up and walk on that leg. Dad says he needs a couple of days to rest and recouperate before getting up. What can we tell him to convince him to go along with this approach?
Immediate weight-bearing after surgery for hip fracture has been proven safe and effective in several studies. But as a general protocol, the medical practice of getting people up and walking again right away has not been adopted universally.
There is still a general idea and belief that older adults need time to recover from surgery and should rest in bed for a couple of days before beginning an ambulation program with the physical therapist. And there's been some thought that older adults with memory or cognitive problems will have a harder time remembering to put weight on the involved leg.
In fact, studies actually show that folks who get up within 24 hours of the surgical stabilization procedure for hip fracture actually have better overall results. They are discharged from the hospital sooner. And they are more likely to go directly home (rather than to a transition unit or to a nursing home). Those two reasons are usually motivation enough to get even the most stubborn patient moving.
It might help your father if the surgeon and the physical therapist explain the reason why they want him up and walking so soon. They may have already discussed this with him, but sometimes after surgery, patients don't always grasp new concepts as easily as they might otherwise.
You can give the doctor and/or therapist a call and at least leave a message about your concerns. You can also speak with the nursing staff who have contact with all other members of the team and can bring this issue up for review. Having family members report problems like this is often helpful in getting everyone on the team on board with a concerted effort to overcome a specific problem like this one.
Antonella Barone, MD, et al. Factors Associated with an Immediate Weight-Bearing and Early Ambulation Program for Older Adults After Hip Fracture Repair. In Archives of Physical Medicine and Rehabilitation. September 2009. Vol. 90. No. 9. Pp. 1495-1498.
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