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Hip fracture: eating and drinking for recovery

Even though the person you care for is in hospital, you can still be involved in helping them eat nutritious food and drink plenty of fluids. It’s also an opportunity to talk to staff about any problems you’re aware of that may be stopping your loved one from eating a healthy, balanced diet.

When someone is recovering from a hip fracture, eating nourishing food and drinking lots of fluids are essential to making a successful recovery. This means taking in extra calories for energy, protein to build up their muscles, and frequent drinks to keep them hydrated and prevent them from developing pressure sores.

During the hours immediately before your loved one has surgery, they may be told not to eat or drink (otherwise known as ‘nil by mouth’). This makes it safer when they receive an anaesthetic, but there’s no need for them to go without food or drink before this time. Most hospitals are moving to permit water or clear fluids until two hours before surgery, and others allow patients to drink water right up until they leave the ward for their operation.

How you can help

As a carer, the close relationship you have with your loved one, and the knowledge you’ve gained from looking after them, make you an invaluable member of their wider care team. So don’t hesitate to ask questions, share your worries or offer to help in practical ways.

  • Share what you know. Have you noticed that your loved one’s appetite is getting weaker? Are you worried that they aren’t getting enough to eat? Are they finding it difficult to chew their food or swallow it? Then be sure to speak to staff as soon as possible so they can deal with any problems at the earliest opportunity.
  • Practical help. Many hospitals actively encourage carers to assist with eating and drinking, so ask if you can be of help at mealtimes. If this isn’t an option, ask if the hospital has a ‘red tray’ system for patients who’ve been identified as malnourished or needing assistance. Such patients will have their food served on a red tray, which prompts staff to give them extra attention when eating, including mashing their food or making it into a puree.
  • Encourage - but don’t pressurise. When you know how important good nutrition is to your loved one’s recovery, it’s easy to feel anxious when offering them food, snacks, and drinks. But however much you want them to eat and drink, keeping calm and offering gentle encouragement is always better than putting them under pressure.
  • Make eating a sociable occasion. Encourage your loved one to get out of bed at mealtimes and join their fellow-patients at the table if possible. Chatting to other people can make mealtimes more enjoyable and lessen any anxieties they might have around eating. One note of caution, however: if they eat very slowly, and everyone else at the table finishes before them, they may say they’re full when they could have eaten more, so it may not always be the best option.
  • Be creative! Instead of bringing in food and snacks in a carrier bag, put them in an eye-catching biscuit tin or a brightly coloured, airtight container. You could call it your ‘secret tuck box’ and get into the habit of ‘raiding’ it together on a regular basis. Putting a snack on a plate they use at home (with a patterned serviette) can also make eating more novel and appealing.

Even people who are overweight can be malnourished if the food they’ve been eating hasn’t provided them with enough nutrients.

Understanding malnutrition

Today, around one in ten people over the age of 65 are found to be malnourished (or at risk of malnutrition), despite the best efforts of family and friends to provide them with nourishing meals and snacks. So what are the main causes for not getting enough to eat and drink?

  • Having little or no appetite for food or interest in cooking.
  • Losing one’s sense of taste and smell, which can take the pleasure out of eating
  • Wearing false teeth that no longer fit properly and make eating difficult.
  • Having problems with chewing and swallowing.
  • Feeling lonely or depressed.
  • Being in hospital, especially for a long period of time.
  • A sudden injury or needing an operation, such as for a hip fracture.

When your loved one is malnourished

Although it can be upsetting to hear that your loved one hasn’t been getting enough to eat and drink, it can be a relief to know that healthcare professionals are aware of the problem, especially if you’ve been worried about their diet for some time. Together with the hospital team, you can then focus on getting their eating and drinking back on track, including making sure they’re getting enough calcium and vitamin D.

After surgery, the human body requires extra calories (energy) to help with the healing process, so don’t be surprised if your loved one is encouraged to have sugar in their tea and coffee made with lots of milk!

Nutrition for bones

Most people who fracture their hip will have a condition called osteoporosis, where bones become weak and are more likely to break.

For more information about osteoporosis including eating the right foods and taking supplements to keep bones as healthy as possible, visit: Royal Osteoporosis Society – Nutrition for bones

The NHS website also has information on choosing food for healthy bones: Food for healthy bones

Preparing for discharge

When someone leaves hospital after a hip fracture, they will usually need more support than they did before they broke their hip, including help with eating, drinking and food preparation. It’s certainly worth talking to the occupational therapist about aids and equipment that could help with independent eating, drinking and preparing meals. These items are provided free of charge and include:

  • A step stool or perching stool for use in the kitchen.
  • A grab stick for reaching or lifting light items in hard-to-reach places.
  • A kitchen trolley to move meals and other items from one place to another.

You could also make sure that their fridge, freezer, and cupboard are stocked with quick and easy meals and snack options.

If someone has problems swallowing

Occasionally, physical problems with swallowing can prevent someone from eating or drinking. This is known as dysphagia, and sometimes means that feeding through a tube needs to be considered.

Usually this would be through a ‘nasogastric tube’, passed through the nose and down into the stomach. This can allow a patient to receive all the food and fluid they need, but the patient needs to be willing to have a tube passed through their nose and be prepared to keep it in place for many days.

For more information about swallowing problems and tube feeding, visit: Dysphagia (swallowing problems)

Find out more

Hip Fracture: a guide for family carers aims to ensure that carers are equipped with the information they need to support the recovery of the person in their care.