The immediate aftermath of hip fracture can be a time of shock and confusion for all those involved. The following steps aim to set out some clear actions that carers can take to support the initial stages of recovery.
Watch for signs of delirium
If your loved one is talking or acting strangely or seems unusually quiet, let staff know without delay as they may have delirium. This is a temporary but serious and distressing condition that can affect their recovery..
NB. If your loved one has been diagnosed with dementia; staff may think that this is the reason for their unusual behaviour. So be sure to point out that what you’re seeing isn’t ‘normal’ for them.
Share what you know about ‘the patient’
If you’re already caring for your loved one or spend a lot of time in their company, you’ll almost certainly know more about them than anyone at the hospital. Not only could your knowledge help staff provide better, safer care, it will also help them to appreciate your loved one as a person as well as a patient.
Here is a checklist for ideas on the kind of information you could share with the hospital team (also available as a separate PDF at page bottom):
✓ What your loved one likes to be called
✓ Their personal preferences, including strong likes and dislikes
✓ If they have any medical conditions e.g. dementia, diabetes, asthma or heart disease
✓ Any recent changes to their health and well-being or behaviour
✓ Medication they take including inhalers, over-the-counter medicines and supplements
✓ Allergies and dietary requirements
✓ Disabilities and mobility problems
✓ If they use a walking stick, frame or other aid
✓ If they are prone to falling or wandering
✓ Vision and hearing problems and if they use spectacles or a hearing aid
✓ If they need help in going to the toilet
✓ If they have any bladder or bowel problems
✓ Their speech and communication needs
✓ If they have made an advance decision (‘living will’) about their future treatment
✓ If a doctor has signed an order indicating that they should not be resuscitated in the event of a cardiac arrest
✓ If you have a Health and Welfare Lasting Power of Attorney (LPA) that allows you to make decisions about their care if they are no longer able to do so for themselves.
- About visiting. Much has changed since the coronavirus pandemic and hospitals will have detailed rules over which patients can have visitors and which people are allowed to visit them.
- For a key contact. A large team of people will be looking after your loved one while they’re in hospital. It will make life easier if one person on the team is asked to liaise with you when you ask for an update. Ideally this should be the person who’s also responsible for planning your loved one’s discharge.
- About pain relief. Staff will give your loved one pain relief to make them as comfortable as possible but if you have reason to believe that they’re still in pain, be sure to let staff know. For instance, if the person you care for has dementia, you may have learned that they show that they’re in pain by becoming agitated or aggressive rather than by asking for pain relief.
- For a copy of the hospital’s guide for visitors. This should provide useful information on visiting times, public transport, car parking, food and drink outlets, a map of the hospital and much more besides.
- A listening ear. Breaking a hip is a traumatic experience that affects people psychologically as well as physically. A 75-year-old woman with a love of rambling may feel that she’s been catapulted into old age and will never wear her walking boots again. An 80-year-old widower who’s been struggling to live on his own may now fear that his only option is to move into residential care. So, give your loved one the opportunity to talk about their feelings. Even though you won’t have all the answers, taking the time to listen can be very helpful.
- Encouragement to exercise. Usually patients are encouraged by hospital staff to get out of bed and start moving the day after surgery. Some people will never be as mobile as they were before however and may need to use a walking frame or stick. They may also need help to get dressed, have a wash, or take a shower from now on. Even so, it’s important to encourage your loved one to work hard at building up their strength and getting their mobility back. Encourage them to continue doing the exercises recommended by the physiotherapist and celebrate every small step towards recovery.
Look after yourself...
Caring for someone who has frailty or is ill or disabled can have a significant impact on your own health and well-being. It’s important to look after yyour own needs if you want to be able to look after theirs. For example, you could:
- Pack your own supplies to make your visits more comfortable
- Tell family and friends about any worries or concerns you have
- Check to see what help is available for family carers using this handy online tool
- Alternatively, get in touch with your local carers’ service for information, advice and support.