When Fracture does not only break a bone but also a life of an elderly person Authors of this research

paper Wenestam and Hansson-Scherman (2008) investigate an important issues surrounding post event of a hip fracture among elderly clients in Sweden. The focus of this research study is to examine impact of hip fracture on lives of elderly clients. Series of interviews completed by authors pointed to emerging themes in this study as reported by the survivors of hip fractures such as: You lost confidence in your body You become more dependent on others and You are old, closer to death and have lost your zest for life (L. Ziden et al. 2008, pg. 803). Further authors elaborate that elderly clients have clearly pointed to the great and complex impact of the hip fracture on overall life activities as compared to the pre-accident level. What started as a broken leg, was experienced as having caused extensive and dramatic changes concerning their [patients] relation to their bodies and to themselves, to others and to their whole life situation (L. Ziden et al. 2008, pg. 803). Further clients reported that they lost confidence in their own bodies and became afraid that the incidence of falling may happen again. Issues surrounding perception of self and ability to know what can be done safely was compromised among some clients whose previous confidence and balance was disrupted. This complex experience as presented in authors of this study points to a needs that must be addressed while working with hip fracture patients. In my pre-nursing career I was able to work with number of hip fracture patients in a role of a Rehabilitation Therapist. I have too, observed complex needs displayed by elderly patients and their spouses and families after the incident of hip fracture. One factor that has had greater impact on my clinical practice was also understanding of the fear of pain and fear of falling during rehabilitation sessions. Patients who have been previously mobile and independent in the community found themselves fearing to make a step even with assistance given by Rehabilitation staff and aid from devices such as walkers. Interestingly I observed that patients suffering from cognitive disorders and short term memory loss such as Alzheimers disease have had higher rates of successful rehabilitation and return to pre hip fracture status of independence. I believe that this was related to the fact that each session, each day was a new start for those patients as they *patients+ did not have short term memory of the previous rehabilitation session which not always may have been successful. Since the long term and or distant memory recall is usually functioning well cognitively impaired clients were more eagerly participating in therapy sessions remembering former level of abilities and function than those clients who [as presented in this research] knew that their functional status has changed significantly. Additionally cognitively impaired patients did not have a memory recall of the fall incident and surgical repair whereas unimpaired clients remembered the trauma of falling, hospitalization, surgery and recovery. In conclusion I believe that in clinical practice we [nurses] have to focus on unique needs and perceptions of our clients and attempt to tailor the best way we can Plan of Care that will be individualized and based on specific needs and expectations of that that we work with.

References: Ziden, L., Wenestam, C., & Hansson-Scherman, M. (2008). A life-breaking event: Early experiences of the consequences of a hip fracture for elderly people. Clinical Rehabilitation, 22, pp 801-811. (library link- http://uproxy.library.dcuoit.ca/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2 010030571&site=ehost-live ) Retrieved on: July 1st 2011