Factured Hip – Five Days Later My Father Was Dead
20 Jul 2003
Some moments in your life you never, never forget. The Sunday morning that my father didn’t answer the telephone, for instance. And later findings him lying on the floor with a fractured hip. The gradual down-hill course followed surgery with long hours at his beside, and finally death five days later. Suddenly, all I had left of the father I had loved so much was a box of cinders after cremation. The disaster of a fractured hip became imbedded in my mind.
Two years ago Katherine Graham, 84 year old publisher of the Washington Post, died following a fall. Recently, Robert Atkins, 72 year old protein-diet guru and 82 year old newsman David Brinkley, both died following falls.
The Centers for Disease Control and Prevention lists falling as the major cause of unintentional-injury death among those ages 75 and up. And the second leading cause for those ages 55 to 74.
Some, like my father, die a few days after a fractured hip. 25 percent will die in the next six months from infection and other complications. Another 50 per cent spend their remaining lives in wheelchairs. Only 25 per cent return to their former lifestyle.
Dr. Mary Tinetti, Professor of Medicine and Director on the Program on Aging at Yale University, is an expert on falls and the elderly. Her report on identifying risk factors for falling and methods for preventing them has recently been published in the New England Journal of Medicine.
Tinetti points to one major misconception. Common sense tells us that elderly frail people are prone to falling. But Tinetti says it’s the more robust older people who suffer the serious injuries. The reason? The stronger ones are more active and take greater risks. Like my tennis friend who while running to return an impossible shot, tripped and struck a tennis post. The result? A fractured hip.
Why we fall is a little like flying. Experts say most plane crashes are due to "pilot overload". Too many dials to watch in an instrument landing, attention diverted momentarily and a fatal crash occurs.
Falling is also a combination of factors. We all have nerves in the feet that send messages to the brain. They tell us where we are in space and how to make the next safe step. But as we age our instrument panel gets blurred.
Nerves in the feet become less sensitive due to diseases such as diabetes or too much alcohol. Our visual depth perception becomes foggy due to bifocal, multifocal lenses or cataracts.
Medication often plays a major role. Single drugs such as sleeping pills, antidepressants and heart pills make people more susceptible to loss of balance. But add a few of these together along with declining muscle strength and it’s a potent mixture for falling.
I stopped counting the number of times I had to drive to Niagara Falls after receiving a call that "Your mother has fallen again". I’d arrive to find her shaken and black and blue. Her triple-A personality meant she always moved too quickly. But she had the luck of the Irish, always landing without breaking her hip, and died at age 93 of other causes.
Common sense can prevent fractured hips. A patient of mine fell off a roof at 84 years of age! His mother should have told him that was dangerous. Others slip on waxy floors. Or fall off a high stool while reaching for something.
The world is full of ways to trip, slip and fall, a loose carpet, narrow stairs. But I’d place the bathroom high on the risk list. Particularly foreign bathrooms that invariably present new challenges and slippery surfaces.
Slowing down is one way to prevent a fractured hip. Just recently, being late for the office, I rushed across a busy intersection, tripped and fell smack in front of a police car! I was considerably embarrassed, slightly bruised, but emerged luckily with only a chipped tooth. But I could hear my mother saying "slow down." And I have!
The National Institute on Aging offers tips to decrease the risk of falling. It can be found on the Web at www.nia.nih.gov/health/agepages/falls.htm
