Fracture Effect on Dementia
Older adults with dementia, which is a severe impairment or loss of intellectual capacity and personality integration, can experience a low recovery rate and poor quality of life after surgery to repair a fracture. A fracture is the breaking of a bone, cartilage, or the like, or the resulting condition. A person with dementia who has a fracture may be unable to follow the instructions necessary to assist in their own recovery. The outcome can be a failure to thrive, which can include a higher risk for developing delirium, and a higher mortality rate, than for people who don't have dementia.
Other People Are Reading
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Preventing Falls
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One of the ways to prevent fractures in the elderly with dementia is by reducing their potential to fall. Examining the patient's history to see if he has had a previous fall and looking at the circumstances surrounding the fall can help the care provider to identify ways in which the patient's routine may need to be altered in order to reduce the risk of a fall.
If the patient is unsteady on his feet, the reasons for the unsteadiness should be examined in order to prevent falls.
Preventing Osteoperosis
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Osteoperosis is a disease of the bones that can lead to an increased risk of fracture. It is most common in postmenopausal women, but men can get it, too. One way to prevent this disease is by making changes to the diet of the patient. Heavy protein consumption can be a cause of osteoperosis, so a decrease in the consumption of protein can help prevent the disease.
Taking calcium or/and vitamin D supplements can strengthen the bones, preventing the onset of osteoperosis. A class of drugs known as bisphosphonates is also helpful in strengthening the bones and treating osteoperosis.
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Physical Rehabilitation
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In general, patients with dementia who get hip fractures, one of the most common types of fractures in the elderly, are considered poor candidates for physical rehabilitation because they have a limited ability to understand instructions.
Elderly patients, especially those afflicted with dementia, take longer to benefit from physical rehabilitation than do their younger counterparts. However, contrary to the beliefs of some in the medical community, positive results are possible for patients with dementia going through physical rehabilitation who had been mobile prior to the fracture.
Insights on Patients Who Require Physical Rehabilitation
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When it comes to patients with dementia recovering from fractures, the first step is most important and may not happen if the patient does not give verbal consent to the physical therapists. Although there can be the appearance of an inability to understand instructions, sometimes the true obstacle to verbal consent is pain. Assisting the patients by walking with them must be done often and with daily regularity. Incorporating music and singing in the physical rehabilitation can help to get the patient moving. Sometimes additional items are required to alleviate pain such as special footwear, drugs or a weight-bearing lift and harness.
Misconceptions
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Nursing homes and physical rehabilitation departments often lack the resources to provide the necessary quality of care. Recovery efforts can also be hampered by a belief that the patient had a failure to thrive and therefore, physical rehabilitation would be seen as a waste of time and resources.
There are benefits to be gained from physical rehabilitation for people who might be classified as having an inability to thrive. Health care professionals, from the physical therapists, to the insurance providers can benefit from education about the advantages of this level of physical rehabilitation.
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References
- Annals of Long Term Care: Hip Fracture Rehabilitation in Persons with Dementia: How Much Should We Invest?
- Dictionary: Dementia
- NCBI: Dementia does not significantly affect complications and functional gain in elderly patients operated on for intracapsular hip fracture
- NCBI: Functional outcome of cognitively impaired hip fracture...
- BMJ: Preventing Fractures In Elderly People
Resources
- Photo Credit elderly lady image by pixelcarpenter from Fotolia.com
