Home care after a hip fracture: the first weeks, movement, pain and warning signs

In older people a hip fracture usually follows a fall and is generally treated with surgery. Getting up and starting physiotherapy as soon as possible after the operation is the key to recovery. Coming home is not the end of the process; it is when the real recovery begins. This guide helps families and caregivers plan the first weeks; the surgeon and physiotherapist decide on movement restrictions and the exercise programme.

Questions to ask before discharge

• Which movements are allowed and which are not? (Depending on the type of operation, there may be restrictions such as not crossing the legs or bending deeply.)
• How much weight can go through the leg? Will a walking frame or a stick be used?
• When and how should painkillers be taken? Are there blood-thinning injections or tablets, and for how long?
• When will the stitches or staples come out, and how should the wound be protected?
• How will physiotherapy at home or follow-up appointments be arranged?

Prepare the home

• Put the bed, toilet and sitting area on the same floor; clear a path wide enough for a walking frame.
• Remove rugs, cables and raised thresholds; add a night light.
• Low armchairs and toilets make standing up harder: ask a specialist about a raised toilet seat, a sturdy chair with armrests and grab rails.
• Move frequently used items to between waist and shoulder height to reduce the need to bend.
• Prepare a non-slip floor and a shower chair; at first, make sure someone is with them while they shower.

Move every day: little but often

Repeat the exercises the physiotherapist gives several times a day in short sessions. Staying in bed all day increases muscle loss, the risk of blood clots, pressure ulcers and pneumonia. Let your relative do whatever they can themselves; doing everything for them can increase dependence. When they walk, stand slightly behind them and close to the affected side, not the unaffected one.

Managing pain

Uncontrolled pain prevents movement and slows recovery. Give painkillers as prescribed and ask whether they should be taken before physiotherapy. In people who cannot describe their pain, for example because of dementia, grimacing, restlessness, reluctance to move or loss of appetite can be signs of pain. Remember that painkillers can cause constipation.

Signs to report straight away

• Swelling, redness, warmth or pain in the calf (possible sign of a blood clot in the leg).
• Sudden breathlessness, chest pain or coughing up blood: call your local emergency number (112 in Türkiye and across the EU).
• Increasing redness, discharge or a bad smell from the wound, or a fever.
• The leg suddenly looking shorter or turning outwards, or a sudden increase in pain.
• Sudden-onset confusion (delirium).
• A new fall.

Preventing another fall and fracture

After a hip fracture, the risk of another fall and fracture rises. Review the causes of falls (medicines, vision, balance, the home environment) with the doctor. Ask whether assessment and treatment for osteoporosis are needed. Ask the doctor or a dietitian for advice on adequate protein, calcium and vitamin D.