Faster treatment for seniors with hip fractures

Adjunct teacher Goh Seng Soon, 73, fractured his hip last year after falling in a public carpark, and had to undergo surgery. He was warded for less than a week and says life is now back to normal.

FOR seniors with hip fractures, getting treatment as soon as possible is key to a speedy recovery.

This is why Tan Tock Seng Hospital (TTSH) has prioritised admissions and surgery for this group of patients, reducing the average length of hospitalisation by a third.

In 2008, the average hip- fracture patient was warded for 15 days. Now, he stays in hospital for only 10 days.

The changes are part of a scheme to make sure elderly hip-fracture patients are better taken care of at all levels - from admission, to a year after surgery.

Known as the integrated hipfracture programme, the initiative was praised by Health Minister Gan Kim Yong in a speech at the Singapore Trauma Conference last month.

The average hip-fracture patient is 80 years old, and delays can cause his condition to worsen quickly, said orthopaedic surgeon Hitendra Doshi.

"If you just keep them lying on a bed, their muscles will start getting weak," Dr Doshi said. This makes them more prone to infections of the lung and urinary tract, which could lead to complications after surgery, he added.

Under the programme, geriatricians, surgeons, nurses and care managers all pitch in to make sure every aspect of a patient's health is addressed.

Dr Rani Ramason, a senior consultant at TTSH's geriatric medicine centre, said: "When we first started, we had a lot of problems with seniors who will say they are too old and they don't want an operation.

"But we explain that those without surgery will end up wheelchair-bound."

Another factor is making sure patients have adequate financial support and have a place to go after being discharged.

"One of the challenges is getting them to go to day rehabilitation after they are discharged," said Dr Ramason.

Care managers continue to follow up with patients up to a year after the operation to make sure that they are adjusting well.

Adjunct teacher Goh Seng Soon, 73, fractured his hip last year after falling in a public carpark, and had to undergo surgery.

"My knee is not very good, so when I missed one step, I fell. It was quite a heavy fall, but I still managed to drive myself home."

He was warded at TTSH for a less than a week, and said life is now back to normal.

This article was first published on May 9, 2015.
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