Hip Fracture Recovery at Home in Delhi | Case Study

Hip Fracture Recovery at Home in Delhi | Elderly Patient Care Case Study

Educational Case Study (Fictional)

Hip Fracture Recovery at Home in Delhi

A clinical case study demonstrating how structured home healthcare, patient attendant support, and physiotherapy improved mobility and safety for an elderly patient recovering from a hip fracture.

Case Summary

Patient Age: 78 years

Gender: Female

Location: South Delhi, Delhi NCR

Primary Condition: Intertrochanteric Hip Fracture

Duration of Care: 12 Weeks

Final Outcome: Ambulatory with a walker, independent for daily activities

Patient Background

A 78-year-old woman living with her family in South Delhi experienced a fall in her bathroom at home. She was unable to stand or bear weight on her right leg. Her family immediately took her to a tertiary care hospital in Delhi.

The patient has a medical history of osteoporosis and hypertension. Before the fall, she was independently managing her daily routine, though she occasionally used a cane for balance during long walks. Her baseline function was good, but the fall suddenly stripped her of her mobility.

After surgical fixation, the family wanted to bring her home but recognized that she would need significant support. They sought professional patient care services in Delhi to ensure her safety and assist with her rehabilitation.

Clinical Context

Elderly patients with hip fractures face a high risk of complications like pressure sores, blood clots, and pneumonia if they remain immobile. Early mobilization with professional home care is critical to prevent these setbacks.

Clinical Diagnosis

Diagnosis

Right intertrochanteric femur fracture.

Clinical Findings

Severe pain in the right hip
Right leg appeared shortened and externally rotated
Inability to bear weight or lift the leg

Neurological Findings

No neurological deficits were observed. Sensation and motor power in the right leg were intact, excluding associated nerve injury.

Radiology

X-ray of the pelvis and right hip confirmed a displaced intertrochanteric fracture. No evidence of pre-existing osteoarthritis was noted in the affected joint.

Important Observation: Specific laboratory blood investigations related to bone metabolism markers were not documented in the available discharge summary. General blood work showed mild anemia, which is common in elderly females.

Hospital Treatment & Discharge

At the hospital in Delhi, the orthopedic team performed an open reduction and internal fixation using a dynamic hip screw. The surgery was uneventful, and the patient was monitored in the post-anesthesia care unit before being shifted to a regular room.

Post-operative care included pain management with analgesics, antibiotics to prevent surgical site infection, and anticoagulants to prevent deep vein thrombosis. The patient was encouraged to sit on the edge of the bed on the second postoperative day.

On day five, the surgeon cleared the patient for discharge with instructions for toe-touch weight bearing using a walker. The family was advised to arrange home nursing and a dedicated attendant to handle the heavy physical assistance required for transfers and toileting.

Discharge Status

Vitals: Stable

Mobility: Toe-touch weight bearing with walker

Surgical Site: Clean and dry

Plan: Home care, wound care, physiotherapy

Why Home Healthcare Was Needed

The decision to initiate home healthcare was driven by the patient’s complete dependence on others for movement and personal care. The primary goals were fall prevention, surgical site care, and early initiation of physiotherapy.

Fall Prevention

With impaired balance and weak leg muscles, the risk of another fall was extremely high. A trained patient care taker was essential to provide physical support during all transfers.

Surgical Site Care

The surgical wound required regular dressing changes and monitoring for signs of infection. A qualified nurse was needed to perform this clinical task safely.

Rehabilitation at Home

Physiotherapy at home in Delhi was prescribed to gradually restore muscle strength, joint mobility, and gait training without the stress of traveling to a clinic.

Complication Prevention

Caregivers were instructed to encourage deep breathing exercises, frequent repositioning, and adequate hydration to prevent pneumonia, pressure ulcers, and constipation.

Home Care Plan by AtHomeCare

The care plan was designed to support the patient’s daily routine while maintaining strict adherence to the treating orthopedic surgeon’s instructions. A combined team of a patient attendant and a visiting home nurse was assigned.

Morning Routine

Bed bath and personal hygiene
Dressing with loose clothing
Safe transfer to a bedside commode
Breakfast assistance

Daytime Support

Assistance with prescribed exercises
Companionship and observation
Medication schedule reminders
Safe repositioning every two hours

Evening & Ongoing

Personal care and meal assistance
Preparation for nighttime rest
Family communication updates
Wound dressing by visiting nurse

Scope of Practice & Safety

The caregiver assisted with daily activities and mobility while staying within the caregiver’s role. The caregiver did not independently diagnose symptoms, change treatment, prescribe medication, or perform clinical procedures outside their qualifications. In the event of sudden chest pain, breathing difficulty, or acute limb swelling, protocols for ICU at Home in Delhi or hospital transfer were kept on standby. Necessary medical equipment like a walker and hospital bed were arranged to ensure a safe home environment.

Recovery Timeline

Day 1

Initial assessment by the AtHomeCare clinical supervisor. The patient attendant established a rapport with the patient. The patient was in significant pain and hesitant to move. The attendant assisted with bed mobility and pressure sore prevention.

Day 3

The home nurse performed the first wound dressing change. The surgical site was clean. The attendant successfully assisted the patient in sitting on the edge of the bed for short intervals.

Week 1

Physiotherapy sessions began at home. The physiotherapist focused on ankle pumps, quadriceps sets, and gentle hip abduction. The patient was assisted to stand with a walker for brief periods.

Week 2

Sutures were removed by the visiting nurse. The patient reported reduced pain. She was able to transfer from bed to wheelchair with moderate assistance from the attendant.

Week 4

The patient began walking short distances within the house using a walker. She required standby assistance only. Sleep quality improved significantly due to better pain management and daytime activity.

Month 2

Stable mobility achieved. The patient was independent for toileting and dressing. The attendant’s role was reduced to supervision and household chores. Physiotherapy focused on balance and outdoor walking.

Month 3

The family attended a follow-up orthopedic consultation. The doctor noted excellent bone healing. Home care services were gradually discontinued. The patient remained independent with a walker.

Clinical Evidence & Functional Status

Structured documentation of the patient’s functional recovery based on caregiver observations and physiotherapy assessments.

Parameter	Baseline (Day 1)	Week 2	Month 2
Mobility	Bed bound with high assistance	Walker with moderate assistance	Walker with supervision
Pain Score (0-10)	8 (at rest and movement)	4 (movement only)	1 (occasional stiffness)
Wound Status	Clean, dry, sutures in place	Healing well, sutures removed	Fully healed
ADL Independence	Total dependence	Moderate dependence	Independent with aids

Note: Values represent functional clinical observations and pain scores documented by the care team. No invasive blood investigations were performed during this home care phase.

Medical Authority

Dr. Ekta Fageriya, MBBS

Geriatric Medicine

RMC Registration No. 44780

Clinical Experience: 7 Years

Treating Doctor Details

Qualification: ____________________

Hospital: ____________________

Medical Registration: ____________________

Clinical Comments: ____________________

Future Recommendations: ____________________

Supporting Clinical Documents

Hospital Discharge Summary

Post-Op X-Ray Radiology Report

Physiotherapy Progress Notes

Note: To protect patient confidentiality, actual document contents are not displayed. All clinical decisions in this case study are based on the uploaded records and treating physician recommendations.

Recovery Outcome

With regular assistance and adherence to the treating specialist’s recommendations, the family was able to manage the patient’s daily activities more effectively at home while supporting the patient’s ongoing rehabilitation plan.

Mobility: Stabilized with a walker. The patient can safely navigate the home environment.
Pain: Effectively managed with minimal analgesics required by the second month.
Nutrition: Improved appetite and dietary intake as mobility increased.
Medical Stability: No post-operative infections, pressure sores, or thromboembolic events occurred.
Family Feedback: The family reported high satisfaction with the attendant’s vigilance and the seamless coordination of nursing and physiotherapy visits.
Remaining Challenges: The patient still requires caution during outdoor walks and bathroom use.
Long-term Care: Transitioned to independent living with a maintenance exercise program.

Key Clinical Learnings

Early Mobilization is Critical

Prolonged bed rest after a hip fracture leads to rapid muscle loss and complications. A coordinated team of a physiotherapist and a patient attendant allows safe, early mobilization at home.

Home Environment Modification

Simple changes like removing loose rugs, installing grab bars, and arranging a bedside commode are as important as the surgery itself in preventing secondary falls and ensuring recovery.

Frequently Asked Questions

Yes. Home-based support can assist with daily activities and mobility, depending on the patient’s condition and discharge plan. It is often the preferred setting for recovery to avoid hospital-acquired infections.

It depends on the patient’s requirements. An attendant is generally appropriate for daily personal and mobility assistance, while clinical nursing needs like wound dressing require a qualified nurse. Often, both are required concurrently.

Rehabilitation is commonly part of recovery, but the patient’s treating doctor or physiotherapist should determine the appropriate programme. It is essential to restore strength and balance.

Common equipment includes a walker, a bedside commode, and sometimes a hospital bed for easier transfers. The exact needs should be guided by the healthcare team.

Yes, overnight or 24-hour support is highly recommended for elderly patients immediately after a hip fracture to assist with nighttime toileting and prevent falls.

Need Home Healthcare in Delhi?

For professional patient attendants, home nursing, or physiotherapy services, reach out to AtHomeCare.

Corporate Office: Unit No. 703, 7th Floor, ILD Trade Centre, D1 Block, Malibu Town, Sector 47, Gurgaon, Haryana 122018

Phone: 9910823218

Email: care@athomecare.in