Could a cognitive condition hamper broken hip recovery?

A fellow caregiver asked...

My mother has broken her hip and had an operation for this over two weeks ago. She is not able to walk as yet and can only transfer with 2 people. She has an element of brain damage and the health professionals are of the opinion that she may never walk due to this as she cannot remember exercises given from physical therapists and motivationmay not be there. She was mobile before the fall and could walk with a frame. Could this be true?

Expert Answer

Laura Cheney, a physical therapist who specializes in geriatrics, graduated with honors from the University of California at San Francisco in 2000. She loves her job working as the sole physical therapist at a premier life-care facility in San Francisco. She has written articles and lectured extensively on fall prevention and other issues relevant to the aging experience. As a registered yoga teacher, she teaches yoga, meditation, and other mindfulness techniques to seniors -- helping them expand their repertoire for coping with stress, pain, and illness in the later years.

I know it is hard to imagine that one broken hip could lead to such a change in function for your mom. It is often the case that one broken hip or other major surgery or medical illness can tip the scales toward a big decline in function for an elderly person when one is already in a fragile state of health. And as you referred to, a person's cognitive status is an important piece in walking safely and recovering from such a big surgery. Safe judgment, the ability to process and motor plan, memory and motivation are all cognitive functions that are important factors in recovering and re-learning how to walk. I never say "never" in my profession but the more time that passes without your mom progressing in her mobility, the less likely it will be that she will be able to walk independently. However, two weeks is still early to make such a long term prognosis. I would recommend that she continue to work with therapists and perhaps have a family member or caregiver trained in the exercises so they can help her do them daily. Finally, it is important to make sure she has good pain control and that her medications are reviewed to rule out any other reason she may not be recovering as quickly as you'd expect.