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Invited Commentary |

Hip Fracture:  A Trigger for Palliative Care in Vulnerable Older Adults

Fred C. Ko, MD, MS1; R. Sean Morrison, MD1,2,3
[+] Author Affiliations
1Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
2National Palliative Care Research Center, New York, New York
3Hertzberg Palliative Care Institute, New York, New York
JAMA Intern Med. 2014;174(8):1281-1282. doi:10.1001/jamainternmed.2014.999.
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Extract

Hip fracture most commonly affects older adults and causes devastating consequences including pain, immobilization, functional decline, delirium, and death. Among those in the Medicare population who sustain hip fractures, 13% die within 3 months and 24% die within 12 months.1 Of those who survive to 6 months, only 50% recover prefracture ability to perform activities of daily living.2 Although long-term nursing home residents are much more likely than community-dwelling older adults to sustain hip fracture and have poorer functional outcomes,3 relatively little is known about the patterns and predictors of mortality and functional decline in long-term nursing home residents with hip fractures.

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Models for Hip Fracture Care in Vulnerable Older Adults

Adapted from work of the Canadian Palliative Care Association and Frank Ferris, MD, and from Meier DE. Increased access to palliative care and hospice services: opportunities to improve value in health care. Milbank Q. 2011;89(3):343-380.

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