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Hip Fracture in the Frail Elderly: Making the Case for Early Integration of Palliative Care and Timely Hospice Referral

Atkinson Smith, Mary; Acker, Kristi; Torres, Lisa

doi: 10.1097/NOR.0000000000000381
Original Articles

With the projected increase of an aging population in the upcoming decades, coupled with increasing elderly longevity, the incidence of hip fractures among this vulnerable population is expected to grow. Current evidence reveals high mortality rates within 6 months to 1 year among frail elderly patients who suffer hip fracture. In addition, the presence of multiple chronic conditions negatively impacts mortality rates in this vulnerable population. The purpose of this article is to discuss both the importance of integrating early palliative care and the appropriateness for hospice referral among frail elderly hip fracture patients. Moreover, the role nurses' play in early recognition of the need for palliative and/or hospice services among this vulnerable population will be explored.

Mary Atkinson Smith, DNP, FNP-BC, ONP-C, RNFA, Nurse Practitioner, Starkville Orthopedic Clinic, Starkville, MS; Associate Professor of Nursing, Olivet Nazarene University, Bourbonnais, IL (

Kristi Acker, DNP, FNP-BC, AOCNP, ACHPN, Assistant Professor and Family Nurse Practitioner Program Coordinator, The University of Alabama, Tuscaloosa; Oncology/Hematology Nurse Practitioner, Manderson Cancer Center, DCH, Tuscaloosa, AL.

Lisa Torres, DNP, MSN, FNP-BC, PNP-BC, Nurse Practitioner, Mayo Clinic Primary Care, Jacksonville, FL; Instructor, Mayo Clinic Health Sciences, Rochester, MN; Adjunct Professor, South University, College of Nursing and Public Health, Savannah, GA.

The authors have disclosed no conflicts of interest.

© 2017 National Association of Orthopaedic Nurses