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Doctors Work To Reduce Hip Breakage

November 11, 1997

SUN CITY, Ariz. (AP) _ ``I get dizzy,″ Beatrice Kelter worries aloud. At 76 she swims every day, lifts weights and generally enjoys an active retirement. But she’s fallen getting out of bed a couple of times recently and is afraid of breaking a hip.

In hopes of avoiding this common and potentially deadly injury of later life, Kelter and scores of other senior citizens who live in this booming retirement haven outside Phoenix are taking advantage of free fall-prevention sessions at a local hospital this autumn.

About 300,000 older Americans suffer hip fractures each year, with serious public health and financial consequences that are increasing as the population ages.

``One in five people who suffer a hip fracture will die within a year. Fifty percent will not be fully functional; they will not walk independently again,″ said Sandra C. Raymond, executive director of the National Osteoporosis Foundation, which is dedicated to eliminating the bone-weakening disease that often is behind hip injuries.

Medicare, the government health insurance program for seniors, spends more than $2 billion a year _ 1 percent of its budget _ to pay the hospital bills of hip fracture patients.

As Medicare tries to control costs by squeezing payments to hospitals, some are doing more to help seniors ``avoid the primary things, like a hip fracture, that people come into the hospital for that can be very expensive,″ said Carol Schadelbauer, spokeswoman for the American Hospital Association.

Young people still have time to build up their bone density with a proper diet and weight-bearing exercise, and some older people can take medicine to help slow deterioration.

But even for the already frail, ``there are all kinds of precautions one can take″ to avoid a broken hip, said Raymond of the Osteoporosis Foundation.

Arizona seniors learned some of these tips last month, at the fourth annual ``Fall-Free Fair,″ devised by Sun City-based Sun Health, which runs two hospitals predominantly serving retirees.

``It’s important that they learn about falls and to minimize their risks,″ said Jean Kiernat, director of Sun Health’s Community Education Center.

At the fair, Beatrice Kelter stood on a wobbly square of pink foam rubber, wearing a pair of dark sunglasses with stripes painted on the inside to test her balance.

Kelter also had her vision tested, and her blood pressure monitored while she stood up from a chair.

It was this last drill that provided a clue to the cause of her dizzy spells: Her blood pressure dropped as she stood.

A nurse recommended that Kelter sit on the edge of her bed for a moment before getting up in the night, then stand slowly to allow her body time to adjust. The active senior was relieved to find such a simple solution.

``I really was pleasantly surprised,″ Kelter said.

Other common risk factors are the destabilizing effects of medication or a poor diet and impaired vision or balance, said Kiernat.

Seniors can reduce their chances of falling by taking such simple steps as eating regular healthy meals, clearing hazards such as throw rugs from their homes, using night lights, and becoming more aware of their balance by practicing standing on one leg at the kitchen sink.

For those who do fall, Sun Health last year built a brand new rehabilitation ward at its Boswell Memorial Hospital to get hip surgery patients _ who used to spend weeks in bed _ back on their feet practicing real-world tasks in just a few days.

``The sooner we get our patients moving the better chance they have of recovering,″ without permanent disability or fatal complications such as blood and fat clots in the bloodstream, said physical therapist Russell Jaffe.

The new facility includes a little grocery store where patients can buy snacks to practice navigating with a walker and shopping basket.

There’s a model crosswalk and an avenue of tricky surfaces _ including the coarse gravel that substitutes for grass in many Arizona yards.

But perhaps most welcome to retirees is the putting green.

``They know its the next step toward going home,″ said Jaffe.

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