Letters

Hip protectors

BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7351.1454/a (Published 15 June 2002) Cite this as: BMJ 2002;324:1454

Carpets can be used to reduce injury from falls

  1. Jed Rowe (jedrowe@geriatrickery.freeserve.co.uk), consultant geriatrician
  1. Well Balanced Clinic, Moseley Hall Hospital, Birmingham B13 8JL
  2. BUPA Care Services, Horsforth, Leeds LS18 4UP
  3. Springfield Road Surgery, Springfield Road, Belfast BT12 7AH
  4. Skegoneill Health Centre, 195 Skegoneill Avenue, Belfast BT15 3LL
  5. Poole Hospital, Poole, Dorset BH15 2JB
  6. Osteoporosis Dorset, Bournemouth, Dorset BH1 4JQ
  7. Poole Hospital NHS Trust, Poole, Dorset BH15 2JB

    EDITOR—It takes about 40 years of wearing hip protectors to prevent one fracture, according to the editorial by Cameron,1 so other strategies may be helpful. Hip protectors look like institutional underwear—white, plain, and unfashionable. Making them more attractive might improve their acceptability. The alternative approach is to pad the floor. Carpet improves gait in older people2 and in a small observational study dramatically reduced serious injury from falls.3 Perhaps it's time for the Axminster trial of hip protection.

    References

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    Integrated approach to care of older people is necessary

    1. Clive Bowman, medical director,
    2. Ian Ireland (bowmanc@bupa.com), head of quality
    1. Well Balanced Clinic, Moseley Hall Hospital, Birmingham B13 8JL
    2. BUPA Care Services, Horsforth, Leeds LS18 4UP
    3. Springfield Road Surgery, Springfield Road, Belfast BT12 7AH
    4. Skegoneill Health Centre, 195 Skegoneill Avenue, Belfast BT15 3LL
    5. Poole Hospital, Poole, Dorset BH15 2JB
    6. Osteoporosis Dorset, Bournemouth, Dorset BH1 4JQ
    7. Poole Hospital NHS Trust, Poole, Dorset BH15 2JB

      EDITOR—We wish to raise the contentious issue of funding in the context of the management of falls in care homes. Critical success factors for the use of hip protectors are accurate fitting and compliance, as mentioned in the editorial by Cameron1; these can be difficult in care homes now that the prevalence of dementia is increasing. Furthermore, wearing hip protectors may be a confounding factor in continence and an impediment to the promotion of continence. A more environmental approach in care homes might be as effective and less intrusive.

      The mechanical assault on a hip from a fall will depend on the properties of the flooring. Floor coverings in institutional settings are inevitably a compromise between homeliness, clinical appropriateness (largely the maintenance of cleanliness), and cost. Floor coverings are available with cushioning, as has been used for reducing head …

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