Recommendations for preventing fracture in long-term care

Abstract

T he 2010 clinical practice guideline for the diagnosis and management of osteoporosis in Canada 1 focused on the care of adults living in the community. However, the fracture rate for adults living in long-term care (residents) is two to four times that of adults of similar age living in the community, and one-third of older adults who experience hip fracture are residents in long-term care. 2 Hip fracture is one of the most serious consequences of osteoporosis and also one of the leading causes of admission to hospital. When residents return to long-term care after a hospital stay, they need additional hours of specialized care. In addition, fracture pain and delirium frequently associated with analgesia are distressing for residents and their families. Vertebral fractures are also a concern for residents, and the reported prevalence is up to 30% (for at least one moderate to severe fracture). ultiple vertebral fractures can be a substantial cause of pain, anxiety, depression, reduced pulmonary function 7 and agitation.