Hip Protectors: Do They Prevent Fractures?

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Caregivers are always searching for ways to improve the lives and safety of those they care for. There are numerous products and services out there claiming to help—and many of them do, making the caregiving relationship easier and prolonging the elderly person’s life and comfort. Medications, therapies, and devices all help elderly loved ones live happier, healthier lives every day. Yet not all products are created equal, and not all of them keep seniors safe and happy. One product stirring debate amongst those caring for seniors are “hip protectors,” which claim to help spread the impact of a fall. These devices are purported to make falls less life-threatening for fragile seniors.

“the risk of hip fracture can be reduced in frail elderly adults through the use of an anatomically designed external hip protector.”

How They Work

Hip protectors and related products are not designed to prevent falls, but to lower their likelihood of causing serious injuries such as hip breaks or fractures, which cause thousands of deaths each year among seniors. Some hip protectors are sold as undergarments, with the durable plastic hip protector sewn into the fabric; the plastic spreads the force away from the jutting bone, which can take the brunt of a fall’s impact. They can also be sold as underwear with pockets, allowing users to place and remove hip protectors when necessary—for example, during sleep for comfort, or to swim. A third type—less common than the more “modest” designs—allow for hip protectors to be worn on the outside of clothing, attached by belts.

The Research

Research done to determine the efficacy of hip protectors—that is, whether or not they actually work to prevent dangerous hip injuries resulting from falls—is conflictual. A relatively recent study in 2007 from the Journal of the American Medical Association, one of the most respected journals in medicine, found that hip protectors did not enhance safety for seniors in a randomized nursing home study. In the conclusion of the study, the authors state very clearly that their findings support the rising notion that “hip protectors, as currently designed, are not effective for preventing hip fracture among nursing home residents.” A study done in 2000, reported in the New England Journal of Medicine, however, supported the use of hip protectors, claiming that, based on their results, “the risk of hip fracture can be reduced in frail elderly adults through the use of an anatomically designed external hip protector.”

Three Things to Consider

What is a caregiver to do with conflicting scientific research published in major medical journals? This is one of many complex decisions that caregivers are forced to make frequently. However, with enough information, a solution can be found to fit each individual. Three simple steps can help determine whether or not a hip protector is an investment worth making.

  1. Evaluate the risk of falls. If an elderly person is struggling with mobility or uses a walker, the person stands some measured risk of falling and experiencing serious injury. However, a senior who has limited mobility and relies on a wheelchair may find that the risk is lower, since they do not move around much without assistance and/or supervision and are lower to the ground, which lowers the likelihood of broken bones. Whatever the situation, caregivers and those in their care, consulting with a doctor as well, may be able to predict how likely it is that the senior will fall within the next few months or years.
  2. Evaluate the financial situation. Hip protectors are provided by the state in countries like Sweden, but not every doctor will find them medically viable for insurance purposes due to conflicting research. This makes it an out-of-pocket expense that could cost only $30 but could run as much as $175. For some seniors and their families, that cost is prohibitive. If the family’s financial situation allows for the purchase of a well-reviewed hip protector, it may be a topic for discussion.
  3. Evaluate the comfort level. Most elderly persons are not likely to experience much discomfort when actually wearing a hip protector, but the 2000 study did find that some seniors found it uncomfortable to wear daily as undergarments. It is important to make sure that the senior can go about his or her daily activities with comfort, since discomfort, soreness, or hesitation in movement can cause more accidents and falls.

A well-designed, well-fitting hip protector will not cause any harm to the senior wearing it. However, it is much more important and effective to work to prevent falls in the first place. Although not a totally worthless investment, a hip protector can only do one thing; make falls less likely to cause fatal injury. By removing obstacles that could cause a fall, having an elderly loved one’s vision and balance checked regularly, keeping the home well-lighted and equipped with appropriate handrails, and assisting the person in tough mobility situations, many falls and injuries can be prevented altogether.

 

 

Sources

HIProtector. Learn How Hip Protectors Work! Available at http://www.hiprotector.com/works.html. Retrieved August 10, 2016.

Kannus, P., Parkkari, J., Niemi, S., Pasanen, M., Palvanen, M., Jarvinen, M., and Vuori, I. (November 23, 2000). Prevention of Hip Fracture in Elderly People with Use of a Hip Protector. The New England Journal of Medicine, 343: 1506-1513. Available at http://www.nejm.org/doi/full/10.1056/NEJM200011233432101#t=article. Retrieved August 10, 2016.

Kiel, D. P., Magaziner, J., Zimmerman, S., Ball, L., Barton, B. A., Brown, K. M., Stone, J. P., Dewkett, D., and Birge, S. J. (July 25, 2007). Efficacy of a Hip Protector to Prevent Hip Fracture in Nursing Home Residents. Journal of the American Medical Association, 298(4): 413-422. Available at http://jama.jamanetwork.com/article.aspx?articleid=208118. Retrieved August 14, 2016.

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