Mum's had a fall, and needs surgery: What to expect

"Your mum is going to need surgery."

Your mum had a fall. Now she has a broken hip. And before you can even think about what happens next, there's an operation to get through.

Everything you're worried about is crowding your head at once. The surgery. The anesthesia at her age. Whether she'll walk again. How long recovery takes. Whether this is the beginning of the end.

Here's what matters right now: hip fracture surgery is common. Hospitals do this every single day. And most people - even very elderly, frail people - get through it.

Let's get you through this part first. Everything else comes after.

This is for you if:

• The doctor has said she needs hip surgery

• She's fractured her hip, pelvis, or spine and surgery is required

• You're hearing terms like "hip replacement," "internal fixation," and "hemiarthroplasty"

• Surgery is happening soon (maybe tomorrow, maybe today)

• You're terrified about the anesthesia risk at her age

• You don't understand what the surgery actually involves

• You're wondering how long recovery takes

• You need to know what happens after the operation

• You're trying to prepare for what "rehab" actually means

• You're scared this might kill her

• Everyone's asking you questions, and you don't have answers

What We're Covering

This article covers the surgery phase - what happens before, during, and immediately after the operation, plus where she goes next.

We'll cover:

• What hip fracture surgery actually involves (in plain language)

• Why timing matters (and why they want to operate quickly)

• The risks at her age (honest answers)

• What happens in the first 24-48 hours after surgery

• Pain management and complications to watch for

• Where she goes after hospital (rehab, home, or residential)

• Recovery timeline (realistic expectations)

• Questions to ask the surgical team

What we won't cover yet:
Long-term care planning, permanent living arrangements, and family coordination. Those come after she's through surgery.

 

Why does a broken hip need surgery?

In Australia, more than three-quarters of people who sustain a hip fracture undergo surgery. Here's why: a broken hip can't heal properly on its own in a way that allows the person to walk again.

Without surgery:

• The bones won't align correctly

• She'd be in severe pain for months

• She'd be immobile (bedridden)

• Complications from immobility would be life-threatening (pneumonia, blood clots, pressure sores)

With surgery:

• The bones are stabilised or replaced

• She can start moving within 24-48 hours

• Pain is manageable

• She has a chance to walk again

The surgery isn't optional. It's the best chance for recovery.

What type of surgery will she have?

There are three main types, depending on where and how the hip is fractured:

1. Internal fixation (pins, plates, or screws)

• Used for certain types of hip fractures

• The broken pieces are held together with metal hardware

• The bone still heals naturally

• Usually for younger patients or less complex fractures

2. Hemiarthroplasty (half hip replacement)

• Replaces the ball of the hip joint (femoral head)

• Keeps the original socket

• Most common for elderly patients with certain fracture types

• Faster surgery than full replacement

3. Total hip replacement

• Replaces both ball and socket

• Used if the joint was already arthritic or damaged

• Longer surgery but better long-term function

You don't need to understand all the technical details. The surgeon will choose based on:

• Where exactly the fracture is

• Her age and health status

• The quality of her bone

• Whether the joint was already damaged

What you need to know:
All three options are common, routine surgeries that orthopedic surgeons do regularly.

Why they want to operate quickly

The Hip Fracture Clinical Care Standard recommends surgery within 36 hours. Here's why speed matters:

Faster surgery means:

• Less time lying in bed immobile

• Lower risk of pneumonia and blood clots

• Less pain (broken hip is excruciating)

• Better chance of regaining mobility

• Lower mortality risk

Every day of delay increases complications.

Sometimes surgery gets delayed if:

• She needs medical stabilisation first (heart condition, blood thinners)

• She's eaten recently (needs an empty stomach for anesthesia)

• Operating theatre availability

• She's waiting for transfer to a hospital that does hip surgery

 

The pre-surgery process

Medical checks:

• Blood tests

• ECG (heart check)

• Chest X-ray

• Review of all her medications

• Anesthetist assessment

They're checking:

• If she's medically stable enough for surgery

• What anesthesia approach is safest

• If medications need adjusting (blood thinners, diabetes meds)

• Her heart and lung function

The consent conversation

Someone will ask her (or you, if you have Power of Attorney) to sign surgical consent forms.

Key questions to ask before signing:

• What type of surgery are you planning?

• What are the main risks?

• What would happen if we didn't do surgery?

• Who will be doing the operation?

• How long will it take?

• What's the success rate for people her age?

About anesthesia at her age:
Yes, anesthesia carries risks, especially in elderly patients. But not operating is more dangerous than the anesthesia risk.

The anesthetist will talk to you about:

• General anesthesia (fully asleep) vs spinal/epidural (numb from waist down, awake or lightly sedated)

• Which is safer for her specific situation

• Delirium risk after surgery (common in elderly patients)

• Pain management plan

What you can do before surgery

Practical tasks:

• Make sure the hospital has her Medicare card and health fund details

• Bring comfortable, loose-fitting clothes for after surgery

• Bring her glasses, hearing aids, and dentures (labelled with her name)

• Don't bring valuables

• Let family know surgery is scheduled

Emotional support:

• Be there before she goes in if possible

• She's likely scared - that's normal

• Simple reassurance: "The surgeon does this every day. We'll see you after."

• Don't make promises you can't keep ("you'll be fine" vs "we'll be right here waiting")

"What if she doesn't survive the surgery?"

This is the fear nobody wants to say out loud.

The honest truth:
Hip fracture surgery has a 30-day mortality rate of 8.2% in Australia. That means more than 91% survive the first month after surgery.

The risks are higher if she:

• Is over 85

• Has serious heart or lung disease

• Has dementia

• Was already frail before the fall

But here's the critical thing: one in four people die within 12 months of a hip fracture and that's WITH surgery. Without surgery, the outlook is much worse.

The surgery gives her the best chance. Not operating almost guarantees a poor outcome.

How long will it take?

• Hemiarthroplasty: 1-2 hours

• Total hip replacement: 2-3 hours

• Internal fixation: 1-2 hours

Plus:

• Pre-op preparation: 30-60 minutes

• Recovery room after: 1-2 hours

Tell family:
Surgery might be 2 hours, but you won't see her for 4-5 hours total.

Where you wait

Most hospitals have a surgical waiting area. The surgeon or a nurse will usually update you:

• When surgery begins

• When it's completed

• If there were any complications

• When you can see her

If you're not at the hospital:
Ask for a phone number where they'll call you with updates.

What's actually happening in there

You don't need the graphic details, but here's the basic process:

1. Anesthesia given

2. Surgical site cleaned and prepared

3. Incision made (usually side of hip)

4. Broken bone repaired or replaced

5. Wound closed (staples or stitches)

6. She's moved to the recovery room

Modern hip surgery is well-established. The techniques are refined. Orthopedic surgeons train for years specifically for this.

In the recovery room

She'll wake up in the recovery room where nurses monitor her closely for 1-2 hours.

What's normal:

• Drowsy, confused, or disoriented (especially with general anesthesia)

• Doesn't remember having surgery

• In pain (they'll give pain medication)

• Has an oxygen mask or nasal tubes

• Has an IV line in her arm

• Has a catheter in the bladder

• Has a drain tube near the surgical site (maybe)

What they're watching for:

• Blood pressure and heart rate

• Oxygen levels

• Pain control

• Bleeding from the surgical site

• Early signs of complications

When you see her

She might:

• Not recognise you immediately

• Be very sleepy

• Say things that don't make sense

• Be agitated or distressed

• Not remember falling or breaking her hip

This is normal post-anesthesia confusion, especially in elderly patients. It usually clears within 24-48 hours.

What helps:

• Speak calmly and simply

• Reassure and orient her gently: "You're in the hospital. You had hip surgery. You're okay."

• Don't argue if she's confused

• Familiar faces help

• Keep visits short if she's very drowsy

Back on the ward

Once stable, she'll move to the orthopedic ward.

First 24 hours priorities:

• Pain management

• Preventing blood clots (she'll get compression stockings and blood-thinning medication)

• Preventing chest infection (breathing exercises)

• Getting her to sit up in bed or chair

• Starting to eat and drink

 

Common post-surgery issues

Delirium (acute confusion):

• Very common in elderly patients after surgery

• Usually temporary (days to weeks)

• Signs: confusion, hallucinations, agitation, seeing things that aren't there

• What helps: familiar people, glasses/hearing aids, keeping day/night routine, reducing medications

Pain:

• Should be manageable, not unbearable

• Tell nurses if pain medication isn't working

• Uncontrolled pain prevents mobilisation

Constipation:

• Very common from pain medications and immobility

• It can be painful and distressing

• Preventable with laxatives (ask for them proactively)

Urinary catheter issues:

• Usually removed within 24-48 hours

• Difficult urination after removal is common

• May need reinsertion temporarily

Serious complications (less common)

Signs to alert nurses immediately:

• Chest pain or trouble breathing

• Severe confusion or agitation

• Fever

• Excessive wound bleeding or drainage

• Leg swelling (one leg much bigger than the other)

• Cannot move toes or foot on surgical side

Post-operative complications include:

• Blood clots (DVT/pulmonary embolism)

• Pneumonia

• Heart problems

• Infection at the surgical site

• Dislocation of the new hip joint

The hospital is watching for all of these. Modern protocols have reduced complication rates significantly.

 

"Wait, they want her to STAND already?"

Yes. It seems counterintuitive, but early physical activity post-surgery reduces the likelihood of death.

Timeline for mobility:

• Day 1-2 after surgery: Sitting up in chair

• Day 2-3: Standing with physiotherapist support

• Day 3-5: Taking a few steps with a walker

• Week 1: Walking short distances with assistance

This is not "if she's up for it." This is the medical treatment.

Early mobility:

• Prevents blood clots

• Prevents pneumonia

• Prevents muscle wasting

• Improves outcomes

She will not want to do this. It hurts. She's scared. She feels weak.

But it's not optional. The physio team will insist, gently but firmly.

Hip precautions (important)

After hip surgery, she needs to follow "hip precautions" for 6-12 weeks to prevent dislocation:

Don't:

• Bend hip more than 90 degrees

• Cross legs

• Turn foot inward

• Sit in low chairs

• Twist at hip

Do:

• Keep knees lower than hips when sitting

• Use a raised toilet seat

• Sleep with a pillow between legs if told to

• Move the whole body, not just the hip

The physio will explain all of this in more detail for you. It's crucial for the first few months.

 

The median hospital stay for hip fracture surgery is 20 days, ranging between 13 and 29 days for most patients.

Discharge destinations

Option 1: Rehabilitation facility

• Most common for hip surgery patients

• 2-6 weeks of intensive therapy

• Goal is to maximise mobility before going home or to permanent care

• Daily physiotherapy and occupational therapy

• Nurse and medical support on-site

Option 2: Transition Care Programme (TCP) at home

• For patients stable enough to manage at home with support

• Therapy and nursing come to the home

• Up to 12 weeks of subsidised care

• Not suitable if she lives alone and can't manage basic safety

Option 3: Residential respite

• Temporary placement in an aged care facility

• Gives time for family to prepare the home or make long-term decisions

• Up to 63 days (with possible extension)

• Can transition to permanent placement if needed

Option 4: Straight home (rare after hip surgery)

• Only if she has excellent support at home

• Professional care services arranged before discharge

• Home is suitable for her mobility limitations

• Family or partner can provide 24/7 supervision initially

What determines where she goes:

• Her mobility level after surgery

• Her cognitive function

• Support available at home

• Safety of home environment

• How far she's progressed in therapy

The discharge planner will discuss options with you. 

 

First month post-surgery

Week 1-2:

• Hospital or rehab facility

• Focus on basic mobility

• Pain is reducing but still significant

• Needs help with everything

Week 3-4:

• Increasing independence with a walker

• Moving from bed to chair safely

• Basic self-care with assistance

• Still very tired

3-6 months post-surgery

Only 44% return to their baseline level of mobility at 120 days. This is the reality check.

Most people at 3-6 months:

• Walking with a walker or a cane

• Managing basic daily tasks

• Still need some support

• Not back to pre-fracture function

Some people:

• Return to independent living

• Walk without aids

• Resume most activities

Some people:

• Need a permanent walking aid

• Require ongoing care support

• Never return to their previous independence level

The factors that help recovery:

• Age (younger does better)

• Pre-fracture mobility (if she was active before)

• Cognitive function (dementia makes recovery harder)

• Nutrition

• Consistent physiotherapy

• Medical complications or none

Long-term outlook

One in four people die within 12 months of hip fracture. This isn't because of the surgery - it's because hip fractures happen to frail, elderly people.

For survivors:

• About half return to independent living

• About half require higher care (home services or residential)

• The risk of falling again is higher

• Fear of falling affects confidence

The honest truth:
This changes your Mum's life. She may not be the same as before the fall. But surgery gives her the best possible chance at recovery.

Before surgery

• What type of surgery are you planning and why?

• Who will be performing the surgery?

• How long will the operation take?

• What are the main risks for someone her age?

• What's the expected outcome - will she walk again?

• When can we see her after surgery?

After surgery

• How did the surgery go?

• Were there any complications?

• What's the pain management plan?

• When will she start physiotherapy?

• How long do you expect her to be in the hospital?

• What happens next - where will she go after here?

About recovery

• What's realistic to expect for her mobility?

• How long until she can walk independently (if at all)?

• What support will she need at home?

• What equipment will we need?

• When should we see improvement?

• What would be the warning signs of problems?

The question that matters most

"What would you do if this was your mum?"

Not all doctors will answer this, but some will. When they do, listen.

 

Your mum needs hip surgery. It's terrifying. You wish this wasn't happening.

This is what matters:

Hip fracture surgery is routine. Thousands happen in Australia every year. The surgeons know what they're doing.

The anesthesia is risky, but not operating is riskier.

She'll be confused after surgery. This is normal. It usually gets better.

They'll make her move soon after surgery. It seems cruel. It's actually the treatment.

Most patients stay in the hospital for about 20 days. Then she'll go to rehab or home with support.

Only 44% return to baseline mobility at 4 months. This is the reality. Recovery is slow and often incomplete.

But surgery gives her the best chance. That's all you can do - give her the best chance.

Right now, you need to:

1. Make sure surgical consent is signed

2. Be there before surgery if possible

3. Understand what type of surgery she's having

4. Know where to wait and who will update you

5. Expect confusion after surgery (it's normal)

6. Support early mobilisation even when she doesn't want to

7. Start thinking about where she goes after hospital

Everything else comes later.

Once surgery is done and she's stable:
→ Read the appropriate article based on where she's going next:

If she's going to rehab:
→ Read: She Can't Go Home Yet: Understanding Rehab, Respite & Bridge Options 

If she's going home eventually:
→ Read: She's Going Home: Your First Week Action Plan 

If you're realising home won't work:
→ Read: Mum Can't Go Home Again: Making the Residential Care Decision (

If family communication is fracturing:
→ Read: The Siblings Who Disappeared All Year Suddenly Have Opinions 

If you're already running on empty:
→ Read: You're Not Just Tired. This Is What Burnout Actually Feels Like 

 

---

 

Let Vera help you navigate the post-surgery phase.