Long-Term Care (Hip)

Long-Term Care — Hip Fracture

Congregate Care Settings (Long-Term Care)
Best Practices for Hip Fracture

Rehabilitative Care for Older Adults Living With/At Risk of Frailty: From Frailty to Resilience (December 2021)

Hip Fracture: Addendum to Rehabilitative Care for Older Adults Living With/At Risk of Frailty: From Frailty to Resilience (June 2022)

Both documents should be consulted when providing best practice care to older adults with hip fracture. Together, they provide rehabilitative care best practices for all older adults with frailty, including those with hip fracture, and additional recommendations specific to hip fracture.

Please note: These two documents replace the earlier Hip Fracture Framework (March 2017/Rev Sept 2018).

Rehabilitative Care Best Practices for Hip Fracture in the Context of COVID-19 (October 2020) Additional evidence-based recommendations that align with current COVID-19 restrictions.
Patient & Family Education Materials
Canadian Orthopaedic Foundation — Hip Fracture Website for patients and caregivers to help them learn how to prepare for and recover from a hip fracture, including patient and caregiver booklet, assistive devices, home adaptation, getting active nutrition and osteoporosis.
Canadian Osteoporosis Patient Network A national network of people living with osteoporosis.
Ontario Health Quality Hip Fracture Patient Reference Guide Booklet reviews what patients and caregivers should ask for in their care.
Ontario Osteoporosis Strategy — Your Fracture Journey Online tool reviews causes of fractures, risk reduction, management options and managing pain.
Osteoporosis Canada Too Fit to Fracture Booklet

French Version

Patient booklet provides guidance on managing osteoporosis through exercise.
Osteoporosis Canada Fact Sheets Patient information sheets:

RGPO Caregiving Strategies Handbook Handbook for the family and friend caregivers who support seniors experiencing frailty. Created with advice from caregivers across Ontario, this handbook had been reviewed by health care professionals.
Too Fit to Fracture – One Page Resource One page resource that provides guidance on managing osteoporosis through exercise
Assessment & Intervention
North East Specialized Geriatric Centre — Baseline Functional Status Addresses baseline functional status, how baseline functional status is determined and subsequent determination of restorative potential.
BC Guidelines — Frailty Identification Guideline addresses the early identification and management of older adults with frailty or vulnerable to frailty.
Bone Fit™ Provides professional training on the most appropriate, safe and effective methods to prescribe and progress exercise for people with osteoporosis.
Canadian Frailty Network — Clinical Practice Guidelines for PT Management of Older Adults with Fracture Webinars provide information on the implementation of a clinical practice guideline for physical therapy management of older adults with fracture.
Clinical Frailty Scale (CFS) 2.0

CFS Guidance

Clinical Frailty Scale (CFS) designed to summarize the results of a Comprehensive Geriatric Assessment and now commonly used as a triage tool to make important clinical decisions.
CMAJ Recommendations for preventing fracture in long term care Guidelines for fracture prevention in Long Term Care Homes.
A Competency Framework for Interprofessional Comprehensive Geriatric Assessment

CGA Self-Assessment Tool (Inter-professional)

Comprehensive Geriatric Assessment (CGA) guides a multidimensional specialized geriatric team approach to care that determines a frail older person’s biomedical, psychosocial, functional, and environmental needs, and initiates an appropriate treatment and follow-up plan. Competency framework describes detailed practice expectations of health professionals participating in the CGA.
GERAS Osteoporosis LTC Resources for Health Professionals Collection of fracture prevention resources for health professionals working in Long Term Care.
JOSPT Physical Therapy Management of Older Adults with Hip Fracture Clinical Practice Guidelines linked to the International Classification of Functioning, Disability and Health from the Academy of Orthopaedic Physical Therapy and the Academy of Geriatric Physical Therapy of the American Physical Therapy Association.
Ontario Health Quality Hip Fracture Quality Standard Quality standard based on evidence and expert consensus. Includes patient reference guide, recommendations for adoption, getting started guide and indicator guide.
Ontario Osteoporosis Strategy Health care provider website related to osteoporosis and fracture prevention.
Ontario Osteoporosis Strategy Long Term Care Tool Box Osteoporosis prevention resources for healthcare professionals working with older adults living in long term care.
LTC Fracture Prevention Order Set Order set to be used for all new residents upon admission.
Provincial Geriatrics Leadership Ontario Cognitive Screening Toolkit Toolkit to help clinicians better understand cognitive screening tools and select the appropriate tool.
Transition Planning
GTA Rehab Network Inter-Organizational Transfer of Accountability (TOA) Guidelines Guideline provides six principles that support the interactive process of transferring information and coordinating follow-up care between organizations across the patient lifespan and care continuum.
GTA Rehab Network Discharge Checklist Checklist outlines key information that should be provided at the time of transfer to the next level of care (to hospital or community) in order to support patient safety and continuity of care.