Why some recover more quickly after a fall injury than others (NYT, 11-15-13)

This New York Times article is about what happens after a fall, and why some recover more quickly than others from a fall injury.  The author describes research findings:

“A group of researchers at Yale, closely following a group of 754 older adults for nearly 14 years, has monitored disability before and after a fall injury and found that recovery is more predictable than we might think. The big clue, obvious only in retrospect: People with only minor disabilities, or none, before the fall are far more likely to recover, either quickly or gradually. Among those already severely disabled, the prognosis is much more grim.” 

Also, researchers learned that the most severe fall-related injury came from hip fractures.

How would a patient’s level of ability before a fall guide his/her treatment after a fall?  A geriatrician said that for those with no disability before the fall, “you really want to be aggressive” with treatment.

For those with greater disability before the fall, the chances of recovery are diminished.  “Palliative care — helpful in reducing the pain that often accompanies fall injuries — might make more sense, while extended physical therapy might be of little help.”

I wonder if the person who had greater disability before the fall, and therefore a poor prognosis at recovering after the fall, would be willing to accept palliative care, rather than extended physical therapy.  And I wonder if that person’s family would accept that treatment plan…?

Here’s a link to the article:


The New Old Age
Why a Fall Is Worse For Some
The New York Times
By Paula Span
15 November 2013