What to do when a parent breaks a hip

If you are reading this because your parent just fell and broke a hip — or you are sitting in an emergency room right now — start here. This is the family member's guide, not the patient's. Your parent is the one in pain, but you are the one who will be answering the phone, talking to the surgeon, making decisions about rehab, and holding the whole thing together. Most articles about hip fractures are written for the person who broke the hip. This one is written for you: the adult child trying to figure out what to do today, what happens next, and how not to make a bad decision under pressure.

The good news is that a broken hip, while serious, follows a fairly predictable path: emergency room, imaging, surgery within a day or two, a short hospital stay, and then almost always a rehab stay before home. Knowing that path ahead of time is the single biggest thing that lowers the panic. Below is what to expect at each step and where you actually have decisions to make.

Here is the whole arc at a glance, so you can see where you are and what is coming next:

| Stage | Typical timing | What happens | Your job | | --- | --- | --- | --- | | At the scene | Minutes | Call 911, do not move your parent, keep them warm and still | Get essentials moving; note which hospital | | Emergency room | Hours | Pain control, X-ray/imaging, blood work, surgical consult | Bring meds list + ID; name a family point person | | Surgery | Usually within 24–48 hours | Repair (pins/screws/rod) or partial/total hip replacement | Understand the timeline and what must happen first | | Hospital stay | A few days | Early movement, pain management, watch for delirium | Track meds and weight-bearing status | | Rehab / SNF | Often 1–3 weeks | Daily physical therapy before home is safe | Join the discharge conversation; describe home honestly | | Home | Ongoing | Recovery, follow-up appointments, fall prevention | Keep recovery on track; prevent the next fall |

This article is educational and is not medical advice. Always follow the instructions you receive from your parent's clinicians and physical therapists. If anything here conflicts with their guidance, follow their instructions.

At the scene: what to do right now

If the fall has just happened and your parent is on the floor, the most important rule is counterintuitive: do not help them up.

• If your parent is in severe pain, cannot stand, or one leg looks shorter or is rotated outward, call 911. These are classic signs of a hip fracture, and moving someone can worsen the break.
• Keep them still and warm. Put a blanket or coat over them. Do not prop them up or drag them to a chair.
• Stay calm and talk to them. Fear makes pain worse. "Help is coming, you're going to be okay, don't try to move" is exactly the right thing to say.
• If they hit their head, are confused, are on blood thinners, or have chest pain or trouble breathing, tell the 911 dispatcher — those change how fast and how carefully they need to be handled.
• Let the paramedics do the lift. This is what they are trained for.

If you were not there when it happened and someone else is calling you, your job is to get the essentials moving: confirm 911 was called, ask which hospital they are heading to, and start gathering the information the ER will need (below).

Grab these before you leave for the hospital

You will be far more useful in the ER if you arrive with information. If you have five minutes, bring or photograph:

• Your parent's current medication list, especially any blood thinners (warfarin, Eliquis, Xarelto, Plavix, aspirin). Blood thinners directly affect how quickly surgery can happen.
• Their insurance and Medicare cards and a photo ID.
• A list of medical conditions and past surgeries, and their primary doctor's name.
• Their advance directive or healthcare proxy paperwork, if it exists, and the name of the person with legal authority to make decisions.
• Their glasses, hearing aids, and dentures if you can grab them — these matter enormously for keeping an older adult oriented in the hospital.

Do not delay leaving to find all of this. Bring what you can grab quickly; the rest can follow.

In the ER: what happens and what to expect

The emergency room will move through a fairly standard sequence. Knowing it helps you tell the difference between "normal" and "something's wrong."

1. Pain control and stabilization first. They will assess your parent's vital signs, manage pain, and check for other injuries (older adults often hit their head or wrist in the same fall).
2. X-ray, and sometimes CT or MRI. A hip fracture is confirmed with imaging. Occasionally a fracture doesn't show clearly on X-ray and they order more detailed imaging. The American Academy of Orthopaedic Surgeons' overview of hip fractures explains the main fracture types, which the surgeon will use to decide the repair method.
3. Blood work and a heart check. Before surgery, the team confirms your parent is stable enough for anesthesia. This is where blood thinners, heart conditions, and infections can slow things down.
4. Admission and the surgical consult. Your parent will be admitted, and an orthopedic surgeon will evaluate them and talk to you about the plan.

This is the point where you name a family point person — one person who will be the main contact for the hospital, take notes on every conversation, and relay updates to siblings. Hospitals hate calling five different people, and you will lose critical details if everyone is half-informed. Decide this early.

The surgery decision and timeline

Nearly all hip fractures in older adults are treated with surgery, because non-surgical management usually means weeks of immobility, which carries its own serious risks. The realistic question is not usually whether surgery, but when and what kind.

• Timing: Many hospitals aim to operate within about 24 to 48 hours once your parent is medically stable, because the American Academy of Orthopaedic Surgeons notes that having surgery as soon as possible, within 24 to 48 hours, may reduce the risk of complications. If it is being delayed, it is almost always to fix something first — usually reversing a blood thinner or stabilizing the heart. Ask the team directly: "What has to happen before surgery, and what's the current target time?"
• Type of repair: Depending on where and how the bone broke, the surgeon will either repair it with pins, screws, or a rod, or replace part or all of the hip joint. The surgeon chooses based on the fracture pattern and your parent's activity level and bone quality.

You do not need to become an expert in fracture types. What you need is to understand the plan well enough to ask good questions and to know the timeline. If your parent has cognitive impairment, tell the team clearly, because it changes anesthesia decisions and delirium risk — when a parent with dementia has a fall or hip fracture covers that situation in depth.

During the hospital stay

Hospital stays after hip surgery are often shorter than families expect — frequently just a few days. The team wants your parent up and moving quickly, sometimes the same day or the day after surgery, because early movement prevents the complications that make hip fractures dangerous: blood clots, pneumonia, pressure sores, and muscle loss.

While your parent is in the hospital, your job is to help the team see the whole person and to start tracking the recovery:

• Keep a running note of new medications, dose changes, and anything the doctors tell you. A hip fracture stay involves a lot of handoffs between shifts.
• Watch for confusion or delirium, which is common in older adults after surgery and anesthesia. If your parent is suddenly much more confused, agitated, or sleepy than their normal self, tell the nurse — this is not "just aging" and often has a treatable cause.
• Ask about pain management honestly. Undertreated pain keeps people from participating in therapy; oversedation causes confusion. The team is balancing both.
• Learn the weight-bearing status. After surgery, the surgeon sets how much weight your parent can put on that leg. This single instruction will shape the entire home recovery, so write down the exact words.

Start learning the warning signs now, because you will be the one watching for them after discharge — warning signs after hip surgery: when to call the doctor is worth reading before your parent leaves the hospital.

The discharge conversation: why most parents go to rehab first

This is the part families are least prepared for, so expect it: most older adults who break a hip do not go straight home from the hospital. They go to a skilled nursing facility (SNF) or inpatient rehab first for a short stay — often one to three weeks — of daily physical therapy before home is safe.

This is normal and, in most cases, a good thing. Your parent will need to relearn to stand, walk, and transfer safely while protecting the surgical site, and that is hard to do at home in the first weeks. A rehab stay gives them supervised therapy, pain and wound management, and a safer environment while they build strength back.

A few things to understand about this decision:

• The recommendation is based on how your parent is actually moving, how much help they need, and what support exists at home — not on a fixed rule. Ask the hospital case manager: "What level of help does my parent need right now, and what would home need to look like to be safe?"
• Medicare usually helps pay for a qualifying skilled nursing rehab stay after a hospital admission, but the coverage rules and day limits matter. Medicare's page on skilled nursing facility care lays out the basic coverage; our guide on what Medicare covers at a skilled nursing facility translates the fine print into plain language.
• If you are weighing the options, understanding the hospital discharge recommendation: home vs. SNF walks through how these decisions get made and what to ask.

The hospital's case manager or discharge planner is your key contact here. Frame the conversation as a shared problem: everyone, including you, wants your parent to recover well and avoid another injury. When you can describe honestly what home actually looks like — stairs, who is around, overnight coverage — you are giving the team the information they need to recommend the right destination.

What "serious" really means — and your job in it

It is fair to be scared. A hip fracture in an older adult is a significant injury, and it is honest, not alarmist, to treat it that way. But the risk is not really the broken bone — the surgery for that is routine. The risk is in the recovery: the complications, the loss of mobility, the second fall. That is precisely where your role matters most.

Your job over the coming weeks is not to be a nurse or a surgeon. It is to keep the recovery on track: get to the surgery on time, support the therapy, watch for warning signs, and — critically — help prevent the next fall. The CDC's information on falls in older adults is a good grounding on why fall prevention is the non-negotiable priority after a hip fracture, since a second fall is the outcome you are now working to avoid. For a realistic picture of the whole recovery arc, recovery after hip fracture surgery: what family caregivers need to know covers what to expect from the SNF-to-home timeline and beyond.

If your parent does come home from the hospital or SNF, a written plan keeps everyone aligned — the hip fracture discharge checklist covers equipment, medications, follow-up appointments, and red flags in one place, tuned to the fracture-to-rehab-to-home path. MedlinePlus's overview of hip injuries and disorders is a reliable place to read more about the injury itself when you have a quiet moment.

Related planning steps

• Warning signs after hip surgery: when to call the doctor — the red flags to know before discharge
• Recovery after hip fracture surgery: what family caregivers need to know — the realistic recovery arc, SNF to home
• Hip fracture discharge checklist — everything to line up before your parent leaves the hospital or rehab
• Understanding the hospital discharge recommendation: home vs. SNF — how the destination decision is made
• When a parent with dementia has a fall or hip fracture — if cognitive impairment is part of the picture