title: Hip fractures and dementia: clinical decisions for the future.
abstract: Severe dementia is a life-limiting condition; hip fractures are more common in patients who have dementia. This study outlines the case of a 92-year-old female with severe dementia who sustained a hip fracture. Despite having a terminal diagnosis (severe dementia and hip fracture) and poor premorbid quality of life, she had a life-prolonging surgery. The report outlines issues around treatment options in such circumstances, informed consent and substitute decision-making. The authors propose a 'goals of care' approach to manage patients in whom the best treatment is unclear, during their attendance to the emergency department. It is suggested that utilization of such a model may help with substitute decision-making and true informed consent.
authors.affiliation: Territory Palliative Care , Royal Darwin Hospital , Tiwi, NT, Australia.
authors.forename: Eswaran
authors.initials: E
authors.lastname: Waran
authors.affiliation: Monash Health, Clayton, VIC, Australia; Eastern Health, Box Hill, VIC, Australia; Monash University, Clayton, VIC, Australia.
authors.forename: Leeroy
authors.initials: L
authors.lastname: William