I helped care for my aunt about 10 years ago when she fell and broke her hip. Now I'm taking care of my mother for the same problem. Both times a physical therapist was involved. But I notice a big difference this time. Therapy for my aunt was in the hospital gym. She went through the program quickly. Mom is only getting range of motion and breathing exercises. Why the difference?

Much has changed in health care delivery over the past 10 to 20 years. Patients are discharged from the hospital much sooner now. In the 1980s, the average stay for a hip fracture was 22 days. Today this has been pared down to only 6.5 days. This means the hospital therapist has much less time to help the patient regain motion and strength.

After discharge, the rehab protocol previously completed in the hospital may or may not be continued at home. If therapy is continued, patients may not be ready for an intense program before the number of days allowed by the insurance company or Medicaire is reached.

Six to 12 visits in six weeks after hip fracture surgery may not be enough to get older adults back on their feet and back to their previous level of function. It may be necessary and a good idea to invest in some additional sessions with the therapist.