Case example

Mr Jones is 85 years old and lives alone in a two-storey house. He sleeps upstairs but has great difficulty getting to bed because of severe osteo-arthritis of his left hip and the effects of a stroke 2 years previously causing mild, left-sided weakness.

His doctor has aggressively treated his raised blood pressure to try to reduce the chance of further stroke but this results in giddy spells, particularly when he rises. This happens because of postural hypotension (sudden drop in blood pressure) when changing posture to a standing position.

He suffered a fractured wrist last year and he was noted to have osteoporosis.

During one night, he got out of bed quickly, as he needed to pass urine urgently. He felt dizzy and tripped over a loose rug onto his left hip causing extensive grazing, bruising and a fracture of the hip. He could not get up and lay on the floor overnight, which caused pneumonia (lung infection).