very, very often, a fall is the "beginning of the end" for a previously fit elderly person, let alone one with other health issues. seems that the shock of the fall shakes them up worse than it would a younger person; they also take longer to recover, lose confidence; often the combination of the fall, shock, blood loss if any, hypothermia if any, plus a general anaesthetic when operating to repair the damage is more than the old system can cope with. two or three days afterwards, on the ward, confusion is not uncommon, especially at night, and doesn't always go away. this makes rehab all the more difficult. quite often the patient is physically well enough to go home, but mentally can't cope alone any more, or is too frightened.