Fear of falling and cognitive functioning may be more important than pain and depression to predict functional recovery after hip fracture surgery. Rehabilitation strategies should take this into account.

The results from these two randomized, controlled trials show that, after hip fracture surgery, no statistically significant benefits can be achieved from a psychiatric intervention in people who are depressed or a psychological intervention to prevent the onset of depression.

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An understanding of the psychological factors which can impede recovery in hip fracture is important for all professionals involved in rehabilitation. Psychologists can provide consultation and support for staff working in physical rehabilitation and can work directly with cases where there is complexity. There is still relatively little known about this important area and further research is needed to provide a clear evidence base.

This individual case study outlines cognitive analytical therapy (CAT) informed work with a man with a diagnosis of Parkinson’s disease, carried out by the first author (CL) while on an older adult clinical psychology doctorate placement. Brief background and description of the work is presented, and consideration is given to the use of CAT in this context, given the lack of established research evidence. It is hoped that this will promote discussion and debate regarding how best to support clients with complex comorbid presentations.

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