DEAR DR. ROACH: One week ago, my 99-year-old dad tripped over a metal strip that connects carpet to tile in a brightly lit concession area at a local movie theater and broke his left hip. Surgery was performed the next day, and he has been suffering the side effects ever since. Hospital personnel told me he would need rehab after the fact, but no one mentioned the effects of anesthesia on the very elderly. He had had throat stretching done twice in the past five years and came out of that anesthesia the very same person who went under, so I was quite unprepared for his current state.

He is suffering from delirium, and has not eaten since before he fell, as he refuses to swallow anything. He is on an IV started a few days ago.

As an only child, I am tasked with finding the appropriate rehab/nursing facility for when he is released. I have tried word-of-mouth and the Medicare site and have visited several locations. How do I choose the one that is right for him? He was very independent previously, even drove his car to errands and lived at an independent-living retirement home. I am heartsick over this entire situation and additionally stressed to make the right decision. — L.D.H.

ANSWER: This is indeed a difficult situation, and your father is lucky to have a concerned child to help him.

First of all, despite the broken hip and the complication of delirium, your father has a good chance of getting back to his function, before breaking his hip. But both delirium and a fractured hip are serious. Delirium is common in the elderly during hospitalizations, and it can be devastating. People with post-surgery delirium can return to normal functioning, but it can take months. Recovery from physical injury, such as the hip fracture, is much slower during delirium.

There are some resources to help you find out more about rehab/nursing facilities. You already have looked at www.medicare.gov, and searched for Nursing Home Compare. This gives ratings based on the Medicare database. However, since what makes a nursing home isn’t the bricks and mortar, but the people who work there, talking to the staff, as well as current or former patients, can give you more information.

The booklet on Alzheimer’s disease gives a detailed presentation of this common illness. Readers can obtain a copy by writing: Dr. Roach — No. 903, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. ROACH: I have two grandchildren who spike fevers and get sick a lot. How valuable are natural wellness formulas to build up their system and get them stronger? Their doctor has told them it will not help, but he isn’t giving them anything to help their immune system get stronger. Any suggestions? — K.L.

ANSWER: The immune system gets stronger as kids age. The key to a healthy immune system remains a good diet, good exercise and sleep, and avoiding too much stress. Good hand hygiene is necessary for reducing exposure to bacteria and viruses. I am skeptical of the ability for supplements to improve the immune system.

That being said, there are vitamins and trace minerals that are essential for the immune system to function at peak level. Most of us can get adequate amounts from a healthy diet. The supplements sold to “boost the immune system” generally are multivitamins with some additional unproven ingredients.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

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