Coroner's Finding: Andrysik, Anne Carol

80y · Female·Fractured left neck of femur on a background of rectal carcinoma and dementia

An 80-year-old woman with dementia and undiagnosed rectal carcinoma died from complications of a fractured left neck of femur sustained during a fall in her aged care facility's memory support unit. She had sustained three falls over 25 days; the final fall on 24 September 2022 resulted in the hip fracture. In accordance with her Advanced Care Directive and family wishes, she was not transferred to hospital for imaging or surgical intervention. The coroner found no shortcomings in care and concluded the falls management plan appropriately balanced risk reduction with respect for autonomy. Clinicians should recognize that comprehensive falls prevention, even with appropriate strategies, cannot entirely eliminate risk in elderly patients with dementia, and that respecting advance directives and family preferences regarding investigation and treatment is lawful and appropriate when clearly documented.