Elderly Hip Fracture with Capacity Assessment

You are asked to see an 84-year-old woman in the acute orthopaedic ward. She was admitted earlier in the afternoon with a peri-prosthetic femoral fracture after a mechanical fall at home. She had a right total hip replacement five years ago for osteoarthritis. She is scheduled for revision total hip arthroplasty tomorrow morning. She has a history of cardiac failure, type 2 diabetes, hypertension and atrial fibrillation. Medications: - rivaroxaban 15 mg daily - atenolol 50 mg daily - metformin 500 mg twice daily - perindopril 5 mg daily At your pre-operative consult she is distressed, in pain and difficult to engage.