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Introduction Older patients with hip fractures are among the frailest and sickest groups of patients in the hospital. In addition to complex medical problems and comorbidities, they have to overcome the additional physiological challenges posed by the hip-fracture, as the subsequent surgery. The recovery process is complicated, and support of both physical, psychological and psychosocial challenges is highly needed. However, people with hip fracture is not a homogeneous group; although some of them are healthy people. It is essential to integrate the patient´s perspective into the healthcare process, and therefore we performed two studies that together bring forth a longitudinal qualitative study.

Objectives To explore how previously independently living older adults perceive their capacity to regain pre-fracture functions in the acute phase following hip fracture surgery and how they adapted to daily life four months later.

Methods An exploratory inductive qualitative longitudinal design. Individual interviews were conducted two to five days’ post hip surgery and follow-up interviews four months later. Inclusion criteria: 65 years or older, Swedish speaking, independent living at the time of injury, and with no cognitive impairment. Data were analysed using manifest inductive content analysis.

Results One main category describes the informants’ perception of their capacity to regain pre-fracture function in the acute phase: Ending up in a new situation with or without control. From being convinced of regaining recovery at admission, this changed into having no faith in regaining pre-fracture function and independent living. This transition occurred as they adapted to the routines in the acute hospital setting and became passive. At four months, one overarching category describes how the informants adapted to daily life: Hip-fracture, an interruption that has consequences for everyday life. Physical restraints affected the informants psychologically and, as a consequence, the psychological effects influenced their physical recovery. Some informants had given up, and some described they vacillated between to continue fighting for independence or to surrender. Some handled the situation to regain everyday life with self-esteem and power. Generating a strong driving force and determination was seen as a necessary basis for recovery.

Conclusion Findings imply that the ward-culture entails passivity and insecurity in the recovery process. It is essential to retain patients’ inner driving force to maintain pre-fracture functions. Sustaining a hip fracture affects self-image in physical, psychological, and psychosocial aspects. Thus, it is most urgent to prevent or delay disability in pre-frail older people. These studies contribute knowledge as to why previously healthy independently living older adults do or do not recover after hip fracture surgery.